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JAMA Patient Page
May 11, 2005

Lead Poisoning

JAMA. 2005;293(18):2304. doi:10.1001/jama.293.18.2304

Lead poisoning is the presence of an elevated level of lead in the blood. It is estimated that about 2% of children younger than 6 years in the United States have elevated blood lead levels. Lead enters the blood and other organs primarily through the lungs (from breathing contaminated air) and the digestive tract (from eating contaminated substances). Lead can have damaging effects on any organ in the body, but it is particularly damaging to the central nervous system (the brain and spinal cord) and red blood cells (cells that carry oxygen in the blood). Lead is toxic to both adults and children. It is particularly dangerous for children younger than 6 years because they are still growing and their nervous system is still developing. Even a slightly increased blood lead level may have toxic effects, so it is important to see your doctor immediately if you believe you or your family to be at risk. The May 11, 2005, issue of JAMA includes an article that reports rates of follow-up testing for children with high blood lead levels in the state of Michigan.

SOURCES OF LEAD EXPOSURE

  • Paint dust and paint chips from lead-based paint (used most commonly in houses built before 1978)

  • Contaminated soil

  • Water that has passed through lead pipes

  • Food that has been stored in lead-glazed earthenware

  • Some hobby materials, such as stained glass and fishing weights

  • Certain toys and jewelry

  • Some preparations of traditional remedies

SYMPTOMS

  • Fatigue

  • Stomach pains

  • Headaches

  • Changes in personality or worsening of school performance

  • Pain in hands, feet, muscles, or joints

In many cases, there are no symptoms.

DIAGNOSIS

Evaluation begins with a complete medical history and physical examination, including a thorough neurological examination. Further testing would usually include a blood test to measure the blood lead level and a red blood cell count to check for anemia (low red blood cell count).

TREATMENT

Appropriate treatment depends on the blood lead level and differs for children and adults. If the level is only slightly elevated, your doctor may advise measures to reduce lead exposure and to have the blood lead level retested. In other cases, immediate medical treatment may be required. Medical treatment primarily consists of chelating agents, medications that specifically bind to lead and assist in its removal from the body. These agents can be administered by mouth or intravenously (through a needle inserted into a vein).

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. A Patient Page on lead poisoning in children was published in the June 23/30, 1999, issue.

Sources: Centers for Disease Control and Prevention, US Environmental Protection Agency, American Academy of Pediatrics

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

TOPIC: POISONING

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