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Lead Poisoning

Topic Overview

What is lead poisoning?

Lead poisoning occurs when you absorb too much lead by breathing or swallowing a substance with lead in it, such as paint, dust, water, or food. Lead can damage almost every organ system.

In children, too much lead in the body can cause lasting problems with growth and development. These can affect behavior, hearing, and learning and can slow the child's growth.

In adults, lead poisoning can damage the brain and nervous system, the stomach, and the kidneys. It can also cause high blood pressure and other health problems.

Although it isn't normal to have lead in your body, a small amount is present in most people. Environmental laws have reduced lead exposure in the United States, but it is still a health risk, especially for young children. It is estimated that lead poisoning affects about 310,000 children in the U.S.1

What causes lead poisoning?

Lead poisoning is usually caused by months or years of exposure to small amounts of lead at home, work, or day care. It can also happen very quickly with exposure to a large amount of lead. Many things can contain or be contaminated with lead: paint, air, water, soil, food, and manufactured goods.

The most common source of lead exposure for children is lead-based paint and the dust and soil that are contaminated by it. This can be a problem in older homes and buildings. Toys and jewelry made in other countries can sometimes contain high lead levels. For a list of recalled products, see the Consumer Product Safety Commission website at www.cpsc.gov.

Adults are most often exposed to lead at work or while doing hobbies that involve lead.

Who is at highest risk of lead poisoning?

Lead poisoning can occur at any age, but children are most likely to be affected by high lead levels. Children at highest risk include those who:

  • Live in or regularly visit homes or buildings built before 1978. These buildings may have lead-based paint. The risk is even higher in buildings built before 1950, when lead-based paint was more commonly used.
  • Are immigrants, refugees, or adoptees from other countries.2 They may have been exposed to higher lead levels in these countries.
  • Are 6 years old or younger. Young children are at higher risk because:
    • They often put their hands and objects in their mouths.
    • They sometimes swallow nonfood items.
    • Their bodies absorb lead at a higher rate.
    • Their brains are developing quickly.

Others at risk for lead poisoning include people who:

  • Drink water that flows through pipes that were soldered with lead.
  • Work with lead either in their job or as a hobby (for example, metal smelters, pottery makers, and stained glass artists).
  • Eat food from cans made with lead solder. These types of cans aren't made in the United States.
  • Cook or store food in ceramic containers. Some ceramic glaze contains lead that may not have been properly fired or cured.
  • Eat or breathe traditional or folk remedies that contain lead, such as some herbs and vitamins from other countries.
  • Live in communities with a lot of industrial pollution.

What are the symptoms?

You may not notice any symptoms at first. The effects are easy to miss and may seem related to other conditions.

In children, symptoms can include:

  • Slightly lower intelligence and smaller size compared to children of the same age.
  • Behavior problems, such as acting angry, moody, or hyperactive.
  • Learning problems.
  • Lack of energy, and not feeling hungry.

In adults, lead poisoning can cause:

  • Changes in behavior, mood, personality, and sleep patterns.
  • Memory loss and trouble thinking clearly.
  • Weakness and muscle problems.
  • Headaches.

Severe cases can cause seizures, paralysis, and coma.

How is lead poisoning diagnosed?

The doctor will ask questions and do a physical exam to look for signs of lead poisoning. If your doctor suspects lead poisoning, he or she will do a blood test to find out the amount of lead in the blood.

Diagnosing lead poisoning is difficult, because the symptoms can be caused by many diseases. Most children with lead poisoning don't have symptoms until their blood lead levels are very high.

In the United States, there are screening programs to check lead levels in children who are likely to be exposed to lead. Whether your child needs to be tested depends in part on where you live, how old your housing is, and other risk factors. Talk to your child's doctor about whether your child is at risk and should be screened.

Adults usually aren't screened for lead poisoning unless they have a job that involves working with lead. For these workers, companies usually are required to provide testing.

If you are pregnant or trying to get pregnant and have a family member who works with lead, you may want to ask your doctor about your risk for lead poisoning. But in general, experts don't recommend routine testing for lead in pregnant women who don't have symptoms.3

How is it treated?

Treatment for lead poisoning includes removing the source of lead, getting good nutrition, and, in some cases, having chelation therapy.

Removing the source of lead. Old paint chips and dirt are the most common sources of lead in the home. Lead-based paint, and the dirt and dust that come along with it, should be removed by professionals. In the workplace, removal usually means removing lead dust that's in the air and making sure that people don't bring contaminated dust or dirt on their clothing into their homes or other places.

Good nutrition. Eating foods that have enough iron and other vitamins and minerals may be enough to reduce lead levels in the body. A person who eats a balanced, nutritious diet may absorb less lead than someone with a poor diet.

Chelation therapy. If removing the lead source and getting good nutrition don't work, or if lead levels are very high, you may need to take chelating medicines. These medicines bind to lead in the body and help remove it.

If blood lead levels don't come down with treatment, home and work areas may need to be rechecked. Call your local health department to see what inspection services are offered in your area.

The best way to avoid lead poisoning is to prevent it. Treatment cannot reverse any damage that has already occurred. But there are many ways to reduce your exposure—and your child's—before it causes symptoms.

Other Places To Get Help

Organizations

Centers for Disease Control and Prevention (CDC): National Center for Environmental Health, Childhood Lead Poisoning Prevention Program
1600 Clifton Road
Atlanta, GA  30333
Phone: 1-800-232-4636 (1-800-CDC-INFO)
TDD: 1-888-232-6348
Email: cdcinfo@cdc.gov
Web Address: www.cdc.gov/nceh/lead
 

The latest information on childhood lead poisoning is available on this Web site.

