What are the other Names for this Condition? (Also known as/Synonyms)

• Colica Pictonum
• Devon Colic
• Painter’s Colic

What is Lead Poisoning? (Definition/Background Information)

• Lead Poisoning is a medical condition which occurs when an excess amount of lead accumulates in the body over an extended period of time. The condition may affect various organs and bodily processes including the heart, bones, intestines, kidneys, reproductive, and nervous system leading to permanent learning and behavioral disorders and other adverse health manifestations
• Children under the age of 6 are most commonly affected by Lead Poisoning. Individuals, who live in older homes (that used lead-based construction materials), or come into contact with old lead-based paints, particularly paint made before “lead restrictions” were in place, are at a higher risk for developing Lead Poisoning
• Lead Poisoning is most commonly due to ingestion or inhalation of high levels of lead in food, water, air, or in toys that come in contact with infants’ mouth. The signs and symptoms develop slowly over time and may vary depending on the age of the individual. It is especially important to have younger children tested for Lead Poisoning if they have experienced a known risk for lead exposure
• A diagnosis is typically made by a medical professional following routine blood tests that allow them to determine elevated lead levels in blood. The complications of Lead Poisoning can vary depending on the length and/or severity of lead exposure
• Individuals with minimal exposure can be treated easily to eliminate the associated symptoms even before they occur, while those with severe exposure (that took place over long periods) are likely to have irreversible neurological issues
• The prognosis is generally dependent on the age of the individual and duration and severity of the lead exposure. Lead Poisoning can be prevented by avoiding contact with lead-based paints, water from lead pipes, and materials that may have been contaminated by lead-based fuels

Who gets Lead Poisoning? (Age and Sex Distribution)

• Lead Poisoning can affect individuals of any age and gender
• Children under the age of 6 years, especially children in the age group of 1 and 3, are known to be most frequently affected
• Lead Poisoning is more commonly observed in males than females
• Individuals of all racial and ethnic groups are at equal risk for poisoning

What are the Risk Factors for Lead Poisoning? (Predisposing Factors)

Following are the risk factors that are likely to increase the incidence of Lead Poisoning:

• Age: Infants and young children are most likely to be affected by Lead Poisoning, although elderly individuals are at a higher risk as well
• Living in older homes: Older homes often contain paint which is made of lead, and so individuals living in these homes carry a higher risk for continued exposure to lead
  • Old homes may also contain lead pipes which can result in higher lead levels in the household
  • Paints of any kind that are made before 1976 (in the US) are likely to contain a lead base and should be avoided on any materials
• Hobbies: Hobbies such as making stained glass or jewelry require the use of lead soldering which may increase one’s exposure risk
• Country of origin: Those living in developing countries are more at risk to acquire Lead Poisoning due to a lack of regulation for lead-based materials
• Individuals with calcium or iron deficiency

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Lead Poisoning? (Etiology)

Lead is usually found in the earth’s crust. But various human activities such as mining, burning fossil fuels and manufacturing have made it more commonly available in the environment. Older fuels and paints were made with lead, resulting in deposits in older homes and soil near roadways.

Lead is most dangerous to humans when it is ingested or inhaled. The possible causes for Lead Poisoning may be due to:

• Contaminated air from many factors including paint sanding or removal
• Contaminated soil: Lead particles settled in soil will remain unchanged for years
• Contaminated water due to lead in piping
• Contaminated food 
• Consumer products, such as toys, which may have lead-based paints or materials
• Lead based paints used on any products made before the 1980s such as furniture, homes, and toys
• Pottery: Glazing work done on pottery and porcelain may contain lead
• Traditional cosmetics: Some cosmetics, such as Kohl, used as eyeliner may contain high levels of lead
• Imported canned goods: Use of lead soldering food cans can cause Lead Poisoning
• Use of leaded gasoline
• Use of pesticides

Use of certain traditional medicines that contain lead are also known to increase one’s chances of developing Lead Poisoning:

• Greta or Azarcon: This is a Hispanic cure for stomach upsets, constipation, diarrhea, and vomiting
• Litargirio that is used as a deodorant
• Ba-baw-san: This is a Chinese herbal medicine used to cure chronic pain in babies
• Ghasard: This is used as a tonic in some regions
• Daw tway contains lead and arsenic in large quantities and is used for digestive help

What are the Signs and Symptoms of Lead Poisoning?

It is important to note that Lead Poisoning happens slowly over time and the signs and symptoms generally develop in stages. The following signs and symptoms may be noted in those with Lead Poisoning:

• In children:
  • Irritability
  • Loss of appetite
  • Weight loss
  • Fatigue
  • Lethargy
  • Pain in the abdomen
  • Vomiting
  • Constipation
  • Learning difficulties
  • Slow growth rate
• In adults:
  • Problems in mental function involving memory loss
  • High blood pressure
  • Pain or numbness in the extremities 
  • Weakness of the muscles
  • Headache
  • Pain in the abdomen
  • Mood problems
  • Abnormal sperm count
  • Miscarriage in pregnant women
  • Premature birth

How is Lead Poisoning Diagnosed?

