The incidence of lead poisoning in industry has fallen dramatically since the beginning of the twentieth century. This reduction has been partly attributable to increased awareness, improved ventilation and hygiene facilities, and technical changes which have allowed other substances to replace lead, but improved medical surveillance of workers exposed to lead in certain defined industries has also been important. Not all industries where lead exposure can occur are at present covered by specific regulations dealing with lead, however. We report the diagnosis and treatment of eleven oxyacetylene metal burners involved in the demolition of a railway station, who rapidly developed frank lead poisoning. The most suitable measurements to employ in evaluating such a population are considered. The selection, based on blood lead and haemoglobin measurements, of those who should receive further treatment is discussed. Symptoms were found to be more nearly related to indices of effect or toxicity of lead than to indices of exposure or absorption. The effects of chelation therapy upon symptoms, blood lead, haemoglobin and urinary porphyrins are recorded. The need for careful follow-up is illustrated.
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