Getting the Lead Out

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     To the Editor: The description accompanying the Images in Clinical Medicine by Shen and Hirschtick (Nov. 4 issue)1 contains two errors that I believe are errors in the understanding of plumbism, rather than purely typographical errors. First, there are two references to the serum lead level, one level of 143.5 μg per deciliter and one of 116 μg per deciliter. Lead levels are measured in whole blood, not serum, because the lead is in the erythrocytes and not in the serum. Second, the normal blood level is 0, not less than 10 μg, as stated in the text. The currently acceptable lead level, according to the Centers for Disease Control and Prevention, is less than or equal to 10 μg per deciliter but may soon be lowered to 5 μg per deciliter.2

    Paul Harris, M.D.

    SUNY–Downstate Medical Center

    Brooklyn, NY 11203

    http://www.100md.com/html/DirDu/2007/01/01/32/72/13.htm