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 who live in or are frequent visitors to deteriorated housing
Children who live near lead smelters, battery-recycling plants
Children whose parents or other family members have a lead-related occupation or hobby
In children, blood lead levels of:
9 ug/dL or less: not considered to be lead poisoned
10-14 ug/dL: need to be rescreened
15-19 ug/dL: nutritional and educational interventions and frequent screening
20-44 ug/dL: need pharmacologic treatment.
45-69 ug/dL: medical and environmental intervention, chelation therapy
70 ug/dL or more: medical emergency
Microcytic anemia with basophiloic strippling may be present.
Elevated free erythrocyte protoporphyrin
Maintain airway
Chelation therapy in cases of blood level 70 ug/dL or more
Symptomatic poisoning:
Chelation therapy with calcium EDTA and BAL
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.
Moderate toxicity -- edetate calcium disodium intravenously or dimercaptosuccinic acid
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.
