Lead

What is Lead Poisoning?

girl chipping paint off wall

The Bottom Line

There are many sources of lead poisoning, including environmental and occupational causes. Poisoning is usually due to lead ingestion or inhalation. Lead poisoning causes multi-organ toxicity, especially of the nervous system and kidneys. If lead concentrations in the blood are high, chelating drugs can be given to reduce the burden of lead in the body.

old lead pipes
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What is lead?

Lead is a soft and malleable heavy metal that is either extracted from natural ores or obtained by recycling and smelting scrap lead products. It is used in lead batteries, weights, and radiation shielding. Paints, ceramics, glass, and plastic can contain lead compounds, which act as pigments, stabilizers, and binders. Lead alloys (lead combined with other elements) are found in bullets, solder, and plumbing.

What is lead poisoning? How much lead is toxic? 

Lead poisoning, also known as plumbism, occurs when the amount of lead in the body builds up to toxic concentrations. Ingestion of a large amount (grams) of soluble lead (such as lead chloride and lead acetate) or lead objects (such as curtain or fishing weights) that are retained in the digestive tract can cause acute toxicity, but this is rare. Poisoning is most often caused by chronic exposure to lead over months or years. However, one can argue that any amount of lead in the body is potentially toxic. Young children are very susceptible to lead poisoning, and even relatively low concentrations of lead in the blood can affect a child’s cognitive function.

Causes of lead poisoning: How do you get lead poisoning? 

Poisoning typically occurs from ingestion, inhalation, and—for organic forms of lead (such as tetraethyl and tetramethyl lead)—skin absorption. In the past, major sources of lead included lead-based paints and leaded gasoline. The use of lead in house paint was discontinued in the 1970s, and the addition of tetraethyl lead to gasoline as an antiknock agent was phased out by the mid-1990s. Older homes can still be a source of lead. Children can swallow paint chips or lead-contaminated yard soil, as well as inhale lead dust. Lead plumbing can corrode and release lead into drinking water.

Lead poisoning can be caused by using lead-glazed ceramics for storing food or drinks. Lead can also be found in plastic toys and jewelry. Lead toxicity can occur from swallowing lead foreign bodies, retained bullets, and inhalation of lead at indoor firing ranges. Lead intoxication can be caused by some Ayurvedic, traditional, or folk medications, as well as by some cosmetics and imported foods. Adults might experience occupational exposure to lead in industries such as lead mining and smelting, battery manufacturing, recycling, and other types of manufacturing involving lead.

What are the symptoms of lead poisoning?

Lead poisoning affects many organ systems in the body, including the digestive tract, nervous system (brain and peripheral nerves), heart, kidneys, and blood. Severe lead poisoning can result in death. Lead can cause constipation and abdominal pain known as lead colic. Headache, fatigue, irritability, trouble concentrating, and muscle weakness (especially in the wrist) are nervous system symptoms of lead toxicity. More serious brain effects include lethargy, convulsions, and coma. In children, chronic exposure to lead can lead to decreased intelligence and behavioral and cognitive disorders. Chronic lead exposure can cause hypertension and kidney dysfunction. Lead also causes anemia.

How to treat lead poisoning: Can lead poisoning be cured?

Lead poisoning can be treated with chelating drugs. Some chelators are given by mouth, and others are administered by injection. Chelators bind to lead, forming a compound that can be excreted from the body. This results in the gradual elimination of lead by the kidneys and decreased blood lead concentrations. Use of chelators is recommended based on blood lead concentrations and symptoms. There are no controlled studies proving that chelators “cure” toxicity already caused by lead. The best way to prevent lead poisoning is to eliminate exposure to lead as much as possible.

What should I do if I suspect lead exposure?

If you are concerned about lead exposure and/or the possibility of lead toxicity, contact your doctor, county or state health department, or Poison Control for guidance on whether laboratory evaluation and/or treatment is needed. If someone swallows a substance containing lead, gets lead on the skin, inhales lead, or if you have a question about handling lead safely, help from experts is available from Poison Control at 1-800-222-1222. Poison Control’s expert guidance is always free, confidential, and available 24 hours a day.

 

Wendy Klein-Schwartz, Pharm.D., MPH
Clinical Toxicologist

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Poisoned?