A diagnosis for Lead Poisoning is made following a thorough physical examination and an evaluation of the medical history of the individual by a medical professional. The following methods can be used in diagnosing Lead Poisoning:

• The blood lead level is first analyzed through laboratory procedures to measure erythrocyte protoporphyrin in blood samples to evaluate the lead exposure 
• Blood film examination is carried out to determine basophilic stippling of red blood cells and the changes that occur due to iron deficiency anemia
• X-ray fluorescence is performed to measure the amount of lead in bones
• Other laboratory test that may be performed include:
  • Bone marrow biopsy
  • Complete blood count (CBC) test
  • Coagulation studies
  • X-ray of the abdomen
• Children between the age of 3 and 6 should undergo a Lead Poisoning test if:
  • They have not been tested before
  • Live in or visit a house which is very old
  • Have a friend or sibling who has already been affected by Lead Poisoning.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Lead Poisoning?

The following are the possible complications that can arise from Lead Poisoning:

• Damage to brain development
• Damage to the kidneys
• More severe cases of Lead Poisoning resulting from high levels of lead exposure can cause damage to the nervous system resulting in:
• Seizures
• Unconsciousness

Severe cases of Lead Poisoning can lead to fatalities.

How is Lead Poisoning Treated?

The treatment and management processes for Lead Poisoning can vary depending on the severity of the case. Simply identifying and removing the cause of the lead exposure can reduce blood lead levels and symptoms to subside in less severe cases. Other treatments for Lead Poisoning may include:

• Treatment to rectify iron, calcium, and zinc deficiency 
• When lead containing materials are present in the gastrointestinal tract, the following procedures may be carried out to minimize the effects:
  • Whole bowel irrigation
  • Cathartics
  • Endoscopy
  • Surgical removal of the lead containing material
  • When lead containing bullets are present in fluid filled or synovial space, surgical removal is the best treatment method
  • Lead encephalopathy may be treated using anticonvulsants to control seizures
  • Use of corticosteroids and mannitol to control swelling of the brain
  • The medication “Succimer” is used for treating mild lead toxicity
• For severe cases of Lead Poisoning the following treatments are used:
  • Chelation therapy: Under this therapy, a medication that binds with lead is used and lead is excreted through urine
  • Chelation therapy or EDTA therapy: A chemical called ethylenediaminetetraacetic acid (EDTA) is used for lowering lead levels in the body
  • Gastric lavage (stomach irrigation): A procedure used to clean/empty the contents of the stomach

How can Lead Poisoning be Prevented?

Simple preventive measures to reduce the risk for Lead Poisoning typically revolve around avoiding the cause of exposure which may include:

• Prevention strategies to be adopted by individuals:
  • Washing hands before eating, bedtime, and after outdoor play prevents hand-to-mouth transfer of dust and soil filled with lead
  • Cleaning of dusty surfaces, wiping dusty areas with damp cloth helps in preventing lead residue
  • When plumbing fixtures are made of lead pipes, run out cold water for some time to flush out the contaminated water, before starting to use the water
• Precautions to be followed while remodeling a house contain paint made of lead:
  • Do not remove the lead paint by sanding
  • Use of open flame torch to remove paint is not advisable
  • Attempt paneling drywall or encapsulation, which will look like a thick coat of paint instead of removing old paint
  • Use of protective clothes and equipment is necessary
  • Avoid eating or drinking in areas where lead dust may be present
• Avoid complementary medicines that are lead-based
• Preventive medicine strategy: Screening programs are available to test the blood of children who carry a high risk for Lead Poisoning
• Prevention measures at the national and municipal levels have been incorporated to increase regulation in order to reduce risk for Lead Poisoning

What is the Prognosis for Lead Poisoning? (Outcomes/Resolutions)

• The prognosis of Lead Poisoning generally depends on:
  • Duration of lead exposure
  • Extent of lead exposure
• When lead exposure only affects the kidneys and blood, the condition can be treated appropriately, and no complications may be noted
• When Lead Poisoning affects the nervous system, largely the complications cannot be reversed, and the prognosis may be worse
• Children affected by Lead Poisoning are at risk for experiencing health issues including cognitive and behavioral problems later in life depending on the severity of the case

Additional and Relevant Useful Information for Lead Poisoning:

The following resource is a useful link for additional information:

https://www.dovemed.com/healthy-living/first-aid/first-aid-lead-poisoning/