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Lead Poisoning Overview

  • Clinical Signs & Symptoms
  • Risk Factors
  • Toxicology
  • Sources of Lead Exposure
  • Other Resources
  • Patient Education
  • Clinical Signs & Symptoms

    Most lead-poisoned children are asymptomatic. If present, symptoms typically are nonspecific complaints, such as stomachache, irritability, headache, fatigue, or loss of appetite. The only way to diagnose lead poisoning is to obtain a blood lead level (BLL).

     Blood Lead Level Possible Health Effects
     less than 10 mcg/dL  Decreased IQ, developmental toxicity (No known lower level for effects)
     10 - 44 mcg/dL  Behavior problems (hyperactivity, irritability), overt physical symptoms rare
     45 - 69 mcg/dL  Apathy/fatigue, anemia, abdominal symptoms (pain, constipation, nausea/vomiting)
     70 - 100 mcg/dL  Nephropathy, colic, encephalopathy
     > 100 mcg/dL  CNS crisis (cerebral edema, ischemia, seizure, coma, possible death)

     

    Risk Factors

    • Age: under 6 years
    • More time spent on floor
    • Increased hand to mouth behavior
    • High absorption of lead
    • Rapid central nervous system development
    • Peak risk: ages 1-2 years
    • Lives or spends significant amounts of time in pre-1978 housing/buildings with paint in poor condition or undergoing renovation
    • Exposure to lead contaminated dust or soil
    • Low income
    • Family member who works with lead
    • Sibling with elevated blood lead level
    • Mother with history of lead exposure/lead poisoning
    • Recent immigration/foreign adoptee, or spends time outside of the U.S.
    • Pica (ingestion of non-food items such as pottery, clay, dirt, plaster and paint chips)
    • Family member with hobby exposure (e.g., stained glass, ceramics, firearms, fishing)
    • Use of certain imported remedies/supplements/cosmetics
    • Use of some types of traditional/imported/handmade dishware
    • Consumption of lead contaminated foods (e.g., Chapulines, some Mexican candy, some imported spices)
    • Exposure to lead contaminated consumer products
    • Lives near source of lead air emissions
    • Exposure to lead contaminated water source

    Toxicology

    ATSDR Toxicological Profile for Lead

    Sources of Lead Exposure

  • Lead-based paint (pre-1978)
  • Lead-contaminated soil
  • Lead-contaminated dust from paint or soil
  • Take-home/hobby exposure
  • Imported food
  • Imported home remedies and imported cosmetics
  • Imported or handmade pottery and tableware with leaded glaze
  • Consumer products
  • Lead Exposure Sources Overview (CDC)
  •  

    Lead-based paint (pre-1978)

    It may have been used both inside and outside of a home or on objects such as furniture.  Children may eat paint chips or chew on the surfaces of windows, woodwork, walls, doors, or railings.

    Further information on housing and abatement

  • Lead Hazard and Reduction Section (CLPPB)
  • US EPA and HUD
  •  

    Lead-contaminated soil

    Lead may be in the soil where children play, especially near busy roadways or factories.  The lead from gasoline used for many years has settled onto soil and is difficult to remove.  Lead in soil may also be from other sources of air emissions and deteriorated lead-based paint on homes.  This soil may also be tracked inside on shoes and clothing.

     

    Lead-contaminated dust from paint or soil

    It clings to windowsills, floors, doorways and children's toys, and is dangerous to young children who crawl and often put their hands and other objects in their mouths.

     

    Take-home exposure

    Lead can be in the dust brought home on clothing, equipment, or in the car or truck driven from work.  Lead dust can also come from hobbies that use lead.

  • Lead jobs and hobbies checklist (PDF)
  • Take-home exposure brochure (PDF) 
  • Further information regarding occupational lead
  • Occupational Lead Poisoning Prevention Program (CDPH)
  • Centers for Disease Control
  • Occupational and Take-Home Lead Poisoning Associated with Restoring Chemically-Stripped Furniture 
  •  

    Imported food

    Candy

    Some imported candies, especially those that contain chili have been found to contain lead.  Lead has also been found in wrappers and ceramic candy containers.

  • Food and Drug Branch - Lead in Candy Test Results
  • Food and Drug Administration (FDA) guidance on lead in candy likely to be consumed frequently by small children.
  • California Health Alerts - Lead in Candy
  • Lead Poisoning Associated with Imported Candy 
  • Childhood Lead Poisoning Associated with Tamarind Candy and Folk Remedies 
  • Food and Spices

    Lead has been found in some imported food including Chapulines (grasshoppers), sweet cured plums, spices and food in cans with lead solder (these cans have wide seams, and are not used in the U.S.)

     

    Home Remedies and Cosmetics

    Some remedies and cosmetics imported from the Middle East, Southeast Asia, India, the Dominican Republic, and Mexico have been found to contain lead.  The remedies are often bright yellow or orange in color.

  • Information on remedies
  • Lead Poisoning Associated with Ayurvedic Medicines
  • Childhood Lead Poisoning Associated with Tamarind Candy and Folk Remedies
  • Lead Poisoning Associated with Use of Traditional Ethnic Remedies 
  •  

    Imported or Handmade Pottery and Tableware with leaded Glaze

    The lead from the glaze can leach into food and beverages when these ceramics are used for cooking or storing food.

    Information on lead in tableware

     

    Consumer Products

    Jewelry

    Lead has been found in children's jewelry and costume jewelry.  Children can be exposed to lead by handling, mouthing or swallowing the jewelry.

  • Department of Toxic Substances Control (DTSC), Lead in Jewelry information
  • Case Report: Death of a Child After Ingestion of a Metallic Charm
  • Brief Report: Lead Poisoning from Ingestion of a Toy Necklace 
  • Other Consumer Products

    Lead has been found in toys, vinyl lunch boxes and other consumer products

  • Lead Recalls
  • US Consumer product Safety Hotline (for information on lead-containing products)
  •  

    Other Resources

  • ATSDR publication on lead poisoning with two free CMEs
  • CDC lead-related publications
  •  

    Patient Education

  • Prevention
  • Nutrition
  • Health Education Materials
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    Last modified on: 10/4/2013 2:54 PM