Seven patients with one or two lead shots retained in the appendix were identified by radiography. For each case, two sex- and age-matched control patients without lead shot in the appendix were found. None of the 7 patients with lead shot in the appendix had blood lead levels (median 0.55 μmol/l) approaching the toxic levels, but they averaged almost twice the levels of the controls (median 0.29 μmol/l). Thus, lead shots may add to individual lead exposures, and blood lead analysis should be performed, at least when more than a few lead shots are present.
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