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Lead Poisoning

Alternate Names

  • lead toxicity
  • plumbism

Definition

Lead is a metal found in the environment. If a person is exposed to lead even in relatively small amounts, poisoning may occur.

What is going on in the body?

Lead is not natural within the body and is not required in the diet. Because of technology, however, lead exposure became increasingly common throughout the mid-20th century. Since the 1970s, lead has been removed from gasoline, from paint, and from other sources that can contaminate the environment.
However, sources such as discarded car batteries and paint in old houses still exist, and cause more damage to the body than people formerly realized. In addition, workers in various industries continue to be exposed to lead in the course of their jobs. Any of these exposures can lead to increased levels of lead in the body, cause harm in several ways.

Risks

What are the causes and risks of the condition?

A person can be exposed to lead from the following sources:
  • leaded gasoline
  • car exhaust
  • paint made before 1978
  • industrial lead exposure
  • burning batteries
  • poorly glazed ceramic objects, which may be used to store beverages
The people most commonly affected by lead poisoning are children. Children who live in old buildings with lead paint that is peeling or dissolving are at high risk. Lead dust or paint chips from lead paints may be breathed into the lungs or eaten.
Though quite rare today, severe lead poisoning can cause death. Other risks are the long-term damage lead poisoning may cause in the brain, nerves, and kidneys.

Prevention

What can be done to prevent the condition?

The government has done the following to prevent lead poisoning:
  • mandated use of unleaded gasoline
  • mandated better car emission standards
  • banned lead paint
Two measures have drastically reduced the number of cases of lead poisoning:
  • Avoiding exposure to lead is the most important prevention. People living in older buildings with peeling lead paint need to have their home or apartment repaired. People working in manufacturing should ask about possible lead exposure and follow published standards for the protection of workers. Batteries should not be burned.
  • Testing to screen for lead poisoning is is second most important measure. Public health experts recommend a blood test to screen for lead poisoning in children living in environments where lead sources are likely to be found. A healthcare professional can determine whether testing is needed for an individual child. Testing is normally started between 6 and 12 months of age.

Diagnosed

How is the condition diagnosed?

A careful history and physical exam may make a healthcare professional suspect lead poisoning. A blood test confirms the diagnosis by detecting the level of lead in the blood.

Long Term Effects

What are the long-term effects of the condition?

The most common long-term effect of lead poisoning is mild brain damage. This damage may be permanent and generally affects children, whose brains are still developing. Behavior problems, emotional problems, and lowered intelligence may all occur.
Kidney damage, nerve damage that may cause paralysis, and even death may also occur.

Other Risks

What are the risks to others?

Lead poisoning is not contagious and poses no risks to others.

Treatments

What are the treatments for the condition?

The most important treatment is stopping the source of lead exposure. For more severe poisoning, medications may be needed to help remove lead from the body. Chelation is a procedure that helps bind the lead and remove it from the body. Life-threatening lead poisoning, which is rare, requires treatment in a hospital.

Side Effects

What are the side effects of the treatments?

Stopping lead exposure may involve major life changes and expense. For example, changing jobs, moving, or repairing the home or apartment may be needed.
All medications have side effects. The medications used to decrease lead in the body may cause allergic reactions and stomach upset. Other side effects depend on the specific medication used.

After Treatment

What happens after treatment for the condition?

If caught early and treated correctly, lead poisoning may require no further treatment. Continued monitoring is advised in all cases, however. If caught late or not treated, the lead poisoning may cause permanent body damage. This may require ongoing treatment, such as psychiatric care.

Monitor

How is the condition monitored?

Repeat blood tests are used to follow the lead level until it is normal. Other monitoring depends on whether the body has been harmed in some way.

Sources

Harrison's Principles of Internal Medicine, 1998, Fauci et al.

Nelson Texbook of Pediatrics, 1996, Behrman et al.

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