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Lead poisoning

Plumbism

Lead is a very strong poison. When a person swallows an object that has lead in it or breathes in lead dust, some of the poison can stay in the body and cause serious health problems.

This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call the local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Where Found

Lead used to be very common in gasoline and house paint in the United States. In children, lead exposure often occurs through ingestion. Children living in cities with older houses are more likely to have high levels of lead in their blood or body. In the United States, it is estimated that half a million children ages 1 through 5 years have unhealthy levels of lead in their bloodstream. In adults, lead exposure is usually through inhalation in the work environment.

Immigrant and refugee children are at much greater risk for lead poisoning than children born in the United States because of diet and other exposure risks before arriving in the United States.

Although gasoline and paint are no longer made with lead in them, lead is still a health problem. Lead is everywhere, including dirt, dust, new toys, and old house paint. Unfortunately, you cannot see, taste, or smell lead.

In 2014, health organizations estimated that nearly a quarter billion people worldwide had toxic (poisonous) blood lead levels.

Lead is found in:

Children get lead in their bodies when they put lead objects in their mouths, especially if they swallow those objects. They can also get lead on their fingers from touching a dusty or peeling lead object, and then putting their fingers in their mouths or eating food afterward. Children also can breathe in tiny amounts of lead.

Symptoms

There are many possible symptoms of lead poisoning. Lead can affect many different parts of the body. A single high dose of lead can cause severe emergency symptoms.

However, it is more common for lead poisoning to occur slowly over time. This results from repeated exposure to small amounts of lead. In this case, there may not be any obvious symptoms. Over time, even low levels of lead exposure can harm a child's mental development. The health problems get worse as the level of lead in the blood gets higher.

Lead is much more harmful to children than adults because it can affect children's developing nerves and brains. The younger the child, the more harmful lead can be. Unborn children are the most vulnerable.

Possible complications include:

The symptoms of lead poisoning may include:

Very high levels of lead may cause vomiting, internal bleeding, staggering walk, muscle weakness, seizures, or coma.

Home Care

You can reduce exposure to lead with the following steps:

Before Calling Emergency

Provide the following information to emergency assistance:

However, DO NOT delay calling for help if this information is not immediately available.

Poison Control

If someone has severe symptoms from possible lead exposure (such as vomiting or seizures) call 911 immediately.

For other symptoms that you think may be caused by lead poisoning, call your local poison control center.

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

Except in severe cases where someone has been exposed to a high dose of lead, a trip to the emergency room is not necessary. Contact your health care provider or department of public health if you suspect possible low-level lead exposure.

A blood lead test can help identify whether a problem exists. Over 10 mcg/dL (0.48 µmol/L) is a definite concern. Levels from 2 to 10 mcg/dL (0.10 and 0.48 µmol/L) should be discussed with your health care provider. In many states, blood screening is recommended for young children at risk.

Other lab tests may include:

For children whose blood levels of lead are moderately high, identify all major sources of lead exposure and keep the child away from them. Follow-up blood testing may be needed.

Chelation therapy (compounds that bind lead) is a procedure that can remove high levels of lead that have built up in a person's body over time.

In cases where someone has potentially eaten a high toxic dose of lead in a short period of time, the following treatments might be done:

Outlook (Prognosis)

Adults who have had mildly high lead levels often recover without problems. In children, even mild lead poisoning can have a permanent impact on attention and IQ.

People with higher lead levels have a greater risk of long-lasting health problems. They must be followed carefully.

Their nerves and muscles can be greatly affected and may no longer function as well as they should. Other body systems may be harmed to various degrees, such as the kidneys and blood vessels. People who survive toxic lead levels may have some permanent brain damage. Children are more vulnerable to serious long-term problems.

A complete recovery from chronic lead poisoning may take months to years.

Related Information

Pica
Malnutrition

References

Centers for Disease Control and Prevention website. Childhood lead poisoning prevention. www.cdc.gov/nceh/lead/default.htm. Updated April 5, 2023. Accessed April 17, 2023.

Markowitz M. Lead poisoning. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 739.

Theobald JL, Mycyk MB. Iron and heavy metals. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 146.

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Review Date: 1/2/2023  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 04/17/2023.

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