Kishan Jasani 3 Yr. B.Sc. Nursing

Kishan jasani
3rd yr. B.Sc. Nursing

 Introduction to lead
 What is lead poisoning
 Classification of lead poisoning
 Sources of exposure
 Who is at risk
 Pathophysiology
 Harmful effect of lead
 Signs and symptoms
 Diagnosis
 Treatment
 Prevention
 conclusion
Lead is a soft, malleable
poor metal. It is also counted
as one of the heavy metals.
It is sometimes found free
in nature, Although lead
makes up only about
0.0013% of the
earth's crust, it is not
considered
to be a rare element since it is easily mined and
refined.
 Lead poisoning is a medical condition caused
by increased levels of the heavy metal lead
in the body, and this can interfere with a
variety of body processes and causes
toxicity to many organs and tissues.
It’s also called plumbism, colica Pictonum or
saturnism
 Depends on: -
1 The amount of lead in the blood and
tissues.
2 The time of exposure.
Lead poisoning may be acute (from intense
exposure of short duration) or chronic
(from repeat low-level exposure over a
prolonged period).
 Acute poisoning:- In acute poisoning, typical
neurological signs are pain, muscle
weakness.

Gastrointestinal problems, such as
diarrhea, poor appetite, or weight loss.

Absorption of large amounts of lead over
a short time can cause shock, Hemolysis.
 Damage to kidneys can cause changes in
urination such as decreased urine output.

Chronic poisoning : - usually presents with
symptoms affecting multiple systems, but is
associated with three main types of
symptoms:
gastrointestinal, neuromuscular, and
neurological. Signs of chronic exposure
include loss of short-term
memory, depression, nausea, abdominal pain,
loss of coordination, and numbness and
tingling in the extremities.
What are the Normal levels of lead??
 Adults:
 Less than 20 micrograms/dL of lead in the
blood
 Children:
 Less than 10 micrograms/dL of lead in the
blood
How can the human be exposed to lead??
1Occupational exposure:- is the main

cause of lead poisoning in adults, as
in lead miners and smelters,
plumbers glass manufacturers,
construction workers …etc.
2Paints:- is the main cause of lead

Poisoning in children. Many of the
children display pica, so even a small
amount of a lead-containing product
can contain hundreds of milligrams
of lead.
3 - Soil:- is the main cause of lead
poisoning in the agricultural areas.
By eating food grown in an
contaminated soil.
4 - Water:- Lead from the soil or

atmosphere can end up in surface
water and groundwater. It is also
potentially in drinking water.
5 - Lead containing products:-
Like plastic toys, bottles, cans……etc.
6- Hunting:- Animals which are

hunted are at high risk of exposure
because of the bullets which may
contain lead.
• Breast feeding is also considered as an important

route of lead exposure because of the presence of the
lead in the affected female milk.
 All children under the age of 6 years old.
 People living in old houses are at great risk.
 People work in industries.
 Pregnant woman & developing baby.
Pathophysiology
 Lead may be taken in through direct contact with
mouth, nose, and eyes, and through breaks in the
skin. Organic lead can be absorbed through the skin
to a limit extend while The main sources of
absorption of inorganic lead are from ingestion and
inhalation.
 The main body compartments that store lead are the

blood, soft tissues, and bone; the half-life of lead in
these tissues is measured in weeks for blood, months
for soft tissues, and years for bone. Lead in the
bones, teeth, hair and nails is bound tightly and not
available to other tissues, and is generally thought
not to be harmful.
 In adults, 94% of absorbed lead is deposited in
the bones and teeth, but children only store 70%
in this manner, a fact which may partially
account for the more serious health effects on
children.. Many other tissues store lead are the
brain, spleen, kidneys, liver, and lungs. It is
removed from the body very slowly, mainly
through urine. Smaller amounts of lead are also
eliminated through the feces, hair, nails, and
sweat.
 Distribution of lead:-
95% long bones.

