Comparing Blood Lead Level among Oral/inhaled Opium Addicts with a Non-addict Control Group in the Southeast of Iran

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Internal Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran

2 PhD Student, Student Research Committee, School of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran

3 Assistant Professor, Department of Community Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran

4 Department of Medical Chemistry, School of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran

5 Associate Professor, Department of Pharmacology and Toxicology, School of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran

Abstract

Background: Opium is widely used among addicts in the Middle East countries such as Iran. Recent reports suggest that opium sellers cheat their customers by adding lead to the opium. Contaminated opium can threaten the health of consumers. This study was designed to evaluate the lead concentration in blood sample of oral and inhaled opium user’s referring to Amir Al-Momenin Hospital in Zabol, Iran, during spring 2015 in comparison with those of control group.Methods: Blood lead level (BLL) of 188 subjects with a mean age of 52.06 years in three categories - including oral opium addicted (55 patients), inhaled opium addicted (55 patients), and healthy control group (n = 78) - was assessed. The BLL of all the subjects was assessed using an atomic absorption spectrophotometer.Findings: Almost all participants consumed “Tariak” (99.09%). Mean ± standard deviation (SD) duration of opium addiction was 13.21 ± 10.26 years. The average blood lead concentration among oral users, inhaled users, and control group were 34.31 ± 21.54, 41.13 ± 26.40, and 9.86 ± 4.40 µg/dl, respectively (P = 0.001).Conclusion: Our study showed significant differences of BLLs between opium users and control group. We also did not find any association between blood lead concentration and method of opium consumption.

Keywords


  1. Needleman HL. Childhood lead poisoning: The promise and abandonment of primary prevention. Am J Public Health 1998; 88(12): 1871-7.
  2. Bates N. Lead and lead salts. In: Bates N, Editor. Pediatric toxicology: Handbook of poisoning in children. Stockton, CA: Stockton Press; 1997.
  3. Dreisbach RH, Robertson WO. Handbook of poisoning. 12th ed. Norwalk, CT: Appleton and Lange; 1987. p. 230-5.
  4. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Hauser SL, et al. Harrison's Principles of Internal Medicine. New York, NY: McGraw-Hill; 1998.
  5. Noji EK, Kelen GD. Manual of toxicologic emergencies. Chicago, IL: Year Book Medical Publishers; 1989. p. 675-8.
  6. Ward J. Rudolph's pediatrics. 19th ed. Norwalk, CT: Appleton and Lange; 1991. p. 807-8.
  7. Aungst BJ, Fung HL. Inhibition of oral lead absorption in rats by phosphate-containing products. J Pharm Sci 1983; 72(4): 345-8.
  8. Staudinger KC, Roth VS. Occupational lead poisoning. Am Fam Physician 1998; 57(4): 719-2.
  9. Cremin JD Jr, Luck ML, Laughlin NK, Smith DR. Oral succimer decreases the gastrointestinal absorption of lead in juvenile monkeys. Environ Health Perspect 2001; 109(6): 613-9.
  10. Rabinowitz MB. Toxicokinetics of bone lead. Environ Health Perspect 1991; 91: 33-7.
  11. Patrick L. Lead toxicity, a review of the literature. Part 1: Exposure, evaluation, and treatment. Altern Med Rev 2006; 11(1): 2-22.
  12. Salehi H, Sayadi AR, Tashakori M, Yazdandoost R, Soltanpoor N, Sadeghi H, et al. Comparison of serum lead level in oral opium addicts with healthy control group. Arch Iran Med 2009; 12(6): 555-8.
  13. Algora M, Martin-Castillo A, Zabala P, Fernandez MN. Lead poisoning due to drug addiction: A new source of poisoning with clinical interest and important epidemiological consequences. An Med Interna 1989; 6(9): 483-5.
  14. Ibrahim AS, Latif AH. Adult lead poisoning from a herbal medicine. Saudi Med J 2002; 23(5): 591-3.
  15. Aghaee-Afshar M, Khazaeli P, Behnam B, Rezazadehkermani M, Ashraf-Ganjooei N. Presence of lead in opium. Arch Iran Med 2008; 11(5): 553-4.
  16. Yannai S, Sachs KM. Absorption and accumulation of cadmium, lead and mercury from foods by rats. Food Chem Toxicol 1993; 31(5): 351-5.
  17. Abdollahi M, Sadeghi Mojarad A, Jalali N. Lead toxicity in employees of a paint factory. Med J Islam Repub Iran 1996; 10(3): 203-6. [In Persian].
  18. Abdollahi M, Shohrati M, Nikfar S, Jalali N. Monitoring of Lead poisoning in bus drivers of Tehran. Iran J Med Sci 1995; 20(1-2): 29-33. [In Persian].
  19. Abdollahi M, Ebrahimi-Mehr M, Nikfar S, Jalali N. Monitoring of lead poisoning in simple workers of a copying center by flame atomic absorption spectroscopy. Med J Islam Repub Iran 1996; 10(1): 69-72. [In Persian].
  20. Haddad LM, Shannon MW, Winchester JF. Clinical management of poisoning and drug overdose. Philadelphia, PA: Saunders; 1998.
  21. Beattie AD, Briggs JD, Canavan JS, Doyle D, Mullin PJ, Watson AA. Acute lead poisoning: Five cases resulting from self-injection of lead and opium. Q J Med 1975; 44(174): 275-84.
  22. Shiri R, Ansari M, Ranta M, Falah-Hassani K. Lead poisoning and recurrent abdominal pain. Ind Health 2007; 45(3): 494-6.
  23. Masoodi M, Zali MR, Ehsani-Ardakani MJ, Mohammad-Alizadeh AH, Aiassofi K, Aghazadeh R, et al. Abdominal pain due to lead-contaminated opium: A new source of inorganic lead poisoning in Iran. Arch Iran Med 2006; 9(1): 72-5.
  24. Vega J, Contreras A, Rios E, Marchetti N, Agurto M. Lead exposure and its effects on child health. Rev Chil Pediatr 1990; 61(3): 154-60.
  25. Amiri M, Amini R. A comparison of blood-lead level (BLL) in opium-dependant addicts with healthy control group using the graphite furnace/atomic absorption spectroscopy (GF-AAS) followed by chemometric analysis. Iran Red Crescent Med J 2012; 14(8): 488-91.
  26. Beigmohammadi MT, Aghdashi M, Najafi A, Mojtahedzadeh M, Karvandian K. Quadriplegia due to lead-contaminated opium-case report. Middle East J Anaesthesiol 2008; 19(6): 1411-6.
  27. Jalili M, Azizkhani R. Lead toxicity resulting from chronic ingestion of opium. West J Emerg Med 2009; 10(4): 244-6.
  28. Soltaninejad K, Flückiger A, Shadnia S. Opium addiction and lead poisoning. J Subst Use 2011; 16(3): 208-12.
  29. Mahaffey KR. Quantities of lead producing health effects in humans: Sources and bioavailability. Environ Health Perspect 1977; 19: 285-95.
  30. Froutan H, Kashefi Zadeh A, Kalani M, Andrabi Y. Lead toxicity: A probable cause of abdominal pain in drug abusers. Med J Islam Repub Iran 2011; 25(1): 16-20. [In Persian].