Impact of EDTA chelation therapy on essential trace elements in patients with occupational chronic lead intoxication: a real-world data analysis
Year: 2026
Type: article
Abstract: CaNa₂EDTA chelation therapy is a cornerstone treatment for occupational chronic lead intoxication, yet its impact on essential trace element homeostasis has not been comprehensively characterized in real-world clinical practice. We aimed to assess serial changes in a broad panel of essential trace elements across repeated CaNa₂EDTA chelation cycles. This retrospective real-world study included patients with occupational chronic lead intoxication treated between November 2021 and November 2025 at a national referral center in Türkiye. Serial blood concentrations of zinc, selenium, copper, chromium, manganese, and molybdenum were assessed at baseline and after each chelation cycle. Linear mixed-effects models with patient as a random intercept were used to account for within-subject correlation and unbalanced repeated measurements, with Bonferroni-adjusted pairwise comparisons and sensitivity analyses. The study included 257 patients with occupational chronic lead intoxication (98.1% male), representing 314 hospitalizations and 538 CaNa₂EDTA chelation cycles. The median blood lead concentration at admission was 52 µg/dL (IQR, 43.5–63). Zinc and selenium concentrations declined markedly after the first chelation cycle ( p < 0.001) and remained significantly below baseline throughout subsequent cycles. Copper and molybdenum showed smaller, transient reductions significant only after the first cycle (copper, p < 0.001; molybdenum, p = 0.003), with values recovering toward baseline thereafter. Chromium and manganese concentrations remained stable throughout treatment ( p = 0.425 and p = 0.252, respectively). A dose-dependent effect was observed for zinc only, with greater reductions at higher EDTA doses ( p = 0.002). Element-specific changes in trace element concentrations were observed during repeated CaNa₂EDTA chelation therapy, with zinc and selenium showing the most pronounced and sustained reductions after the first cycle. These findings support targeted monitoring of zinc and selenium during repeated chelation therapy, with supplementation considered if deficiency is confirmed or clinically indicated. Not applicable.
Source: BMC Pharmacology and Toxicology
Institutions: Hacettepe University, Ministry of Health, Mustafa Kemal University
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7223469629
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