Binds into matrix.
Released during
osteolysis.
 4% brain,liver,
kidneys.
 1% blood.
Crosses placenta,
foetal BBB is open
Harmful effect of lead:-
1Lead also interferes with DNA transcription,
enzymes that help in the synthesis of vitamin D,
and enzymes that maintain the integrity of the cell
membrane.
2Lead interferes with metabolism of bones and teeth .
3 - Lead alters the permeability of blood vessels and
collagen synthesis
4 - Lead may also be harmful to the developing
immune system, causing production of excessive
inflammatory proteins.
5 Lead exposure has also been associated with a
decrease in activity of immune cells such as PMN
leukocytes.
6 Lead also interferes with the normal metabolism of
calcium in cells and causes it to build up within
them.
7 Lead also inhibits the enzyme ferrochelatase, and
in turn inhibits RBC synthesis and leads to anemia.
8 Lead interferes with the release of
neurotransmitters, glutamate, a neurotransmitter
important in many functions including learning.
Signs and symptoms:-
 Lead poisoning can cause a variety of symptoms
and signs which vary depending on the individual
and the duration of lead exposure. Symptoms
from exposure to organic lead, which is probably
more toxic than inorganic lead due to its lipid
solubility, occur rapidly . Poisoning by organic
lead compounds has symptoms predominantly in
the central nervous system, such as
insomnia, delirium, cognitive
deficits, tremor, hallucinations, and convulsions.
 Symptoms may be different in adults and
children
 the main signs and symptoms in adults
are : - 1 - headache
2 memory loss
3male reproductive
problems
4weakness, pain in the
extremities
5 malaise
6 problems with sleep.
 The classic signs and symptoms in
children are:-
1 - loss of
appetite 2 -
vomiting
3 weight loss
4 constipation
5 anemia
6 Irritability
7 learning
disabilities
8 behavior
problems.
9 Children may also experience hearing
loss, delayed
 Renal system: The toxic effect of lead causes
nephropathy and may cause Fanconi syndrome.
 Cardiovascular system: Evidence suggests lead
exposure is associated with high blood
pressure, coronary heart disease, heart rate
variability, and death from stroke.
 Reproductive system: Lead affects both the
male and female reproductive systems. In men,
when blood lead levels exceed 40 μg/dL, sperm
count is reduced and changes occur in volume
of sperm, their motility, and their morphology.
 A pregnant woman's elevated blood lead level
can lead to miscarriage, prematurity, low
birth weight.
 Nervous system: Lead affects the peripheral
nervous system (especially motor nerves) and
the central nervous system. Peripheral
nervous system effects are more prominent in
adults and central nervous system effects are
more prominent in children. Lead causes the
axons of nerve cells to degenerate and lose
their myelin coats.
 Lead also causes bone and teeth decay.
◦ Blood film examination may reveal basophilic
stippling of red blood cells
◦ Exposure to lead also can be evaluated by
measuring erythrocyte protoporphyrin (EP) in
blood samples
◦ Examination of hair, nails are also
introduced.
◦ Fecal and urine examination.
Treatment
Treatment for lead poisoning begins with
removing the sources of lead and providing
balanced nutrition.
 CHELATION THERAPY
Chelating agents are used for
severe lead poisoning.
 EDTA THERAPY
Doctors treat lead levels greater than 45
mcg/dL of blood with a chemical called
ethylenediaminetetraacetic acid (EDTA).
Depending on your lead level, you may
need more than one treatment.
- In such severe cases, however, it may not
be possible to reverse damage that has
already occurred.
Prevention:-
 In most cases, lead poisoning is preventable;
the way to prevent it is to prevent exposure
to lead.Prevention strategies can be divided
into individual (measures taken by a family),
preventive medicine (identifying and
intervening with high-risk individuals), and
public health (reducing risk on a population
level).
1 - Substitution.
2 - Isolation
3 - Good house keeping
4 - Periodic examination of workers

5 - Working atmosphere
6 - Personal hygiene
7 - Health education
8 - Local exhaust ventilation
9 - Personal protection
Lead is a relatively rare element. Known as one of the top six
primary pollutants which is also a metal, we should take
precautions to make sure we don’t come in contact with lead.
Exposure to lead causes lead poisoning, which depending on the
level of exposure leads to diseases, brain damage, kidney
damage, death, and even more. Lead poisoning can be prevented
and detected as well. To prevent children from coming in contact
with lead, parents or guardians should make sure they play in
safe, clean areas and they do not put old toys, paint, or any metals
in their mouths.

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Kishan jasani

3rd yr. B.Sc. Nursing

urination such as decreased urine output.

1Occupational exposure:- is the main

2Paints:- is the main cause of lead

4 - Water:- Lead from the soil or

6- Hunting:- Animals which are

• Breast feeding is also considered as an important

 The main body compartments that store lead are the

95% long bones.

3 - Good house keeping

4 - Periodic examination of workers

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