It has been suggested that the measurement of the degree of inhibition of red blood cell (RBC) δ-aminolevulinic acid dehydrase (ALAD) activity is a useful indicator for the detection of children with increased lead absorption. Twenty children had simultaneous measurements of blood lead and RBC-ALAD activity, and then received chelation treatment with edetic acid (EDTA). The inhibition of RBC-ALAD activity was found to be highly correlated with the amount of lead excreted in the urine. In this study, the measurement of RBC-ALAD appeared to be superior to the measurement of blood lead in identifying those children with an increased burden of "chelatable" lead.
Nieburg PI, Weiner LS, Oski BF, Oski FA. Red Blood Cell δ-Aminolevulinic Acid Dehydrase Activity: An Index of Body Lead Burden. Am J Dis Child. 1974;127(3):348–350. doi:10.1001/archpedi.1974.02110220046005
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