Lead Poisoning (Plumbism)

Lead Toxicity

What is lead poisoning? — Lead poisoning is a serious medical problem that mostly affects children. It happens when too much lead gets into a person's body.
Lead poisoning can damage the brain, kidneys, and other organs. In children, lead poisoning can cause learning and memory problems that can never be fixed.
Lead is a metal, so people think of it as something that you find only in pipes or other metal objects. The truth is, lead can be found in all kinds of things, including dust, wall paint, old toys or toys that came from outside the US, pottery, soil, and even drinking water.
How can a person get lead poisoning? — That depends on whether the person is a child or an adult.
A child can get lead poisoning in a few different ways:
The child can swallow or inhale lead in dust. House paint used to be made with lead in it. Many old houses still have that paint. As the paint slowly chips or peels, lead can get into dust. Young children often end up eating that dust, because they get it on their hands and then put their hands in their mouth. Children can also get very sick if they eat peeling paint that has lead in it. Children who live in homes built before 1978 are at especially high risk of getting lead poisoning this way.
The child can swallow lead in water or food. The pipes in some homes have lead in them, so lead can get into water that way. Foods can get lead in them if they are stored in certain types of cans or if they have certain spices. Foods made in countries besides the US are more likely to have lead in them than those made in the US.
The child can chew or suck on toys, jewelry, or other products that have lead in them. This does not happen often, but toys imported from countries besides the US sometimes have lead in them.
In adults, lead poisoning is less common than it is in children. That's because the body develops a natural way to protect itself from lead as it gets older. Even so, adults can get lead poisoning if they have a job or a hobby that involves using materials that have lead. For example, adults can get lead poisoning if they:
Work with lead paint (painting bridges or boats, for example)
Are exposed to lead fumes (because they work in battery recycling or in a plant that processes lead, for example)
Make ceramics or stained glass
Remodel their home and there is lead in the paint that was used when the home was built
What are the symptoms of lead poisoning? — Most young children with lead poisoning have no symptoms. That is why it's so important to screen children at risk for lead poisoning (such as those living in houses built before 1978). When symptoms occur, they vary depending on how much lead a person is exposed to.
In general, a child with symptoms might:
Feel tired
Have a stomach ache
Feel constipated
Feel irritable
Vomit
Is there a test for lead poisoning? — Yes. There are blood tests that measure the amount of lead in a person's body. You should ask your child's doctor if your child needs to be screened for lead poisoning.
How is lead poisoning treated? — The most important "treatment" for lead poisoning is to get rid of the source of the lead. For example, if a child got lead poisoning from paint dust in his or her home, then a professional should remove all the lead paint (called "lead abatement") from the child's home. If that is not possible, the child should move to a new home that is lead-free. Both options are complicated and expensive. But the only way to fully protect a child is to remove the source of lead from his or her surroundings.
If the child lives in a rented home, the person who owns the home might be responsible for removing the lead.
For people with very high levels of lead, doctors sometimes suggest a treatment called "chelation" therapy. This involves taking a medicine that helps pull lead out of the body. The medicine can be given through a thin tube that goes into a vein called an "IV," in pills, or in a shot. But doctors can give this medicine only if they are sure that the person is no longer being exposed to lead. If the person is still being exposed to lead, the medicine can actually make lead poisoning worse. Plus, chelation does not prevent or undo the long-term effects of lead on learning and intelligence.
Can lead poisoning be prevented? — Yes. The most important thing you can do to prevent lead poisoning is to avoid exposure to lead in paint (table 1), soil (table 2), and other sources (table 3). If you know there is lead in your home, it's also important to clean your house the right way (table 4).
If you decide to have lead removed from your home, make sure to hire a contractor who is "certified in lead abatement." These are contractors who know how to remove lead safely. They also know how to protect your family and the things inside your home while the work is being done.
Another way to prevent or reduce the effects of lead poisoning is to eat a diet rich in calcium, vitamin D, vitamin C, and iron. Good food choices include milk, yogurt, fortified cereals, fish, lean meats, oranges, and tomatoes. Plus, children should get a multivitamin with iron every day. (Check with your doctor or pharmacist about which multivitamin is right for your child.)
What if I am pregnant? — If you are pregnant and have been told you have lead levels that are too high, you might need treatment. Make sure that your baby's doctor knows the levels of lead in your body. Even tiny amounts of lead can cause serious problems for a baby.
If you have lead poisoning, the blood from your baby's umbilical cord should be tested at birth, or your baby should have a lead test within 2 weeks of being born.
If you have lead poisoning, do not breastfeed unless your doctor tells you it is safe. If you are able to breastfeed, you and your baby will need blood tests to make sure that your baby's lead level does not get any higher.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16244 Version 6.0
Release: 28.2.2 - C28.105
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