Blood lead levels in children with encephalopathy.

OBJECTIVE To determine the prevalence of elevated blood lead levels (EBLL i.e blood lead >10 micrograms/dL, Centers Disease Control criteria) in children with encephalopathy. SETTING Hospital. DESIGN Case control study. PARTICIPANTS 100 children, 49 with encephalopathy and 51 consecutive hospital controls. OUTCOME MEASURES Blood lead levels, demographics, clinical, environmental correlates and residual neurological sequel or death at discharge. RESULTS 42 (encephalopathy) and 49 (hospital controls) children were available for analysis. The overall (n=91) mean blood lead was 7.88+/-10.44 micrograms/dL (range 0.07-67.68 micrograms/dL). The predictors of EBLL were presence of wasting (P<0.03), anemia (P<0.04), use of surma (P< 0.02), recent removal of house paint (P<0.01) or recently repainted (P<0.01). The mean blood lead levels were significantly higher (P<0.01) in patients of encephalopathy (12.18+/- 13.90 micrograms/dL) than in controls (4.19+/- 2.84 micrograms/dL). EBLL was present in 3/17 (17.6%) patients with infective encephalopathy and in 18/25 (72%) with non-infective encephalopathy. The proportion of children with residual neurological sequelae, or death increased when associated with EBLL (0 to 21%, and 69% to 100% respectively). CONCLUSION Children hospitalized with encephalopathy have elevated blood lead levels.