Lead poisoning disease

Alternative names
Plumbism

Definition
Lead poisoing disease is chronic (long-term) poisoning with the heavy metal, lead.

Causes, incidence, and risk factors

Lead occurs naturally in the environment at very low levels. Relatively high level sources of lead occurred in car exhaust prior to 1980 (the lead from exhaust fumes was ultimately deposited onto the ground) as well as in older paints (modern paint does not contain lead). 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 pipes were soldered with lead solder. New building codes require lead-free solder.

Infants and children most at risk are those living in pre-1960’s housing where paint often contained lead. Small children 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.

Symptoms

The symptoms of lead poisoning are numerous and affect many different body systems. Chronic exposure to even low levels of lead is detrimental to mental development in children, and has been correlated with decreased IQ and behavioral problems.

Other symptoms of lead piosoning may include hyperirritability, aggressive behavior, decreased appetite and energy, poor sleeping, headaches, constipation, and loss of recently acquired developmental skills (in young children). Anemia and abdominal cramping are also common.

Very high levels may cause acute encephalopathy with vomiting, staggering gait, muscle weakness, seizures, or coma.

Signs and tests

Laboratory tests may include:

     
  • serum lead levels  
  • erythrocyte protoporphyrin  
  • iron level  
  • complete blood count and coagulation studies  
  • bone marrow biopsy (stippled erythroblasts)  
  • X-ray of the long bones and abdomen

Treatment
For long-term exposure:

     
  • isolation from or disposal of the lead source  
  • chelation therapy to remove lead from the body

In cases where someone has potentially eaten toxic doses of lead in a short period of time, the following treatments might be done:

     
  • gastric lavage  
  • bowel irrigation with polyethylene glycol solution

Expectations (prognosis)

The outlook varies depending on the severity of toxicity. People with mildly elevated lead levels often recover without problems. However, even mild lead poisoning in children can cause permanent mental deficits.

People with higher lead levels have an increased risk of long-lasting health impairments and must be followed carefully. Children who have had acute encephalopathy from lead exposure have a much more guarded outlook.

Complications

A possible complication is acute encephalopathy (brain disease).

Calling your health care provider
Call your health care provider or local poison control center if signs of lead poisoning exist.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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