Lead toxicity

Background

Pathophysiology

• Lead has multisystem effects, and is a powerful neurotoxin

Risk Factors

• Occupational exposure to lead:
  • Battery manufacturing
  • Plumbing
  • Mining
  • Painting
  • Paper hanging
  • Auto repair

Clinical Manifestations

• Acute exposure
  • Abdominal pain and constipation
  • Headache, cognitive deficits, and peripheral neuropathy
  • Myalgias and arthralgias
  • Anemia
  • Anorexia
• Chronic exposure
  • Fatigue and insomnia
  • Hypertension
  • Neuropsychiatric symptoms
  • Nephropathy
  • Miscarriage and stillbirth

Investigations

• Labs:
  • CBC showing microcytic anemia
  • Peripheral blood film showing basophilic stippling

Diagnosis

• Blood lead level strongly correlates with exposure level and health effects
  • Shows acute exposures (i.e. within months)
• Since lead deposits in the bones, can do X-ray defraction for cumulative lead exposure