Lead poisoning

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 8, 2016
StartDiseasesLead poisoning

Lead poisoning is known by many names, including colica pictorum, plumbism, saturnism, painter’s colic, and Devon colic. Lead is a form of metal that was used in paint, pipes, and many other everyday materials before it was determined to be toxic. Even trace amounts of the metal can cause health issues. The abundance of this toxic material makes lead poisoning an extremely common medical problem.

Contents

Definition & Facts

Lead poisoning occurs when lead accumulates in the body at levels that are higher than safe. In its natural state, lead is a dull gray metal, but it is added to bullets, batteries, consumer products, and building materials because it is easy to work with and is available in high amounts.

Though lead is less commonly used in production now that it is known to be unsafe, it can still be present in older homes, water, and soil. When trace amounts of lead are inhaled or ingested, the lead prevents bones, heart, intestines, nervous systems, kidneys, and reproductive systems from functioning properly.

Symptoms & Complaints

Initially, there are few symptoms of lead poisoning. At first, people with lead poisoning may just feel generally unwell and fatigued, have insomnia, lose their appetite, feel nauseous, have muscle pain, and experience strange bowel movements. However, once high levels accumulate, symptoms can quickly become problematic.

The main symptoms of lead poisoning are abdominal pain, memory loss, low sperm count, feelings of weakness or tingling in extremities, headaches, and kidney failure. As poisoning becomes more severe, people experience a great deal of pain, weakness, digestive problems, pale skin, ruptured red blood cells, slurred speech, a blue line along their gums, depression, and vision problems.

Lead interferes with development in children, so children with lead poisoning may have learning difficulties, developmental delays, hearing loss, irritability, inability to gain weight or height, and behavioral disorders. Lead is also absorbed faster by children, so they will show effects of lead poisoning far faster than any adults exposed to the same amount of lead will. Pregnant women who are exposed to lead tend to either miscarry, have premature births, or have children with a low birth weight.

Causes

Lead poisoning may be caused by natural lead deposits seeping into groundwater and soil that can end up being inhaled or consumed. However, there are also many other sources of lead that people are exposed to in day to day life. Lead was once a major ingredient in paint, but it was banned in 1978. Older homes may still have leaded paint, which can add more lead to the air, and children are particularly prone to eating chips of leaded paint.

Older plumbing pipes are often soldered with lead, that can leak into drinking water occasionally. Many traditional alternative medicines, including the Hispanic remedy called greta, the Indian tonic called ghasard, the Thailand digestive aid called daw tway, and the Chinese herbal remedy called ba-baw-san, all contain high levels of lead.

Adults who work in industries that still use lead are often exposed to lead while manufacturing batteries, developing X-rays, making ammunition, welding, or mining lead. Consumer goods, including toys and makeup, that are imported from other countries with lax safety regulations may still be made with lead.

Diagnosis & Tests

Because lead is so prevalent and because it takes a while for lead symptoms to show, many routine wellness exams may include a test for lead. Otherwise, a person may only get a test to detect lead poisoning if they are presenting the symptoms of lead poisoning. The most basic way to diagnose lead poisoning is to do a blood test that checks the level of lead in the blood. A brief finger prick can collect enough blood for the test, and then a lab will determine the amount of lead micrograms per deciliter (mcg/dL) in the blood.

Lead levels of 5 mcg/dL or higher show that a person is being exposed to high levels of lead, so further testing will be required in the future. At 10 mcg/dL, children are at a greater risk for developmental and learning disabilities. Adults exposed to 20 to 50 mcg/dL may experience issues with cognition. At 40 mcg/dL, lead affects reproductive systems, making it difficult for adults to conceive. If a test for lead shows over 60 mcg/dL of lead, severe physical symptoms will most likely be evident.

Treatment & Therapy

When first diagnosed with lead poisoning, it is critical for a person to stop being exposed to lead. Changing the patient’s environment, sealing lead paint, and altering eating and drinking habits is often enough to naturally lower the levels of lead in a person’s body. For patients with extremely high levels of lead, it is unsafe to just wait for the amount of lead to lessen naturally.

Instead, chelation therapy is often recommended. This treatment involves taking a medicine that helps the body to excrete lead through urination. If a person has over 45 mcg/dL of lead in their blood, treatments such as ethylenediaminetetraacetic acid may be required.

Though it is always possible to lower lead levels, sometimes medical care may not be able to reverse the severe physical symptoms of lead poisoning. After the damage has been done, a person may continue to suffer with lessened brain function or other problems, especially if the patient is younger.

Prevention & Prophylaxis

Avoiding exposure to lead is the best way to prevent lead poisoning from ever occurring. In many nations, issues such as leaded paint and leaded gasoline are banned. However, many developing nations still allow lead in consumer products, so research anything that is imported. Be cautious of anything produced before 1980 because lead was much more common before it was realized to be unsafe in the 1970s.

Old pipes that were soldered with lead are one of the most common issues, so testing water for lead levels can prevent a person from drinking water with high lead levels. If lead-based paint cannot be removed, there are commercial grade sealants that can at least prevent the paint from chipping off or releasing lead into the air.