Inorganic lead toxicology, clinical effects, and OSHA medical surveillance. Toxicokinetics: absorption, distribution to bone (long-term reservoir) and soft tissue, biological half-life, and blood lead level (BLL) as the key biomarker. Hematological effects of heme synthesis disruption: ALA-dehydratase and ferrochelatase inhibition, zinc protoporphyrin (ZPP) elevation, basophilic stippling, microcytic anemia. Neurological effects: peripheral motor neuropathy (wrist drop), encephalopathy in severe exposure, neurodevelopmental effects in children. Renal effects: chronic nephropathy and saturnine gout. Reproductive and developmental risks. Chelation therapy (EDTA, succimer/DMSA). Surveillance, biological monitoring, and medical removal protection under 29 CFR 1910.1025.
A 42-year-old worker in lead smelting presents with new-onset weakness. Which clinical pattern is most characteristic of lead-induced peripheral neuropathy?