LEAD POISONING

General Information

DEFINITION--A high body level of lead, an element with no known biological value. Lead is found everywhere (in the air, such as from exhaust fumes, on the ground, in the home and in objects). A little bit of lead finds its way into everyone and usually causes no problems. Too much lead in the body can cause serious consequences. It affects almost every body organ, especially the kidneys and the central nervous system.

BODY PARTS INVOLVED--Gastrointestinal; nervous.

SEX OR AGE MOST AFFECTED--Both sexes; all ages, most common in young children.

SIGNS & SYMPTOMS

Often no symptoms are apparent or they may be delayed. Mild to moderate levels of lead:

• Paleness, fatigue, lethargy.
• Behavioral changes (e.g., irritability).
• Abdominal discomfort.
• Difficulty concentrating; headache; tremor.
• Vomiting; weight loss; sleep disorders.

Severe lead poisoning:

• Metallic taste; constipation; severe abdominal cramps; rigidity of the abdominal wall.
• Muscular weakness or paralysis.
• Cerebral type or lead encephalopathy (more common in children)-seizures, coma, long-term sequelae including neurologic defects, retarded mental development, chronic hyperactivity.

CAUSES--Inhalation of lead dust or fumes, or ingestion of lead. The body excretes lead very slowly, so it accumulates in the body tissues, particularly the bones.

RISK INCREASES WITH

• Children are at increased risk because of incomplete development of the blood-brain barrier before age 3 years allowing more lead into the central nervous system.
• Common childhood behaviors such as frequent hand-to-mouth activity and pica (see Pica in Illness section) greatly increase the risk of ingesting lead.
• Residence or frequent visitor in deteriorating, pre-1980 housing with leaded-paint surfaces. Children may lick or eat the old paint.
• Lead dissolved in water from lead or lead-soldered plumbing.
• Lead glazed ceramics, especially with acidic food or drink; crayons made outside U.S.
• Food stored in inverted plastic bread bags printed with colored ink.
• Soil/dust near lead industries.
• Hobbies such as glazed pottery making, lead soldering, painting, preparing lead shot, stained-glass making, car or boat repair, etc.
• Occupational exposure-plumbers, pipe fitters, lead miners, auto repairers.

HOW TO PREVENT

• Screening of blood-lead levels in all children at 9-12 months and again at age 2.
• If ceramic tableware is purchased outside the U.S., have it tested for lead release at a commercial laboratory when you return, or use it for decorative purposes only.
• Routine blood-lead testing for workers who are exposed to lead.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Diagnostic tests may include blood and urine studies to measure lead levels, and x-rays of the bones and abdomen to reveal lead deposits.

APPROPRIATE HEALTH CARE--Treatment involves the avoidance of further exposure to the lead, and for some patients, medical therapy that will help the body excrete the lead.

POSSIBLE COMPLICATIONS

• Long-term lead exposure may cause chronic renal failure, gout, lead line (blue-black) on gingival tissue.
• High blood pressure; miscarriages (possibly).
• If brain damage occurs, permanent problems (mental retardation, seizure disorder, blindness, muscle weakness) may occur.
• Coma, death.

PROBABLE OUTCOME--Symptomatic lead poisoning without any apparent brain damage generally improves with treatment, but subtle central nervous system toxicity may be long lasting or permanent.

How To Treat

GENERAL MEASURES--

• If the source is in the home, the patient must reside elsewhere until the source is eliminated.
• See Resources for Additional Information.

MEDICATION--Chelating agents to help the body excrete the lead at a faster rate may be prescribed.

ACTIVITY--No restrictions.

DIET--Consume adequate calcium and iron. Eat a low fat diet to reduce absorption of lead.

Call Your Doctor If

• You have symptoms of lead poisoning.
• Symptoms worsen or don't improve after treatment.