

Lead Poisoning

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The best way to deal with lead is to avoid lead exposure in the first place. The number of people in the United States who have elevated blood lead levels has decreased dramatically in recent years since lead was eliminated from house paints, gasoline, water pipes, and other household products, and because of the close monitoring of lead in industry.

Screening of children and occupational screening of adults is used to identify and guide treatment of lead poisoning. The most common treatment is to identify the source of the lead and eliminate or minimize further exposure. This may include measures such as wet mopping living areas frequently and flushing water from the tap before drinking if lead pipes are used. Lead abatement of a house may be necessary in some cases. This is the process of methodically removing lead paint or other lead sources from a building or area and is usually performed by a trained professional. Do not attempt to remove lead-based paint yourself – you are likely to endanger yourself and your family.

Children with blood levels greater than 25 micrograms per deciliter (mcg/dL) may be considered for chelation therapy depending on symptoms. Chelation therapy is a treatment to rid the body of high amounts of lead. Chelation involves giving a patient a drug called succimer. Lead will preferentially bind to succimer and then be excreted in the urine. The treatment can usually be done as an outpatient treatment (i.e., in the doctor's office).

For children with blood levels greater than 45 but less than 70 mcg/dL, chelation therapy with succimer in the hospital is indicated unless the patient is encephalopathic. Lead levels greater than 70 mcg/dL are considered a medical emergency. Patients will be hospitalized and receive aggressive chelation therapy. In this case, chelation therapy involves administration of EDTA. Lead will preferentially bind to EDTA and then be excreted in the urine. The treatment can be dangerous, however, because the chemical-lead combination can be poisonous to the kidneys.

Adults can tolerate higher blood levels than children. If they have occupational lead levels greater than 40 mcg/dL, OSHA requires that they be removed from further lead exposure and transferred to a low-lead job (called medical removal) until their lead level drops to a lower level. At higher concentrations, chelation is considered on a case-by-case basis. It is not usually necessary unless the patient is symptomatic. If several workers have significantly elevated lead levels and/or excessive levels persist, then abatement at the work site may be required.


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