Effect of bone fracture(s) on blood lead levels from retained lead pellets in craniomaxillofacial region

Abstract

Background: Missile-related blood lead elevations and toxicity are well documented in the literature but reports on its associated risk factor(s) are few. Objective: To determine if bone fracture(s) contribute to an elevated lead blood level. Method: This is a prospective study of subjects with retained pellets in the craniomaxillofacial region following gunshot injuries who met the inclusion criteria. Blood samples were collected from the test subjects and their corresponding control subjects via venipuncture. Collected blood samples were used for blood lead measurement by the wet method of the atomic absorption spectrophotometry. Using appropriate statistical tests, p < 0.05 was considered significant. Results: A total number of 48 subjects were studied. The mean blood lead levels (BLLs) of the study population were 6.88 ± 1.17 µg/dl while that of the control group was 1.52 ± 0.87 µg/dl and the mean difference was statistically significant ( p = 0.03). The mean and standard deviation of BLL of subjects with fractures were 4.77 ± 0.9, 5.08 ± 1.0, and 5.22 ± 1.0 µg/dl at days 3, 21, and 42 postinjury, respectively, while for those without bone fractures were 3.07 ± 1.4, 3.70 ± 0.8, and 4.33 ± 1.7 µg/dl. The difference was statistically significant ( p = 0.04). Conclusion: Subjects with bone fractures were found to have higher BLLs than those without bone fractures, where pellets were retained in their bodies.