Lead Poisoning
Basics
Description
Description
- 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
- Distribution:
- 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
Etiology
Etiology
- Acute toxicity:
- Most often due to inhalation of an environmental source or ingestion of substance containing lead
- Pottery glaze
- Certain folk remedies
- Cosmetics
- Jewelry
- Weights
- Home-distilled alcoholic beverages
- Lead dust from ammunition and primer
- Most often due to inhalation of an environmental source or ingestion of substance containing lead
- Chronic toxicity:
- Occupational exposures (usually via inhalation):
- Battery manufacturing/recycling
- Bridge painting
- Construction workers
- De-leading
- Electronic waste recycling
- Firing range instructors
- Mining and smelting
- Pottery workers
- Welders
- 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
- Occupational exposures (usually via inhalation):
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Citation
Schaider, Jeffrey J., et al., editors. "Lead Poisoning." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307146/all/Lead_Poisoning.
Lead Poisoning. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307146/all/Lead_Poisoning. Accessed December 10, 2024.
Lead Poisoning. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307146/all/Lead_Poisoning
Lead Poisoning [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 10]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307146/all/Lead_Poisoning.
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