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Lead Poisoning

Overview

Lead poisoning is a serious condition that can lead to fatal complications if not addressed on time. Lead is a toxic metal usually present in wall paints and art supplies. Lead poisoning does not develop in an instance, and it takes months or years for symptoms to appear. A slow intake of lead in any form can lead to severe physical and neurological complications. The good news is that lead poisoning is treatable if diagnosed earlier. Lack of diagnosis or treatment may result in serious consequences that may be fatal. 

Causes

One of the leading causes of lead poisoning a few decades ago was lead-based paints. They were banned later in the United States, but there are still old houses and properties where lead-based paints have been used. Young children got lead poisoning by eating the scrapes of that paint. Lead is also used in plumbing pipes, solders, batteries, pottery, and some roofing materials. These agents can cause lead poisoning in both children and adults.

 

Inhaling air that is contaminated with lead is another source of lead poisoning. This is common among plumbers, wall painters, or people who spend more time around lead-based products. Few other lead sources include soil, dust, pottery, toys, bullets, and certain cosmetic and herbal products. Prolonged exposure to lead in any form can lead to lead poisoning. 

Risk Factors And Epidemiology

Infants and young children are at higher risk of developing lead poisoning. This is because young children often ingest small household items or scraps of wall paint. This factor and their weak immune system can increase the risk of serious complications. Those living in older homes are also at risk due to lead-based paint or contaminated dust. Certain occupations involve a greater exposure to lead or lead-based products. If special precautions are not taken in these jobs, you may develop lead poisoning after a few weeks or months.

 

The occurrence of lead poisoning is usually observed in children younger than 10 years of age. In the United States, lead-based paints and certain other lead-based products were banned in 1978, leading to a decrease in the cases of lead poisoning. 

Signs And Symptoms

Signs and symptoms of lead poisoning are difficult to detect because they do not appear until a heavy amount of lead has been ingested or inhaled. A person with a low level of lead poisoning may appear healthy with no apparent signs.

Children: If lead poisoning symptoms occur in children, they usually involve:

·         Delay in normal development

·         Loss of appetite

·         Weight loss

·         Fatigue

·         Irritability

·         Nausea/ vomiting

·         Constipation

·         Hearing loss  

·         Seizures

 These children may also develop mental abnormalities such as difficulty learning, confused behavior, or eating inedible materials like sand.

Pregnant: If a pregnant mother has lead poisoning, it may lead to premature birth, low birth weight, or delayed growth.

 

 Adults: Lead poisoning in adults can present with high blood pressure, headache, abdominal pain, joint and muscle issues, reduced sperm count, and mood irregularities. 

Diagnosis

Lead poisoning is detected by performing a blood lead test. Before this test, your doctor will ask for a brief medical history and may perform a physical examination to notice the possible symptoms. A blood sample is then taken and sent to a lab to detect the presence of lead. No amount of lead is safe at any time. But generally, an amount of 5 mcg/dL is considered unsafe for children. Infants and young children should undergo lead screening during routine checkups. Even if a child or adult appears healthy, it is possible that they may be carrying some amount of lead in their blood, especially if their living environment includes lead products. It is beneficial to get tested early and get appropriate treatment.

Differential Diagnosis

Certain symptoms of lead poisoning can be confused with other medical conditions. Lead poisoning should be differentiated from other conditions like megaloblastic anemia, Guillain–Barré syndrome, carpal tunnel syndrome, renal colic, pancreatitis, gastroenteritis, appendicitis, encephalitis, iron deficiency, and certain mental disorders such as autism, Down’s syndrome, etc.

Treatment

The first step toward treating lead poisoning is to remove the source of contamination. If your walls are covered in lead-based paints, it is better to seal off the old paint. Get help from your local health department to remove all possible causes of lead poisoning. Without eliminating the cause, you might be at risk again even after treatment.

 

A low level of lead poisoning in children or adults is treated by removing the possible cause. No other medication is required. The level of lead in blood declines on its own over time. If the level of lead exceeds 45 mcg/dL, chelation therapy is used to treat lead poisoning. In this method, a chemical agent is injected into your body which binds with the lead in your blood. This lead can then be excreted from your body via urine. Chelating agents are DMSA or EDTA. EDTA is not recommended in children because of its potent side effects.

Medication

Apart from chelating agents, no other medication is required in the treatment of lead poisoning. Any medication used for symptomatic care should be taken after consultation with your doctor, especially in the case of young children. 

Prognosis

The prognosis of lead poisoning depends on the amount and duration of exposure. Even with treatment, if a child develops neurological abnormalities, it is hard to reverse that. Early detection and treatment can prevent severe complications. 

Prevention

Lead poisoning can be prevented by limiting exposure to lead-based products. Special care should be taken if you have children at home. Keep your house clean and free of dust as much as possible. Any part of the wall with deteriorated paint should be corrected. Wash your own and your children’s hands before eating or drinking. Do not use hot water immediately if you have lead pipes at home. Let cold water flow through it once before using warm or hot water.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 24, 2023.

References

Lead poisoning (who.int)

https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health

Lead poisoning | NHS inform

https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/lead-poisoning