LEAD POISONING

CONTENTS
•Source & Uses
•Body stores & Distribution
•Lead poisoning
•Clinical features
•Diagnosis
•Management
•Prevention
 SOURCE & USES
•Lead(Pb) is a heavy metal
•Occupational & Non-occupational sources
•Main source of environmental(non-occupational)
source of Pb is Gasoline
•Also through drinking water from lead pipes, chewing
lead paints on toys etc..
 Contd…
Pb is used in various industries due to:-
low B.P
anticorrosive
easily oxidised
mixes with other metals easily to form alloys.
It is used in:- Storage batteries, glass manufacture,
ship building, printing and potteries, rubber industry
etc..
 Body Stores & Distribution
Body store:- 150 to 400mg(blood level- 25µg/100ml)
Clinical symptoms- >70µg/100ml in blood
Normal adult ingest-0.2 to 0.3mg of lead/day
 DISTRIBUTION

LIVER
INGESTION ABSORPTION CIRCULATION ERYTHROCYTES & BONES
KIDNEY

9
5
%

FAECES
characteristic finding of lead
poisoning, dense metaphyseal
lines.
 LEAD
POISONING(PLUMBISM)
All lead compounds are toxic
MOST Dangerous- lead arsenate,lead oxide,lead
carbonate.
Least toxic-lead sulphide.
Plumbism occur in 3 ways-
INHALATION(most common), INGESTION, through
SKIN.
 PATHOLOGY
Pb + essential SH-groups of certain enzymes

Increase in permeability

Potassium leakage
 CLINICAL FEATURES
INORGANIC Pb exposure:- Abd. Colic
obstinate constipation
loss of appetite
blue lines on gums
stippling of red cells
anaemia
wrist drop
foot drop
 Contd..
Organic Pb compounds:- (toxic effect mainly on CNS)
Insomnia
Headache
Mental confusion
Delirium etc..
 DIAGNOSIS
History
Clinical
features
Laboratory diagnosis
a)Coproporphyrin in urine(CPU)
Normal- <150µg/L
b)Amino levulinic acid in urine(ALAU)
>5mg/L
c)Pb in blood and urine
(In urine Nl is 0.2-0.8mg)
In urine- >0.8mg/L Indicates
In blood- >70µg/100ml Pb absorption

d)Basophilic stippling of RBC

 MANAGEMENT
Aim
a) To prevent further absorption
b) To remove lead from soft tissues
c) To prevent recurrence
TREATMENT
 Saline purge (remove lead from the gut)
 d-penicillamine(promote Pb excretion in urine)
 PREVENTIVE
MEASURES
a)Substitution
Pb compounds should be substituted by less toxic
materials.
b)Isolation
Pb dust or fumes should be enclosed and segregated
c)Local exhaust ventillation
To remove dust & fumes
 Contd…
d)Personal protection
By approved respirators
e)Good housekeeping
f)In working atmosphere
Pb conc. Should be kept <2mg per 10cu.m of air
g)Periodic medical examination of workers
h)Personal hygiene (Hand washing)
i)Health education
 WHO states that in the case of exposure to lead, it
is not only the average level of lead in the blood
that is important, but also the number of subjects
whose blood level exceeds a certain value.

Pb poisoning is a notifiable and compensatable disease

in India since 1924.