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April 12, 1976

Prophylactic Chelation Therapy for Lead Exposure

Author Affiliations

Director National Institute for Occupational Safety and Health Rockville, Md

JAMA. 1976;235(15):1553. doi:10.1001/jama.1976.03260410017012

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To the Editor.—  Regrettably, workers exposed or potentially exposed to lead, including those with elevated blood lead levels, are still treated prophylactically on an outpatient basis with chelating agents, eg, edetate disodium calcium or penicillamine. The National Institute for Occupational Safety and Health (NIOSH) and the American Occupational Medical Association strongly oppose this practice. Prophylactic treatment of workers with chelating agents or penicillamine, while failing to control the source of lead exposure, in effect, places workers in double jeopardy by virtue of the potentially harmful effects of such long-term drug therapy—particularly on the kidneys—combined with continued excess exposure to lead, a known renal toxin.In a recent report presented at an International Conference on Heavy Metals in the Environment held in Toronto, Oct 27 through 31, 1975, Ruth Lilis, MD, and Alf Fischbein, MD, critically reviewed the subject of chelation therapy among workers exposed to lead. They concluded that chelation