Patient education: Lead poisoning (The Basics)

What is lead poisoning? — 

This is a serious medical problem that mostly affects children. It happens when too much lead gets into the body.

Lead poisoning can damage the brain, kidneys, and other organs. In children, lead poisoning can cause permanent learning and memory problems.

Lead is a metal, so people think it is something only found in pipes or other metal objects. But lead can be found in all kinds of things, including:

●Dust (such as at a firing range)

●Wall paint or paint chips

●Old toys

●Curtain or fishing weights

●Some products from outside the US, like some toys, cosmetics, and spices

●Pottery

●Soil

●Some types of gasoline (such as in aviation, racing cars, some farm equipment, and marine engines)

●Some herbal supplements and Ayurvedic medicines

●Living near an industry that works with lead, such as lead battery manufacturing, recycling plants, or gold mines

Even drinking water can sometimes contain lead.

How can a person get lead poisoning? — 

It depends on whether the person is a child or an adult.

A child can get lead poisoning in a few different ways:

●They 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.

●They can swallow lead in water or food. 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.

●They 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.

Lead poisoning is less common in adults than it is in children. 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 (for example, painting bridges or boats)

●Are exposed to lead fumes (for example, because they work in battery recycling or in a plant that processes lead)

●Make ceramics or stained glass

●Remodel their home, and the original paint had lead in it

●Go to firing ranges, or have pieces of a lead bullet in their body

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 was exposed to.

In general, a child with symptoms might:

●Feel tired

●Have a stomach ache

●Feel constipated

●Feel irritable

●Vomit

Many adults who are exposed to lead have no symptoms. But if the amount of lead in the blood gets high enough, they might:

●Feel tired

●Have a stomach ache

●Feel constipated

●Have joint or muscle aches

●Have headaches, trouble concentrating, or trouble remembering things

●Feel irritable or depressed

Is there a test for lead poisoning? — 

Yes. There are blood tests that measure the amount of lead in the body. Ask your child's doctor if your child needs to be screened for lead poisoning.

If you are an adult in the US, depending on your occupation, there might be regulations that require you to be tested or "screened" for lead exposure. Also, if you know you work around lead and have any symptoms, you can ask your doctor to check the lead level in your blood.

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 their home, a professional should remove all the lead paint (called "lead abatement") from the 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 their 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 an IV (a thin tube that goes into a vein), as pills, or as a shot. But doctors only give this medicine if they are sure 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.

If you have a high blood lead level from working around lead, you need to do things to lower your exposure (see below). You should also get another blood test after 1 or more months. Depending on how high the level was, you might need to stay away from the workplace.

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, clean your house the right way (table 4).

If you decide to have lead removed from your home, 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 take a multivitamin with iron every day. (Check with your doctor or pharmacist about which multivitamin is right for your child.)

If you know you work around lead, there are things you can do to protect yourself. For example:

●Use protective equipment (such as respirators).

●Avoid eating or smoking at work.

●Use appropriate hand decontamination (for example, cleaning with special wipes).

●Do not bring home clothing or shoes that might have been exposed to lead.

It is also a good idea to find an occupational or environmental medicine clinician with experience in lead exposure. They can help with finding possible sources of lead, assessing a work site, and suggesting other ways to protect yourself.

What if I am pregnant? — 

If you are pregnant and have been told you have high lead levels, you might need treatment. Make sure your doctor knows the lead levels 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 birth.

If you have lead poisoning, do not breastfeed unless your doctor tells you it is safe. If you can breastfeed, you and your baby will need blood tests to make sure your baby's lead level does not get any higher.

More on this topic

Patient education: Lead levels in adults (The Basics)
Patient education: Lead levels in children (The Basics)
Patient education: Accidental ingestion in children (The Basics)