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lead poisoning

Alternative Names 
lead toxicity, plumbism

Definition
Lead is a metal found in the environment. If a person is exposed to large amounts of lead, poisoning may occur.

What is going on in the body? 
Lead is not natural within the body and is not required in the diet. Because of technology, however, lead exposure has become fairly common. This exposure can lead to increased levels of lead in the body, which may cause harm.

What are the signs and symptoms of the condition? 
The symptoms of lead poisoning can vary widely. The effects of lead poisoning depend on the person's age, the amount of lead in the body, and how long the exposure has been going on. Lead poisoning is called acute if the exposure happens quickly. Chronic exposure occurs over weeks or months.

Both types of poisoning are harmful, but the symptoms tend to be slightly different. Acute or sudden poisoning may cause: Chronic or slow poisoning may cause:
  • gradual changes in behaviour, such as a child who becomes hyperactive
  • decreased school performance
  • intelligence problems and memory loss
  • occasional abdominal distress
  • paralysis of the hands or feet, which usually only occurs in adults
  • fatigue
  • joint pain
  • anaemia, or low red blood cell counts
  • kidney damage
  • a bluish-black line at the area where the teeth and gums meet
What are the causes and risks of the condition? 
A person can be exposed to lead from the following sources:
  • leaded petrol
  • car exhaust
  • paint made before lead was removed
  • industrial lead exposure
  • burning batteries
  • poorly glazed ceramic objects, which may be used to store beverages
The people most commonly affected by lead poisoning are children. Children who live in old buildings with lead paint that is peeling or dissolving are at high risk. Lead dust or paint chips from lead paints may be breathed into the lungs or eaten.

Though quite rare today, severe lead poisoning can cause death. Other risks are the long-term damage lead poisoning may cause in the brain, nerves, and kidneys.

What can be done to prevent the condition? 
  • mandated increased use of unleaded petrol
  • mandated better car emission standards
  • ban lead paint
These three measures have drastically reduced the number of cases of lead poisoning.

Avoiding exposure to lead is the most important prevention. People living in older buildings with peeling lead paint need to have their home or apartment repaired. People working in manufacturing should ask about possible lead exposure. Batteries should not be burned.

Some experts recommend a blood test to screen for lead poisoning in all children. A doctor can determine whether testing is needed for an individual child. Testing is normally started between 6 and 12 months of age.

If homes are being renovated which contain lead paint, it is recommened that the family find alternative accommodation until the paint is removed.

How is the condition diagnosed? 
The history and physical examination may make a doctor suspect lead poisoning. A blood test is commonly used to diagnose lead poisoning. This test can detect the level of lead in the blood.

What are the long-term effects of the condition? 
The most common long-term effect of lead poisoning is mild brain damage. This damage may be permanent and generally affects children, whose brains are still developing. Behaviour problems, emotional problems, and lowered intelligence may all occur.

Kidney damage, nerve damage that may cause paralysis, and even death may also occur.

What are the risks to others? 
Lead poisoning is not contagious and poses no risks to others.

What are the treatments for the condition? 
The most important treatment is stopping the source of lead exposure. For more severe poisoning, medications may be needed to help remove lead from the body. Chelation is a procedure that helps bind the lead and remove it from the body. Life-threatening lead poisoning, which is rare, requires treatment in a hospital.

What are the side effects of the treatments? 
Stopping lead exposure may involve major life changes and expense. For example, changing jobs, moving, or repairing the home or apartment may be needed.

All medications have side effects. The medications used to decrease lead in the body may cause allergic reactions and stomach upset. Other side effects depend on the specific medication used.

What happens after treatment for the condition? 
If caught early and treated correctly, lead poisoning may require no further treatment. Continued monitoring is advised in all cases, however. If caught late or not treated, the lead poisoning may cause permanent body damage. This may require ongoing treatment, such as psychiatric care.

How is the condition monitored? 
Repeat blood tests are used to follow the lead level until it is normal. Other monitoring depends on whether the body has been harmed in some way.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request
 


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