Blood lead concentrations as a result of retained lead pellets in the craniomaxillofacial region in Benin City, Nigeria

Patients who survive gunshot wounds often retain pellets in their bodies, which cause delayed morbidity from lead poisoning, and even death. Our aim was to find out whether there is a high concentration of lead in the blood of patients who have asymptomatic retention of lead pellets in the craniomaxillofacial region. We prospectively studied 28 patients who were admitted to our hospital with gunshot injuries to the region, and 28 control subjects. Each was originally recruited three days after injury. The control subjects were chosen from people who lived in the same household or worked in the same place as the patients. Any previous exposure to lead was excluded. Blood samples were collected three days and three months after injury and analysed for the presence of lead by atomic absorption spectrophotometry. The mean (SD) age for both patients and control subjects was 33 (12) years. The mean (SD) and range of concentrations of lead in patients three days after injury was 0.11 (0.07), range 0.01-0.32 μmol/L, while those of the control subjects were 0.03 (0.02) and 0-0.06, respectively. Three months after injury, the mean (SD) and range of concentrations of the patients were 0.30 (0.11) and 0.12-0.59 μmol/L, while those of the control subjects were 0-1.25 and 0.12 (0.006) μmol/L, respectively (p= 0.000). The study showed a higher mean blood lead concentration in patients with gunshot injuries than in control subjects, but lower than the threshold values published by the Centers for Disease Control/Occupational Health and Safety Administration in the United States.