- Lead poisoning may result from inhalation or ingestion of excessive lead
- Typically from occupational or environmental exposure.
- Occupations at risk of lead exposure include lead miners, plumbers, mechanics, and smelter workers
- Mechanism
- Acutely, lead poisoning causes widespread disruption of membrane permeability, oxidative stress and altered heme metabolism.
- Clinical
- Abdominal pain due to lead toxicity is generalized, severe and colicky in nature and may be accompanied by nausea, vomiting and ileus.
- Neurological symptoms ranging from irritability and poor concentration through to encephalopathy, seizures and peripheral motor neuropathy may also be present.
- Diagnosis
- The key investigation for diagnosis of acute lead poisoning is a blood lead level (BLL), which is diagnostic above levels of 3.4 μmol/L for adults and above 2.1 μmol/L for children.
- Management
- Treatment involves chelation therapy with either 2,3 dimercaptosuccinic acid (DMSA) or calcium disodium ethylenediaminetetraacetic acid (EDTA).
- A toxicologist or poisons service can be consulted for guiding initial management whilst patients should be referred to an occupation and environmental medical physician for long-term follow up.