Introduction
This topic covers tetraethyl lead (TEL) intoxication, an occupational poisoning caused by an organic lead compound that was once added to petrol as an anti-knock agent. It is different from chronic lead poisoning by inorganic lead salts: the organic compound is lipophilic, acts mainly on the central nervous system, and produces an acute, sometimes fatal, encephalopathy as well as chronic effects. The answer should cover etiology, pathogenesis, the acute and chronic clinical picture, diagnosis, treatment and medical expertise.
Etiology and sources of exposure
TEL, (C_2H_5)_4Pb, was used for decades as an octane booster in leaded petrol. Occupational exposure occurred in refineries, fuel blending and storage, mixing and loading of anti-knock additive, tank cleaning, garage work and maintenance of petrol engines. Lead shot and other metallic lead compounds are a separate source and are not the subject of this topic, although they are mentioned in the differential picture.
- Main routes of exposure: inhalation of vapour, skin contact (the most important route in workers handling the liquid), and accidental or deliberate ingestion.
- Risk factors: lack of protective clothing, poor ventilation, handling of contaminated rags and clothing, and eating or smoking at the workplace.