Lead testing
Lead testing

Lead poisoning disease

Definition:
Chronic intoxication with the heavy metal, lead.

Alternative Names:
Plumbism

Causes, incidence, and risk factors:

Lead occurs naturally in the environment at very low levels. Relatively high level sources of lead occur in older paint (modern paint does not contain lead), and pre-1980 car exhaust (the lead from exhaust is ultimately deposited on the ground in dust which children play in). Other sources exist such as pewter pitchers and dinnerware, birdshot, and fishing weights.

In the past, toothpaste tubes were made of lead and condensed milk cans were soldered with lead. This has been corrected. Lead can also be found in drinking water from homes whose copper pipes were soldered with lead solder. New building codes require lead free solder.

Infants and children most at risk are those living in pre-sixties housing where paint often contained led. These children, when small, often ingest paint chips or dust from lead based paint. Soil in cities with high traffic density may contain high levels of lead from car exhaust.

There are few clear cut symptoms of lead poisoning. Very high levels may lead to an acute encephalopathy. Low levels of lead are thought to be detrimental to mental development and have been implicated in decreased IQ and mental functioning. Hard evidence for this, however, is still questionable. Anemia with lead poisoning is common.

Specific symptoms are nebulous but hyperirritability, aggressive behavior, decreased appetite and energy, poor sleeping, headaches, constipation, and loss of recently acquired developmental skills. Abdominal cramping may be present.

In severe intoxication lead encephalopathy develops with vomiting, staggering gait, motor weakness from peripheral neuropathy, seizures, and coma.

Symptoms:
Acute symptoms: Chronic symptoms:
  • irritability
  • loss of appetite
  • loss of energy
  • colic or abdominal cramping
  • loss or recently acquired developmental skills
  • decreased intellectual functioning
  • person has a history of being exposed to lead-containing paint, dirt, etc.
Signs and tests:

Signs include:

  • anemia
  • behavioral disorders
  • school problems
  • encephalopathy

Tests include:

Treatment:
  • removal from the source of lead (often easier than removing the source of lead)
  • chelation therapy to remove lead from the body

In cases of acute ingestion of potentially toxic doses of lead salts the following treatments might be done:

  • gastric lavage
  • polyethylene glyco lavage solution
Expectations (prognosis):
Expectations vary depending on the severity of toxicity. Children with levels above normal (greater than 30 micrograms/cc but less than 50) generally recover without problem. Children with medium and high serum levels of lead must be carefully followed and removed from all exposure. Children who have had an acute encephalopathy have a more guarded prognosis. Even mild lead poisoning is suspected as causing poor school performance and some loss in IQ.
Complications:
Acute encephalopathy
Calling your health care provider:
Call for an appointment with your health care provider if signs of lead poisoning exist.
Prevention:
Avoidance of lead ingestion or inhalation.

Review Date: 12/10/2001
Reviewed By: Boaz Rosenblat, M.D., Department of Emergency Medicine, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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