Lead Poisoning


ByGerald F. O’Malley, DO, Grand Strand Regional Medical Center;
Rika O’Malley, MD, Grand Strand Medical Center
Reviewed/Revised May 2022 | Modified Sep 2022

Lead poisoning affects many parts of the body, including the brain, nerves, kidneys, liver, and blood. Children are particularly susceptible because their nervous system is still developing.

  • Some causes of lead poisoning are ingesting lead paint and eating or drinking from certain imported, improperly lead-glazed ceramics.

  • Very high levels of lead in the blood may cause personality changes, headaches, loss of sensation, weakness, a metallic taste in the mouth, uncoordinated walking, digestive problems, and anemia.

  • The diagnosis is based on symptoms and a blood test.

  • Testing household water, ceramics, and paint for lead can help identify potential sources of lead poisoning.

  • Treatment consists of stopping exposure to lead and removing accumulated lead from the body.

(See also Overview of Poisoning.)

Lead poisoning is far less common since paint containing lead pigment was banned (in 1978 in the United States) and lead was eliminated from automotive gasoline (in 1986 in the United States and by 2011 in all but 6 countries in the developing world). However, lead poisoning is still a major public health problem in cities on the East Coast of the United States as well as in other isolated cities.

Sources of lead

The most common cause of lead poisoning is eating or drinking something that contains lead. This typically happens in

  • Children who live in older houses that contain peeling lead paint or lead pipes

During home remodeling, people may be exposed to significant amounts of lead in particles scraped or sanded off while preparing surfaces for repainting. Young children may eat enough paint chips, particularly during remodeling, to develop symptoms of lead poisoning. Lead pipes used in plumbing and containment tanks may leach lead into the water supply, which can be ingested at the tap.

There are various other sources of lead poisoning:

  • Some ceramic glazes contain lead. Ceramic ware, such as pitchers, cups, and plates, made using these glazes (common outside the United States) can leach lead, particularly when in contact with acidic substances (such as fruits, cola drinks, tomatoes, wine, and cider).

  • Lead-contaminated moonshine whiskey and folk remedies are possible sources.

  • Occasionally, lead foreign objects are in the stomach or tissues (such as bullets or curtain or fishing weights). Bullets lodged in certain soft tissues may increase levels of lead in the blood, but that process takes years to occur.

  • Occupational exposure can occur during battery manufacture and recycling, bronzing, brass making, glass making, pipe cutting, soldering and welding, smelting, or working with pottery or pigments.

  • Certain ethnic cosmetic products and imported herbal products and medicinal herbs contain lead and have caused cluster outbreaks of lead poisoning in immigrant communities.

  • Fumes of leaded gasoline (in countries where it is still available) recreationally inhaled for the intoxicating effects on the brain may cause lead poisoning.

Effects of lead on the body

Lead affects many parts of the body, including the brain, nerves, kidneys, liver, blood, digestive tract, and sex organs. Children are particularly susceptible because lead causes the most damage in nervous systems that are still developing.

If the level of lead in the blood is high, symptoms of brain damage (encephalopathy) usually develop. Lower blood levels that are sustained for longer periods of time sometimes cause long-term intellectual deficits.

Symptoms of Lead Poisoning

Many people with mild lead poisoning have no symptoms. Symptoms that do occur usually develop over several weeks or longer. Sometimes symptoms flare up periodically.

Typical symptoms of lead poisoning include personality changes, headaches, loss of sensation, weakness, a metallic taste in the mouth, uncoordinated walking, poor appetite, vomiting, constipation, crampy abdominal pain, bone or joint pains, high blood pressure, and anemia. Kidney damage often develops without symptoms.

  • Young children who have been exposed to lead may become cranky and their attention span and play activity may decrease over the course of several weeks. Encephalopathy can then begin suddenly and worsen over the next several days, resulting in persistent, forceful vomiting; poor coordination and difficulty walking; confusion; sleepiness; and, finally, seizures and coma. Chronic lead poisoning in children may cause intellectual disability, seizures, aggressive behavior, developmental regression, chronic abdominal pain, and anemia.

  • Adults who are exposed to lead at work typically develop symptoms (such as personality changes, headaches, abdominal pain, and damage to nerves, with numbness and loss of sensation in the feet and legs) over several weeks or longer. Adults may develop loss of sex drive, infertility, and, in men, erectile dysfunction (impotence). Encephalopathy rarely develops in adults.

  • Children and adults may develop anemia.

  • Children and adults who inhale the fumes from leaded gasoline may develop symptoms of psychosis in addition to typical symptoms of lead poisoning.

Some symptoms may diminish if exposure to lead is stopped, only to worsen again if exposure is resumed.

Diagnosis of Lead Poisoning

  • Lead levels in blood

  • Sometimes x-rays of abdomen

  • Sometimes x-rays of long bones (in children with suspected long-term exposure to lead)

The diagnosis of lead poisoning is based on symptoms and a blood test to measure lead level. Adults whose jobs involve handling lead need frequent blood tests. Children living in communities with many older houses, where peeling lead-based paint is common, should also undergo blood tests for lead, even if they do not have any symptoms. In children, bone and abdominal x-rays often show evidence of lead poisoning.

Did You Know...

  • Children living in communities where houses are old should be tested for lead poisoning, even if they do not have any symptoms.

Prevention of Lead Poisoning

Commercially available kits should be used to test household paint (except in houses built after 1978), ceramics made outside the United States, and water supplies for lead content. Measures that reduce the risk of household poisoning include regular cleaning, such as

  • Hand washing

  • Washing of children’s toys and pacifiers

  • Cleaning of household surfaces

  • Dusting affected windowsills weekly with a damp cloth

Chipped leaded paint should be repaired. Larger renovation projects to remove leaded paint can release large quantities of lead into the house and should be done professionally. Commercially available faucet filters can remove most lead from drinking water.

Adults exposed to lead dust at work should

  • Use appropriate personal protective equipment

  • Change their clothing and shoes before going home

  • Shower before going to bed

Treatment of Lead Poisoning

  • Stopping exposure to lead

  • Sometimes whole-bowel irrigation

  • Sometimes chelation therapy and mineral supplements

Doctors remove lead from the body by giving drugs that bind with the lead (chelation therapy), allowing it to pass into the urine. All drugs that remove lead work slowly and can cause serious side effects.

Even after treatment, many children with encephalopathy develop some degree of permanent brain damage. Kidney damage is also sometimes permanent.

More Information

The following are some English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

  1. American Association of Poison Control Centers: Represents the US-based poison centers that provide 24/7 free, confidential services through the Poison Help Line (1-800-222-1222)

  2. United States Environmental Protection Agency's recommended lead test kits: Information on evaluating and eliminating lead-based paint hazards and access to several approved lead test kits

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