Lead exposure and poisoning prevention — formative SAQs

SAQ 1 (10 marks)

Parents of a 2-year-old live in a 1950s house. They have been sanding paint. A capillary blood lead is 8 micrograms/dL. The child is asymptomatic. ^[1]

1. What is the next laboratory step and why? (2) ^[1]
2. List five exposure sources you must cover in the history. (3) ^{[1] [2]}
3. Outline your management plan for the next month, including what you will not promise. (5) ^{[2] [4] [6]}

Model answer

Confirm with venous whole blood lead. Capillary samples can be contaminated by surface lead and should not alone drive major decisions. ^[1]

Sources: deteriorated paint/dust (including renovation), water plumbing, soil, take-home occupational dust, traditional cosmetics/remedies, and pica for non-food items. ^{[1] [2]}

Management: stop unsafe sanding; arrange environmental assessment/remediation pathways; educate on wet cleaning and hand washing; assess iron status and diet (iron/calcium support); developmental surveillance; public-health notification as required; retest venous BLL on schedule; test other young household members. Do not promise that any level is fully safe, and do not offer chelation as an IQ-restoring treatment — prevention and source control are the core. ^{[2] [4] [6]}