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Albahary C, Truhaut R, Boudene C. The diagnosis of lead poisoning following urinary elimination of lead induced by calcium disodium versenate. Archiv. Maladies Professionnelles de Med. Du Travail et de Securite Sociale. 1958; 19:121-131 (Mar.-Apr.). (1883) [CaNa2EDTA was administered to about 50 individuals by different routes and the urinary Pb excretion induced by the versenate was measured polarographically. The authors conclude from their experiments that determination of the rate of urinary Pb excretion induced by iv administration of EDTA provides a very good means for the diagnosis of saturnism, particularly in cases of unrecognized, disputable or hysterical and atypical cases. The following series of tests were made: (1) Four men with signs of Pb poisoning and 3 controls were given iv infusions of 2 g EDTA/day for 3 days; a 5th subject received 0.50 g/day for 3 days. (2) The results on urinary Pb excretion in a welder from the above group were compared when EDTA was administered by iv infusion (2 g/day for 3 days, or 1.0, 0.5, 0.5 g, respectively, per day), by iv injection (0.50 g/day for 2 days), or when BAL (450 mg/day for 3 days) was administered. Three other subjects and 6 controls were given 1-3 iv injections of 0.50 g EDTA each. (3) Six subjects and 3 controls were treated orally with 4 g EDTA/day, distributed in 2 daily doses, for 3-6 days. (4) Ten subjects and 1 control inhaled 1 g EDTA as an aerosol.
Venous infusion with 2 g EDTA/day for several days is generally considered to be the best method of detoxication, but it is complicated and cumbersome. Intravenous injection with 0.5 g EDTA has proved to be satisfactory both therapeutically and for the purpose of diagnosis. The authors are unable to ascertain whether an iv dose of 1 g EDTA is more efficacious than a 0.5 g dose since the induced Pb excretion varies widely in different subjects. They believe that induced Pb excretion increases with the degree of poisoning; however, if the Pb exposure has been far in the past, mobilization of Pb by the versenate may be slow. An excretion curve reaching a plateau is more indicative of Pb poisoning than a bell-shaped curve. Controls sometimes show abnormal, transient increased Pb excretion. The period elapsed between injection of EDTA and maximum Pb excretion and the threshold limit of Pb excretion are significant criteria for the diagnosis.
In the cases studied the maximum excretion was reached between 3-10 hr, usually after 6 hr. The threshold limit was estimated as 800 mg Pb/1; values above this limit call for diagnosis of saturnism. Oral treatment with EDTA is not efficient. The threshold limit of urinary Pb excretion by this method is 400 mg/1 within 24 hr. Inhalation of 1 g EDTA as aerosol in a 20% suspension for 20-30 min is unsatisfactory therapeutically but it is a convenient method for diagnosis. The urinary Pb excretion increases 2-6 fold; the threshold limit is about 400 mg Pb/1. The mobilization of Pb is so rapid that the urine needs to be tested only for 10 hr following inhalation. The authors suggest that inhalation of small quantities of EDTA may possibly be used for protection in occupational Pb exposure provided further studies confirm its innocuousness. EDTA doe not act as a detoxicant in Hg poisoning. Furthermore the authors do not expect that EDTA will activate the urinary elimination of essential metals, such as Fe, Cu, Cd, Mn and others or that it may promote vitamin deficiency.]

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