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Lead Poisoning

more about Lead Poisoning

  • Lead is found in multiple products including paints, pottery, storage batteries, solder, gasoline, plumbing supplies, and some traditional medications.  Lead poisoning usually occurs from repeated exposure over time.  Lead interferes with blood cell formation, affects the nervous system and gastrointestinal tract.  Acute poisoning occurs when an object containing lead is consumed (such as a fishing weight).

  • Children may be asymptomatic
  • Mild-to-moderate poisoning:
    1. Headache
    2. Irritability
    3. Abdominal pain
    4. Constipation
    5. Wrist drop
    6. Learning problems, behavioral problems
    7. Lack or energy, fatigue
    8. Poor appetite
    9. Vomiting 
  • Severe poisoning
  • Irregularity of muscular action
  • Impaired muscular action
  • Change of consciousness
    1. Seizure
    2. Coma

  • Exposure to:
    1. Paint on the window wells and sills 
    2. Soil and dust
    3. Air pollution (lead removed from gasoline)
    4. Imported ceramic object
    5. Eye cosmetics
    6. Water contaminated with lead
    7. Food containing lead

  • In children, blood lead levels of:
    1. 9 ug/dL or less: not considered to be lead poisoned
    2. 10-14 ug/dL: need to be rescreened
    3. 15-19 ug/dL: nutritional and educational interventions and frequent screening
    4. 20-44 ug/dL: need pharmacologic treatment.
    5. 45-69 ug/dL: medical and environmental intervention, chelation therapy
    6. 70 ug/dL or more: medical emergency
  • Microcytic anemia with basophiloic strippling may be present.
  • Elevated free erythrocyte protoporphyrin

  • High-risk children:
    1. Children who live in or are frequent visitors to deteriorated housing
    2. Children who live near lead smelters, battery-recycling plants
    3. Children whose parents or other family members have a lead-related occupation or hobby

  • Maintain airway
  • Chelation therapy in cases of blood level 70 ug/dL or more
  • Symptomatic poisoning:
    1. Chelation therapy with calcium EDTA and BAL
    2. Acute poisoning (e.g., swallowed a fishing weight) -- induce Diarrhea, irrigate bowel, administer endoscopy or surgery to remove the object.  This will prevent further absorption.
    3. Moderate toxicity -- edetate calcium disodium intravenously or dimercaptosuccinic acid
    4. Severe toxicity -- administer edetate calcium disodium intravenously; some physicians will also add Dimercaprol intramuscularly.

  • Lead sources at work should be investigated.
  • Homes should be evaluated for lead-based paints.  If found, this should be removed and replaced.
  • Note: it is against the law for employed workers who have lead exposure at work to be treated with medications just to keep the lead levels in their blood down.  The source of the lead toxicity must be removed from the work place.
  • Screening test for high-risk children:
    1. Start at 6 months of age
    2. Every 6 months until age 3
    3. Every 12 months between 3 and 6 years of age.
  • Screening test for lower-risk children:
    1. Start at 12-15 months of age
    2. Repeat at 24 months of age

more about Lead Poisoning

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