Lead poisoning in China – Authors' reply

www.thelancet.com Vol 378 November 5, 2011 e3 Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/ Chelation therapies are major measures implemented to treat lead poisoning. However, all the chelating agents have potential risks. For example, dimercaprol has long been used in chelation therapy for lead poisoning. However, side-eff ects have been reported in up to 50% of patients. In China, succimer was considered as the fi rst-line drug, together with sodium calcium edetate. Succimer is a chelating agent with fewer sideeff ects and greater effi cacy than other agents, but it does not remove lead from intracellular sites and it does not provide protection in terms of clinical or biochemical recovery. So, the most important measures to control lead poisoning are reduction of the potential exposure possibilities, rather than treatment after the event. Considering that, we mainly focused on the preventive measures in our Comment. Cohen and Amon also point out other problems that emerged after the breakout of the cases. Such reports can also be found in Chinese offi cial media. For example, in Jiahe, Hunan province, the local police arrested residents seeking treatment. The report led to the dismissal of several local offi cials. For the same reason that our Comment concentrated on prevention rather than treatment, such reports were not considered in our Comment. But more eff orts are needed, especially from local govern ments. Along with the eff orts from the government and the public, we hope that fewer poisoning cases will happen in the near future.