Nurses Toolbox : Lead Poisoning
Lead Poisoning Diagnosis, Treatment, and Avoidance
Lead is a naturally occurring mineral that is still found in many products made today such as batteries, pipes, pottery, roofing material and some cosmetics. The United States has taken steps to remove sources of lead including banning lead in paints in 1978 and in food can solders in 1995 but many countries still use lead in the manufacturing of cribs, high-chairs and toys. Nurses can help to educate their communities about the dangers of Lead Poisoning – the message we give should be “ there is no safe level of lead “.
What is it : poisoning caused by exposure to lead in the environment over many months or years.
Who is at risk : Infants and young children are more likely to be exposed as they may chew on paint chips and any lead dust may get on their hands. Lead absorbs easier and does more harm in young children than it does in adults. Those living in houses built before the 1970s are more at risk because older homes often retain remnants of lead-based paint. Working with stained glass can increase your risk due to the use of lead solder. Refinishing old furniture can also uncover layers of lead paint.
Cause : Lead poisoning occurs when you absorb too much lead by breathing or swallowing a substance with lead in it, such as food, dust, paint, or water.
How It’s Diagnosed : Poisoning can be determined by a number of tests. Blood film examination may reveal basophilic stippling of red blood cells. Lead levels in the blood are an indicator mainly of recent or current lead exposure, not of total body burden. Lead in bones can be measured noninvasively by X-ray fluorescence; this may be the best measure of cumulative exposure and total body burden.
The current reference range for acceptable blood lead concentrations in healthy persons without excessive exposure to environmental sources of lead is less than 5 µg/dL for children and 10 µg/dL in adults as recommended by the National Institute for Occupational Safety and Health (CDC/NIOSH).
Symptoms and Complications : Symptoms in children can include developmental delay, learning difficulties, irritability, loss of appetite, weight loss, sluggishness and fatigue, abdominal pain, vomiting, constipation, hearing loss. In Newborns, lead poisoning can cause learning difficulties and slowed growth.
Adults who have been exposed to lead poisoning can experience high blood pressure, abdominal pain, constipation, joint pains, muscle pain, decline in mental functioning, pain, numbness or tingling of the extremities, headache, memory loss, mood disorders, reduced sperm count, abnormal sperm, miscarriage or premature birth in pregnant women.
Treatment : One mainstay of treatment is called chelation therapy. A chelating agent is a molecule with at least two negatively charged groups that allow it to form complexes with metal ions with multiple positive charges, such as lead. EDTA therapy is a chelating agent used for treatment for adults with lead levels higher than 45 mcg/dL. The chemical name for EDTA is Ethylenediaminetetraacetic acid.
Prevention : Washing children’s hands and toys regularly reduce the hand-to-mouth transfer of contaminated dust or soil. Cleaning dusty surfaces with a wet mop. Running cold water for at least a minute if you have older plumbing containing lead pipes or fittings and avoid the use of hot tap water to make baby formula or for cooking. Eating a healthy diet may lower lead absorption.
Did you know ? Even one chip of heavily leaded paint can cause lead poisoning if swallowed.