Some causes of lead poisoning are ingesting lead paint and eating or drinking from certain imported, improperly lead-glazed ceramics.
Very high levels of lead in the blood may cause personality changes, headaches, loss of sensation, weakness, a metallic taste in the mouth, uncoordinated walking, digestive problems, and anemia.
The diagnosis is based on symptoms and a blood test.
Testing household water, ceramics, and paint for lead can help identify potential sources of lead poisoning.
Treatment consists of stopping exposure to lead and removing accumulated lead from the body.
(See also Overview of Poisoning Overview of Poisoning Poisoning is the harmful effect that occurs when a toxic substance is swallowed, is inhaled, or comes in contact with the skin, eyes, or mucous membranes, such as those of the mouth or nose... read more .)
Lead poisoning is far less common since paint containing lead pigment was banned (in 1978 in the United States) and lead was eliminated from automotive gasoline (in 1986 in the United States and by 2011 in all but 6 countries in the developing world). However, lead poisoning is still a major public health problem in cities on the East Coast of the United States as well as in other isolated cities.
Sources of lead
The most common cause of lead poisoning is eating or drinking something that contains lead. This typically happens in
Children who live in older houses that contain peeling lead paint or lead pipes
During home remodeling, people may be exposed to significant amounts of lead in particles scraped or sanded off while preparing surfaces for repainting. Young children may eat enough paint chips, particularly during remodeling, to develop symptoms of lead poisoning. Lead pipes used in plumbing and containment tanks may leach lead into the water supply, which can be ingested at the tap.
There are various other sources of lead poisoning:
Some ceramic glazes contain lead. Ceramic ware, such as pitchers, cups, and plates, made using these glazes (common outside the United States) can leach lead, particularly when in contact with acidic substances (such as fruits, cola drinks, tomatoes, wine, and cider).
Lead-contaminated moonshine whiskey and folk remedies are possible sources.
Occasionally, lead foreign objects are in the stomach or tissues (such as bullets or curtain or fishing weights). Bullets lodged in certain soft tissues may increase levels of lead in the blood, but that process takes years to occur.
Occupational exposure can occur during battery manufacture and recycling, bronzing, brass making, glass making, pipe cutting, soldering and welding, smelting, or working with pottery or pigments.
Certain ethnic cosmetic products and imported herbal products and medicinal herbs contain lead and have caused cluster outbreaks of lead poisoning in immigrant communities.
Fumes of leaded gasoline (in countries where it is still available) recreationally inhaled for the intoxicating effects on the brain may cause lead poisoning.
Effects of lead on the body
Lead affects many parts of the body, including the brain, nerves, kidneys, liver, blood, digestive tract, and sex organs. Children are particularly susceptible because lead causes the most damage in nervous systems that are still developing.
If the level of lead in the blood is high, symptoms of brain damage (encephalopathy) usually develop. Lower blood levels that are sustained for longer periods of time sometimes cause long-term intellectual deficits.
Symptoms of Lead Poisoning
Many people with mild lead poisoning have no symptoms. Symptoms that do occur usually develop over several weeks or longer. Sometimes symptoms flare up periodically.
Typical symptoms of lead poisoning include personality changes, headaches, loss of sensation, weakness, a metallic taste in the mouth, uncoordinated walking, poor appetite, vomiting, constipation, crampy abdominal pain, bone or joint pains, high blood pressure, and anemia Anemia . Kidney damage often develops without symptoms.
Young children who have been exposed to lead may become cranky and their attention span and play activity may decrease over the course of several weeks. Encephalopathy can then begin suddenly and worsen over the next several days, resulting in persistent, forceful vomiting; poor coordination and difficulty walking; confusion; sleepiness; and, finally, seizures and coma. Chronic lead poisoning in children may cause intellectual disability, seizures Seizure Disorders In seizure disorders, the brain's electrical activity is periodically disturbed, resulting in some degree of temporary brain dysfunction. Many people have unusual sensations just before a seizure... read more , aggressive behavior, developmental regression, chronic abdominal pain, and anemia.
Adults who are exposed to lead at work typically develop symptoms (such as personality changes, headaches, abdominal pain, and damage to nerves, with numbness and loss of sensation in the feet and legs) over several weeks or longer. Adults may develop loss of sex drive, infertility, and, in men, erectile dysfunction Erectile Dysfunction (ED) Erectile dysfunction (ED) is the inability to attain or sustain an erection satisfactory for sexual intercourse. (See also Overview of Sexual Dysfunction in Men.) Every man occasionally has... read more (impotence). Encephalopathy rarely develops in adults.
Children and adults who inhale the fumes from leaded gasoline may develop symptoms of psychosis in addition to typical symptoms of lead poisoning.
Some symptoms may diminish if exposure to lead is stopped, only to worsen again if exposure is resumed.
Diagnosis of Lead Poisoning
Lead levels in blood
Sometimes x-rays of abdomen
Sometimes x-rays of long bones (in children with suspected long-term exposure to lead)
The diagnosis of lead poisoning is based on symptoms and a blood test to measure lead level. Adults whose jobs involve handling lead need frequent blood tests. Children living in communities with many older houses, where peeling lead-based paint is common, should also undergo blood tests for lead, even if they do not have any symptoms. In children, bone and abdominal x-rays often show evidence of lead poisoning.
Did You Know...
Prevention of Lead Poisoning
Commercially available kits should be used to test household paint (except in houses built after 1978), ceramics made outside the United States, and water supplies for lead content. Measures that reduce the risk of household poisoning include regular cleaning, such as
Washing of children’s toys and pacifiers
Cleaning of household surfaces
Dusting affected windowsills weekly with a damp cloth
Chipped leaded paint should be repaired. Larger renovation projects to remove leaded paint can release large quantities of lead into the house and should be done professionally. Commercially available faucet filters can remove most lead from drinking water.
Adults exposed to lead dust at work should
Use appropriate personal protective equipment
Change their clothing and shoes before going home
Shower before going to bed
Treatment of Lead Poisoning
Stopping exposure to lead
Sometimes whole-bowel irrigation
Sometimes chelation therapy and mineral supplements
Treatment consists of stopping exposure to lead and removing accumulated lead from the body. If an abdominal x-ray shows lead chips, a special solution of polyethylene glycol is given by mouth or through a stomach tube to flush out the contents of the stomach and intestines (a process called whole-bowel irrigation).
Doctors remove lead from the body by giving drugs that bind with the lead (chelation therapy Chelation Therapy Chelation, a biologically based practice, describes a chemical reaction in which certain molecules bind to metal atoms (such as calcium, copper, iron, or lead). Chelating drugs, such as ethylenediaminetetraacetic... read more ), allowing it to pass into the urine. All drugs that remove lead work slowly and can cause serious side effects.
Succimer is one drug used in chelation therapy. People with mild lead poisoning are given succimer by mouth. People with more serious lead poisoning are treated in the hospital with injections of chelating drugs, such as dimercaprol, succimer, and edetate calcium disodium. Because chelating drugs also can remove beneficial minerals, such as zinc, copper, and iron, from the body, the person often is given supplements of these minerals.
Even after treatment, many children with encephalopathy develop some degree of permanent brain damage. Kidney damage is also sometimes permanent.
The following are some English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
American Association of Poison Control Centers: Represents the US-based poison centers that provide 24/7 free, confidential services through the Poison Help Line (1-800-222-1222)
United States Environmental Protection Agency's recommended lead test kits: Information on evaluating and eliminating lead-based paint hazards and access to several approved lead test kits