Chronic Thumb-Sucking as a Pathway for Childhood Lead Exposure in Libya: A Case Report

Abstract

Background: Lead poisoning is a major global health issue, particularly among children. The Centers for Disease Control and Prevention (CDC) states that there is no safe blood lead level for children. Libya currently lacks a lead screening program. Young children are more exposed due to behaviors such as thumb sucking, especially when they come into contact with lead-contaminated soil. High blood lead levels in early childhood are linked to speech delays, even at levels that were once thought to be low risk.

Case Presentation: Herein, we report a lead poisoning case involving a 4 years' boy and his younger sister who were exposed to the same environment simultaneously, sharing the same type of food, but the boy had a habit of chronic thumb sucking. However, the boy presented with delayed expressive language, whereas his sister showed no significant symptoms. Upon investigation, the boy exhibited an elevated plasma lead level of 19 µg/dL, whereas his sister had a plasma lead level of 10 µg/dL. The boy received calcium and iron supplementation for three months, and a bitter-tasting deterrent was applied to the thumb to stop the sucking habit. The habit was resolved, and the follow-up blood lead level decreased to 9 µg/dL. Expressive speech became fluent with a decline in the blood lead level.

Conclusion: Thumb sucking is important pathway of lead exposure in children and behavioral intervention combined with environmental counseling can evidently lowering blood lead levels.