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- Lead has multiple mechanisms of toxicity:
- Binds sulfhydryl groups and affects multiple enzymatic processes
- Resembles Ca2+ thereby interfering with Ca2+-dependent processes, such as cell signaling
- May have mutagenic potential and play a role in human carcinogenesis
- Up to 99% of lead is bound to erythrocytes after initial absorption.
- Ultimately redistributed into bone:
- 95% of total body lead in adults
- 70% of total body lead in children
- High lead levels in the serum compromise the blood–brain barrier and result in lead entry into the CNS and neurotoxicity.
- Often coexists with iron deficiency; this allows for increased lead absorption in the gut.
- Impairs heme synthesis, leading to elevated free erythrocyte protoporphyrin (FEP); these complex with zinc, resulting in elevated zinc protoporphyrin (ZPP).
- Levels correlate poorly with symptoms:
- Associated with drops in intelligence quotient (IQ) and increase in violent behavior
- Acute toxicity:
- Most often due to inhalation of an environmental source or ingestion of substance containing lead
- Pottery glaze
- Certain folk remedies
- Home-distilled alcoholic beverages
- Lead dust from ammunition and primer
- Chronic toxicity:
- Occupational exposures (usually via inhalation):
- Battery manufacturing/recycling
- Bridge painting
- Construction workers
- Electronic waste recycling
- Firing range instructors
- Mining and smelting
- Pottery workers
- Home exposures (pediatric poisoning):
- Lead-based paint inhalation/ingestion from toys and walls
- Contaminated water from old pipes
- Lead dust from the clothing of a parent exposed at work
- Imported foods
- Folk medicines
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