Lead poisoning

Lead poisoning

• Lead as a metal is usually found deep in the ground between rockets at a depth of 30 km

Uses :

1. It is the most commonly used metal in the world. The annual production is about 2.5 million ton.
2. .Batteries
3. .Printer ink
4. .Bullets
5. .Radiation protective clothes
6. .Plastic production
7. .Glasses
8. .Paints
9. Petroleum

Lead exposure

1. Natural exposure

• Air
• Water
• Food

1. Occupational exposure

• Batteries
• Printing

Factors affecting intoxication:

• High temp
• Vapor
• Dust
• Ventilation
• Cleaning
• Personal factors

High-risk occupations :

• Batteries industries

Les risk exposure :

• Police
• Drivers
• Petroleum service station
• Plastic

Home exposure

• Tomato paste
• Old Batteries
•  Lead pipes water
• Paints
• Dyes

Metabolism:

Routes of absorption :

• Respiratory system
• Skin
• GIT

• Absorption through the respiratory  system is the most common and depends on:

• Dust 
• Mucus membrane motility
• Effects
• RBCs .
• Bones
• Liver
• Kidney
• Excretions (milk)

Blood formation system : 

Anemia due to

• Hb production suppression 

• Decrease RBCs half life

Lead encephalopathy

• Symptoms :

• Loss of conc

• Headache

• Fits

• Depression

• Cerebral edema

• Vomiting

• Fainting attacks

Peripheral n. system:

• Lead palsy
• wrist drop (Rt hand).

Kidneys

• .RFT, BP

GIT

• Loss of appetite
• Constipation
• Lead colic Recurrent in nature

Circulation

• Hypertension
• Tachycardia
• Arrhythmias
• Inverted T  Waves

Clinical picture

• Fatigue
• Insomnia
• Headache
• Anorexia
• Abd pain & muscle ache
• Bone & joints pain
• lead colic

Diagnosis

• History of exposure
• Examination
• Lead blood level
• 5ug\dl for children (60 ug\dl for symptoms to appear)
• 10ug\dl  for an adult (50ug – 60ug\dl for symptoms to appear)
• Reticulocytes
• Urine coproporphyrin
• X-ray dense line in the bones of children

Differential Diagnosis:

• Appendicitis
• Peptic ulcer
• Gastritis
• Renal colic
• Neuritis
• Meningitis

Prevention

• Engineering and technical precautions 
• Lead dust below 0.15mg \ cubic meter
• Lead-free process
• Exhaust ventilation
• Humid environment
• Cleanliness
• Blood lead levels measurement
• Personal protection tools
• Medical precautions
• Pre & Periodical clinical examination
• Cardiovascular diseases
• Gastric ulcer
• Psychiatric disorders
• Liver & renal diseases
• Pregnancy
• Hb measurement
• Lead blood level

• The mainstays of treatment are :

1- Removal from the source of the lead of poisoning,

2-Chelation therapy. EDTA, a chelating agent, binds a heavy metal, sequestering it. A chelating agent form complex nontoxic^[140] and can be excreted in the urine,(CaNa₂EDTA), dimercaprol (BAL), which are injected, and succimer and d-penicillamine, which are administered orally.

3-Treatment of iron, calcium, and zinc deficiencies, which are associated with increased lead absorption.

4-Anticonvulsants may be given to control seizures

5- Mannitol & CORTICOSTEROIDS.