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Prevention Tips

  • Check that imported toys, toy jewelry, and cosmetics do not contain lead.
  • Pay attention to public health alerts and recalls related to lead.
  • Do not store food in lead-glazed ceramic containers.
  • If you live in an old house, have the paint and water tested for lead.
  • Inspect and maintain all painted surfaces in your home.
  • Keep your home clean and dust-free.
  • If you are remodeling, take precautions to avoid lead dust exposure. 
  • If you work with lead, remove contaminated work clothes before entering the house.
  • Do not let children eat soil; wash hands after playing outdoors.

This Really Happened

Case 1. A family was visiting friends who lived in an old house, where their 2-year-old son swallowed a few paint chips. He was still playing and had no symptoms. The parents were concerned about lead toxicity and called Poison Control. They were told that the amount of lead in a few paint chips is low. Since this was a one-time exposure rather than a chronic exposure over months or years, their son would likely be fine.

Case 2. A 6-year-old girl swallowed a lead fishing sinker. Since she had no symptoms initially, her parents waited several hours before calling Poison Control. They were told that their daughter was at risk for lead toxicity and that they should take her to an emergency room (ER). In the ER, the girl complained of mild abdominal pain. An x-ray showed the fishing sinker beyond the stomach and in the intestine. Poison Control recommended giving a large volume of polyethylene glycol electrolyte solution to flush the sinker out of the girl’s digestive tract. Blood was drawn to measure her blood lead concentration. Several hours later, the sinker was flushed out. Her blood lead concentration was elevated, so the girl was treated as an outpatient with an oral chelator for several weeks until her blood lead concentration decreased significantly.

For More Information

Childhood lead poisoning prevention guidelines and recommendations. US Centers for Disease Control and Prevention. Accessed August 12, 2024.

Learn about lead. US Environmental Protection Agency. Updated February 7, 2024. Accessed August 12, 2024.

References

Council on Environmental Health. Prevention of childhood lead toxicity. Pediatrics. 2016;138(1):e20161493.

Canfield RL, Henderson CR Jr, Cory-Slechta DA, Cox C, Jusko T, Lanpher BP. Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. N Engl J Med. 2003;348(16):1517-1526.

Gorospe EC, Gerstenberger SL. Atypical sources of childhood lead poisoning in the United States: a systematic review from 1966-2006. Clin Toxicol (Phila). 2008;46(8):728-737.

Gupta SR, Mezoff E, Dienhart M. Lead toxicity from a swallowed fishing sinker: a case report. JPGN Rep. 2021;2(3):e084.

Koh DH, Locke SJ, Chen YC, Purdue MP, Friesen MC. Lead exposure in US worksites: a literature review and development of an occupational lead exposure database from the published literature. Am J Ind Med. 2015;58:605-616.

Kosnett MJ, Wedeen RP, Rothenberg SJ, et al.. Recommendations for medical management of adult lead exposure. Environ Health Perspect. 2007;115:463-471.

McRae A, Vilcins D, Le HHTC, et al. Lead in traditional and complementary medicine: a systematic review. Rev Environ Health. 2022;39(1):111-120.

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Check that imported toys, toy jewelry, and cosmetics do not contain lead.
  • Pay attention to public health alerts and recalls related to lead.
  • Do not store food in lead-glazed ceramic containers.
  • If you live in an old house, have the paint and water tested for lead.
  • Inspect and maintain all painted surfaces in your home.
  • Keep your home clean and dust-free.
  • If you are remodeling, take precautions to avoid lead dust exposure. 
  • If you work with lead, remove contaminated work clothes before entering the house.
  • Do not let children eat soil; wash hands after playing outdoors.

This Really Happened

Case 1. A family was visiting friends who lived in an old house, where their 2-year-old son swallowed a few paint chips. He was still playing and had no symptoms. The parents were concerned about lead toxicity and called Poison Control. They were told that the amount of lead in a few paint chips is low. Since this was a one-time exposure rather than a chronic exposure over months or years, their son would likely be fine.

Case 2. A 6-year-old girl swallowed a lead fishing sinker. Since she had no symptoms initially, her parents waited several hours before calling Poison Control. They were told that their daughter was at risk for lead toxicity and that they should take her to an emergency room (ER). In the ER, the girl complained of mild abdominal pain. An x-ray showed the fishing sinker beyond the stomach and in the intestine. Poison Control recommended giving a large volume of polyethylene glycol electrolyte solution to flush the sinker out of the girl’s digestive tract. Blood was drawn to measure her blood lead concentration. Several hours later, the sinker was flushed out. Her blood lead concentration was elevated, so the girl was treated as an outpatient with an oral chelator for several weeks until her blood lead concentration decreased significantly.