KidsHealth for Parents, Children, and Teens
10140 Centurion Parkway North
Jacksonville, FL  32256
Phone: (904) 697-4100
Fax: (904) 697-4220
Web Address: www.kidshealth.org
 

This website is sponsored by the Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This website offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly emails about your area of interest.

National Library of Medicine: ToxTown
8600 Rockville Pike
Bethesda, MD  20894
Phone: 1-888-FIND-NLM (1-888-346-3656)
Email: tehip@teh.nlm.nih.gov
Web Address: http://toxtown.nlm.nih.gov
 

The ToxTown website gives you information about toxic chemicals and environmental health risks that you might encounter in everyday life. It provides facts on everyday places where toxic chemicals may be found, and it gives information about how the environment can affect health. ToxTown includes common environmental hazards in towns, cities, farms, and U.S.-Mexico border communities. The site is interactive and very user-friendly. You click on simple graphics to be directed to specific information that you are interested in learning about.

Occupational Safety and Health Administration (OSHA), U.S. Department of Labor
200 Constitution Avenue NW
Washington, DC  20210
Phone: 1-800-321-OSHA (1-800-321-6742)
TDD: 1-877-889-5627 toll-free
Web Address: www.osha.gov
 

The Occupational Safety and Health Administration (OSHA) provides information about hazards at the workplace and about worker safety.

U.S. Environmental Protection Agency: Lead in Paint, Dust, and Soil
422 South Clinton Avenue
Rochester, NY  14620
Phone: 1-800-424-LEAD (1-800-424-5323)
Fax: (585) 232-3111
Web Address: www.epa.gov/lead/index.html
 

From this Web site, you can get information about lead poisoning, lead exposure, local resources, and lead testing. You can also link to National Lead Information Center information about lead hazards and their prevention.

References

Citations

  1. U.S. Centers for Disease Control (2005). Blood lead levels—United States, 1999–2002. MMWR, 54(20): 513–516. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5420a5.htm.
  2. Committee on Environmental Health, American Academy of Pediatrics (2005, reaffirmed 2009). Lead exposure in children: Prevention, detection, and management. Pediatrics, 116: 1036–1046. Also available online: http://www.pediatrics.org/cgi/content/full/116/4/1036.
  3. U.S. Preventive Services Task Force (2006). Screening for elevated blood lead levels in children and pregnant women. Available online: http://www.ahrq.gov/clinic/uspstf/uspslead.htm.

Other Works Consulted

  • Woolf AD, et al. (2007). Update on the clinical management of childhood lead poisoning. Pediatric Clinics of North America, 54(2): 271–294.
  • Binns HJ, et al. (2007). Interpreting and managing blood lead levels of less than 10 mcg/dL in children and reducing childhood exposure to lead: Recommendations of the Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention. Pediatrics, 120(5): e1285–e1298.
  • Centers for Disease Control and Prevention (2002). Managing elevated blood lead levels among young children: Recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention. Available online: http://www.cdc.gov/nceh/lead/CaseManagement/caseManage_main.htm.
  • Centers for Disease Control and Prevention (2005). Preventing lead poisoning in young children. Available online: http://www.cdc.gov/nceh/lead/publications/prevleadpoisoning.pdf.
  • Grandjean P (2008). Lead section of Health significance of metal exposures. In RB Wallace, ed., Wallace/Maxcy-Rosenau-Last Public Health and Preventive Medicine, 15th ed., pp. 609–611. New York: McGraw-Hill.
  • Henretig FM (2009). Lead section of Toxins. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 319–321. Philadelphia: Saunders Elsevier.
  • Kemper AR, et al. (2005). Follow-up testing among children with elevated screening blood lead levels. JAMA, 293(18): 2232–2237.
  • Markowitz M (2007). Lead poisoning. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 2913–2918. Philadelphia: Saunders Elsevier.
  • McGuigan MA (2008). Lead section of Chronic poisoning: Trace metals and others. In L Goldman, D Ausiello, eds., Cecil Medicine, 23rd ed., pp. 102–103. Philadelphia: Saunders Elsevier.
  • Needleman HL (2006). Lead poisoning. In JA McMillan et al., eds., Oski's Pediatrics: Principles and Practice, 4th ed., chap. 123, pp. 767–772. Philadelphia: Lippincott Williams and Wilkins.
  • Olson KR (2010). Lead section of Poisoning. In SJ McPhee, MA Papadakis, eds., Current Medical Diagnosis and Treatment 2010, 49th ed., p. 1438. New York: McGraw-Hill.
  • Shannon MW (2007). Lead. In MW Shannon et al., eds., Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose, 4th ed., pp. 1129–1146. Philadelphia: Saunders Elsevier.
  • Woolfenden YB, et al. (2008). Household interventions for prevention of domestic lead exposure in children. Cochrane Database of Systematic Reviews (2).

Credits

By Healthwise Staff
Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer R. Steven Tharratt, MD, MPVM, FACP, FCCP - Pulmonology, Critical Care Medicine, Medical Toxicology
Last Revised July 11, 2011

Last Revised: July 11, 2011

Author: Healthwise Staff

Medical Review: Susan C. Kim, MD - Pediatrics & Adam Husney, MD - Family Medicine & R. Steven Tharratt, MD, MPVM, FACP, FCCP - Pulmonology, Critical Care Medicine, Medical Toxicology

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