Lead Poisoning
● Lead is a heavy metal. It is sometimes found free in nature, it is not considered to be a rare element since it is easily mined and refined.
● The main environmental source of Lead is Gasoline. Also, through drinking water from lead pipes, chewing lead paints on toys.
● It is used in Storage batteries, glass manufacture, shipbuilding, printing and potteries, rubber industry.
● Body store:150 to 400mg (blood level- 25μg/100ml). Clinical symptoms- >70μg/100ml in blood. Normal adults ingest-0.2 to 0.3mg of lead/day.
What is Lead poisoning?
- Lead poisoning is a medical condition caused by elevated levels of the heavy metal lead in the body, and this can interrupt a variety of body processes and causes toxicity to many organs and tissues.
- It is also called plumbism, colica Pictonum or Saturnism.
Classification:
- Depends on:
1- Lead content in blood and tissues.
2- The time of exposure.
- Lead poisoning may be acute or chronic.
● Acute poisoning:
- Neurological signs are pain, muscle weakness.
-Gastrointestinal problems, such as diarrhea, loss of appetite, or weight loss.
- Absorption of large amounts of lead in a short time can cause shock and hemolysis.
- Kidney damage can cause changes in urination, such as decreased urine output.
● Chronic poisoning:
- There are three main types of symptoms: gastrointestinal, neuromuscular, and neurological symptoms.
- Signs of chronic contacts are short-term memory loss, depression, nausea, abdominal pain, loss of coordination, and numbness and tingling of the limbs.
How can humans be exposed to lead?
1- Occupational exposure: is the main cause of lead poisoning in adults, as in lead miners and smelters, plumbers glass manufacturers, construction workers.
2- Paints: is the main cause of lead poisoning in children. Many children display pica, so even a small amount of lead-containing products can contain hundreds of milligrams of lead.
3- Soil: is the main cause of lead poisoning in agricultural areas. By eating food grown in contaminated soil.
4- Water: Lead from the soil or atmosphere can end up in surface water and groundwater. It is also potentially in drinking water.
5- Lead comprises products: Like plastic toys, bottles, cans.
Who is at high risk?
- All children under 6 years old.
- People living in old houses.
- People work in industries.
Pathophysiology:
- Can absorb lead through direct contact Mouth, nose and eyes, and through the skin. Organic lead can be absorbed through the skin to a certain extent, while the main source of inorganic lead absorption is through ingestion and inhalation.
- The main body compartment for storing lead is Blood, soft tissue, and bone; half-life of lead These tissues need several weeks of blood measurement, months for soft tissues, for bones, it takes years.
The lead in bones, teeth, hair, and nails is tightly bound, and other tissues cannot be used and are generally considered harmless.
- In adults, 94% of absorbed lead is stored in
the bones and teeth, while children only store 70%, This fact may partly explain the more serious impact on children’s health. Many other tissues that store lead are the brain, spleen, kidneys, liver, and lungs.
It is slowly removed from the body mainly through urine. Feces, hair, nails, and sweat also eliminate small amounts of lead.
1- Lead also interferes with DNA transcription, enzymes that help vitamin D synthesis, and enzymes that maintain the integrity of cell membranes.
2- Lead interferes with the metabolism of bones and teeth.
3- Lead changes blood vessel permeability and collagen synthesis
4- Lead may also be harmful to the developing immune system, causing the production of excessive inflammatory proteins.
5- Lead exposure has also been associated with a decrease in the activity of immune cells such as PMN leukocytes.
6- Lead also restrict the normal metabolism of
calcium in cells and causes it to accumulate.
7- Lead also inhibits the enzyme ferrochelatase, and in turn inhibits RBC synthesis and causes anemia.
8- Lead interferes with the release of the neurotransmitter glutamate, which is an important neurotransmitter in many functions, including learning.
-The main signs and symptoms of adults are:
1- Headache
2-memory loss
3- male reproductive problems
4- weakness, pain in the extremities
5- malaise
6- problems with sleep.
1- loss of appetite
2- vomiting
3- weight loss
4- constipation
5- anemia
6- Irritability
7- learning disabilities
8- behavior problems.
9- Children may also experience hearing loss, delayed growth, drowsiness, clumsiness, or loss of new abilities, especially speaking skills.
- Nephropathy and may cause Fanconi syndrome.
- Hypertension, coronary heart disease, heart rate variability, and stroke death.
- Reduce sperm count and changes in the volume of sperm, their motility, and their morphology.
- A pregnant woman's elevated blood lead level
can lead to miscarriage, prematurity, low
birth weight.
- Nervous system: Lead affects the peripheral
nervous system (especially motor nerves) and
the central nervous system.
- Lead also causes bone and teeth decay.
◦The anemia is hypochromic or hemolytic and BM show ring sideroblasts and free erythrocytes protoporphyrin are raised.
◦ Blood film examination may reveal basophilic stippling of red blood cells.
The harmful effects of lead:
1- Lead also interferes with DNA transcription, enzymes that help vitamin D synthesis, and enzymes that maintain the integrity of cell membranes.
2- Lead interferes with the metabolism of bones and teeth.
3- Lead changes blood vessel permeability and collagen synthesis
4- Lead may also be harmful to the developing immune system, causing the production of excessive inflammatory proteins.
5- Lead exposure has also been associated with a decrease in the activity of immune cells such as PMN leukocytes.
6- Lead also restrict the normal metabolism of
calcium in cells and causes it to accumulate.
7- Lead also inhibits the enzyme ferrochelatase, and in turn inhibits RBC synthesis and causes anemia.
8- Lead interferes with the release of the neurotransmitter glutamate, which is an important neurotransmitter in many functions, including learning.
Signs and symptoms:
-The main signs and symptoms of adults are:
1- Headache
2-memory loss
3- male reproductive problems
4- weakness, pain in the extremities
5- malaise
6- problems with sleep.
- The typical signs and symptoms of children are:
1- loss of appetite
2- vomiting
3- weight loss
4- constipation
5- anemia
6- Irritability
7- learning disabilities
8- behavior problems.
9- Children may also experience hearing loss, delayed growth, drowsiness, clumsiness, or loss of new abilities, especially speaking skills.
Complications:
- Nephropathy and may cause Fanconi syndrome.
- Hypertension, coronary heart disease, heart rate variability, and stroke death.
- Reduce sperm count and changes in the volume of sperm, their motility, and their morphology.
- A pregnant woman's elevated blood lead level
can lead to miscarriage, prematurity, low
birth weight.
- Nervous system: Lead affects the peripheral
nervous system (especially motor nerves) and
the central nervous system.
- Lead also causes bone and teeth decay.
Diagnosis:
◦The anemia is hypochromic or hemolytic and BM show ring sideroblasts and free erythrocytes protoporphyrin are raised.
◦ Blood film examination may reveal basophilic stippling of red blood cells.
◦ Examination of hair, nails are also introduced.
◦ Fecal and urine examination.
Treatment
- The treatment of lead poisoning begins by eliminating the source of lead and providing balanced nutrition.
- Chelating agents should be used for severe lead poisoning.
- Ethylenediaminetetraacetic acid (EDTA).
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