Lead poisoning

Lead is one of the heavy metals that occurs in the environment and is toxic to the body. It occurs, for example, in ambient air, soil, food and drinking water. Anyone who is exposed to lead too much can suffer from lead poisoning.
Lead can remain in the body for a long time and accumulates in the body. 95% of the absorbed lead accumulates in the bones and comes out
slowly released again. The half-life (the time it takes for an amount to be exactly halved) of lead in bones is 20 to 30 years.
From the bones it is spread to the blood, soft tissues, hair and teeth.
Anyone who ingested too much lead in childhood may still have too much lead in his or her blood as an adult. In the Netherlands, the standard is 10 micrograms of lead in the blood. More than 7,600 children in the Netherlands even have more than 10 micrograms of lead in their blood (Unicef 2020).
Blood levels of lead increase during exposure, for two to six months. This also applies to lead levels in organs.
After that, the values remain fairly constant, except in the elderly where the concentration increases in the bones and aorta.

 

Causes

A person can catch a lead poisoning by inhaling (dust, smoke, sprays or fumes), or by drinking water containing lead or eating foods containing lead. Children can catch it by putting soil contaminated with lead dust in their mouths.
Lead mainly enters the food chain through lead-containing dust that ends up in the soil where crops (grains) and plants absorb it from the soil. If those plants are eaten by livestock, lead can leach into dairy products and meat. If the grains, plants or fruits are intended for human consumption, they can end up in bread, vegetables, fruit drinks and tea.
The best-known culprit is drinking from old water installations that still contain lead water pipes.
The drinking water may then contain lead. The water comes into contact with the wall of the water pipe and picks up particles of lead.
In the Netherlands, this applies to old water installations from before 1960. New installations and taps can also release lead particles during the first three months. For example with brass taps. Brass is an alloy that contains lead.
With new taps and water installations, make sure that you let the tap run for the first three months before drinking. NB! The owner of a building is responsible for replacing water pipes that contain lead.
In the past, lead was used much more than now, so it is still found in the environment and in the home. Think of construction
water pipes, household appliances, leaded petrol, leaded plaster and paint. For example, anyone who is renovating a house and scraping off lead-containing paint can be exposed to lead. Another source of concern, according to UNICEF, is the improper and illegal recycling of lead-acid batteries from cars and other vehicles.

 

Complaints/symptoms of lead poisoning

The complaints mentioned below occur with several conditions. However, in the case of a combination of these complaints in combination with anemia, lead poisoning should be considered. The severity of the complaints can vary.

Complaints that may occur with acute lead poisoning are:

• acute abdominal pain
  
• colic
  
• nausea
  
• vomit
  
• anemia (increased breakdown of red blood cells)
  
• liver damage
  
• neuropsychological consequences
  
• Brain damage (Lead encephalopathy) may be associated with:
  
  • drowsiness, lethargy or 
    
  • restlessness and insomnia
    
  • confusion
    
  • disorientation
    
  • hallucinations
    
  • difficulty walking, ataxia
    
  • tremble
    
  • muscle twitching and convulsions
    
  • coma - possibly resulting in death after 2-3 days
• very occasionally nerve damage at the ends of the long nerves in the body. That leads to changes in sensation and movement, and can cause pain (peripheral neuropathy).
  
• numbness in the thigh
  
• If the lead poisoning occured in unborn children or children who are still developing, this can cause reduced intelligence that can make a difference of 5 points. Possible behavioral problems.

 

Read more about encephalopathy, the brain disease that can be caused by, for example, lead poisoning, on the special page about
encephalopathy.

 

The chronic symptoms of lead poisoning may include:

• Abdominal pain widespread (diffuse abdominal pain) or colic pain in the abdomen
  
• Nausea or vomiting
  
• Metallic taste in the mouth
  
• Diarrhea
  
• Weight loss
  
• Lack of appetite
  
• Constipation
  
• Fatigue
  
• Anemia, damaged red blood cells
  
• Headache
  
• High bloodpressure
  
• Heart and vascular disease
  
• Nerve damage (peripheral neuropathy) with pricking tingling pain in hands or feet (paresthesia), weakening (paresis) or paralysis
  (paralysis)
  
• Damage to the kidneys
  
• Gout (painful inflammation of a joint in the foot or toe)
  
• Blue line around the gums (Burton lines) and gray discoloration of the oral mucosa
  
• Influence on the thyroid gland
  
• Influence on reproduction. In men due to decrease in the motility of sperm cells, too few sperm cells and infertility in women,
  miscarriages, premature labor and premature rupture of waters.
  
• Influence on the adrenal gland
  
• A 'wrist drop' (wrist and fingers cannot extend, drooping hand) or 'ankle drop' (drooping foot) due to muscle paralysis.
  

There are indications that long-term exposure to low concentrations of lead in adults can lead to behavioral changes and
neuropsychiatric disorders.

 

Risk groups

• Due to the effects on the fetus, pregnant women should avoid the risks, because lead is especially dangerous for the unborn child.
  The smaller the child, the greater the percentage of lead absorption. That is very bad for the child's development. The nervous system and the brains still need to be built.
  
• Children up to seven years old. This is because they have a greater chance of recording. Because they put more lead-contaminated dust in their mouths soil, but also because the intestines reabsorb more and less lead is stored in the bone, and because lead can cross the blood-brain barrier in young children. Too much intake can affect brain development and lead to an IQ loss of 1 point.
  
• Older people. Lead poisoning is also dangerous because it can damage the blood, liver, kidneys, brain and nervous system.
  Professional groups that work with: lead-containing grease, tin soldering, lead-containing paints, lead powder, lead compounds, lead and zinc smelting, lead oxide and lead dust. See external image of these professional groups.
  
• People who suffer from environmental contamination by lead, such as soil contamination, are at increased risk
  
• People stripping off old layers of lead-containing paint
  
• People who consume beverages stored in crystal decanters
  
• People who often visit shooting ranges
  
• People who cast lead themselves for, for example, bullets or fishing lead
• People who make art from lead or process lead as a hobby with, for example, precious metals or solder
  
• People who renovate old houses that still have lead-containing paint or lead-containing roofing
  
• People who have had a hunting incident that left lead-containing bullets in their bodies

 

Measures and therapy

Further exposure to lead should be avoided immediately.
In someone who has recently ingested lead, vomiting should be induced or the stomach should be flushed.
Medicines can be given that ensure that lead is bound to sulphate and that the lead can leave the body via the intestines, such as NaSO44 or MgSO4.
Substances that encapsulate unwanted metals can be introduced into the bloodstream via an infusion (chelation therapy). The encapsulated substances are later excreted.
Detecting lead in soil and drinking water

 

For more information, see here and here.