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.
Paint dust and paint chips from lead-based paint (used most commonly
in houses built before 1978)
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
Changes in personality or worsening of school performance
Pain in hands, feet, muscles, or joints
In many cases, there are no symptoms.
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).
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).
National Lead Information Center800/424-5323
US Environmental Protection Agencyhttp://www.epa.gov/lead/index.html
Centers for Disease Control and Prevention 404/639-3534http://www.cdc.gov/lead
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
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Ringold S, Lynm C, Glass RM. Lead Poisoning. JAMA. 2005;293(18):2304. doi:10.1001/jama.293.18.2304