Lead Poisoning: How Much Lead Is Toxic?

girl chipping paint off wall

The Bottom Line

There are many sources of lead poisoning, including both environmental and occupational causes. Poisoning is usually due to lead ingestion and/or inhalation. Lead poisoning causes multi-organ toxicity, especially of the nervous system and kidneys. If lead levels in the blood are high, chelating drugs can be given to reduce the burden of lead in the body.

old lead pipes

What is lead?

Lead is a soft and malleable heavy metal that is either extracted from natural ores or obtained by recycling and smelting scrap lead products. It is used in lead batteries, weights, and radiation shielding. Paints, ceramics, glass, and plastic may contain lead compounds, which act as pigments, stabilizers, and binders. Lead alloys (lead combined with other elements) are found in bullets, solder, and plumbing.   

What is lead poisoning? How much lead is toxic? 

Lead poisoning, also known as plumbism, occurs when the amount of lead in the body builds up to toxic levels. Ingestion of a large amount (grams) of soluble lead (such as lead chloride and lead acetate) or lead objects (such as curtain or fishing weights) that are retained in the digestive tract can cause acute toxicity, but this is rare. Poisoning is most often caused by chronic exposure to lead over months or years. However, one can argue that any amount of lead in the body is potentially toxic. Young children are very susceptible to lead poisoning, and even relatively low levels of lead in the blood can affect a child’s cognitive function. 

Causes of lead poisoning: How do you get lead poisoning? 

Poisoning typically occurs from ingestion, inhalation and – for organic forms of lead (such as tetraethyl and tetramethyl lead) – skin absorption. In the past, major sources of lead included lead-based paints and leaded gasoline. The use of lead in house paint was discontinued in the 1970s and the addition of tetraethyl lead to gasoline as an antiknock agent was phased out by the mid-1990s. Older homes can still be a source of lead. Children can ingest paint chips or lead-contaminated yard soil, as well as inhale lead dust. Lead plumbing may corrode, dissolving into drinking water. 

Lead poisoning can be caused by using lead-glazed ceramics for storing food or drinks. Lead can also be found in plastic toys and jewelry. Lead toxicity can occur from ingested lead foreign bodies, retained bullets, and inhalation of lead at indoor firing ranges. Lead intoxication may be caused by some Ayurvedic, traditional, or folk medications, as well as by some cosmetics and imported foods. Adults may experience occupational exposure to lead in industries such as lead mining and smelting, battery manufacturing, recycling, and other types of manufacturing involving lead.

What are the symptoms of lead poisoning?

Lead poisoning affects many organ systems in the body, including the digestive tract, nervous system (brain and peripheral nerves), heart, kidneys, and blood. Severe lead poisoning can result in death. Lead can cause constipation and abdominal pain known as lead colic. Headache, fatigue, irritability, trouble concentrating, and muscle weakness (especially in the wrist) are nervous system symptoms of lead toxicity. More serious brain effects include lethargy, convulsions, and coma. In children, chronic exposure to lead can lead to decreased intelligence and behavioral and cognitive disorders. Chronic lead exposure can cause hypertension and kidney dysfunction. Lead also causes anemia. 

How to treat lead poisoning: Can lead poisoning be cured?

Lead poisoning can be treated with chelating drugs. Some chelators are given by mouth and others are administered by injection. Chelators bind to lead, forming a compound that can be excreted from the body. This results in the gradual elimination of lead by the kidneys and decreased blood lead levels. Use of chelators is recommended based on blood lead levels and symptoms. There are no controlled studies proving that chelators “cure” toxicity already caused by lead. The best way to prevent lead poisoning is to eliminate exposure to lead as much as possible.

What should I do if I suspect lead exposure?

If you are concerned about lead exposure and/or the possibility of lead toxicity, contact your doctor, county or state health department, or Poison Control for guidance on whether laboratory evaluation and/or treatment is needed. If someone swallows a substance containing lead, gets lead on the skin, inhales lead, or if you have a question about handling lead safely, help from experts is available from Poison Control at 1-800-222-1222. Poison Control’s expert guidance is always free, confidential, and available 24 hours a day.
 
Wendy Klein-Schwartz, Pharm.D., MPH
Clinical Toxicologist 

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Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Check that imported toys, toy jewelry, and cosmetics do not contain lead.
  • Pay attention to public health alerts and recalls related to lead.
  • Do not store food in lead-glazed ceramic containers.
  • If you live in an old house, have the paint and water tested for lead.
  • Inspect and maintain all painted surfaces in your home.
  • Keep your home clean and dust-free.
  • If you are remodeling, take precautions to avoid lead dust exposure. 
  • If you work with lead, remove contaminated work clothes before entering the house.
  • Do not let children eat soil; wash hands after playing outdoors.

This Really Happened

Case 1. A family was visiting friends who lived in an old house, where their 2-year-old son swallowed a few paint chips. He was still playing and had no symptoms. The parents were concerned about lead toxicity and called Poison Control. The poison center specialist informed them that the amount of lead in a few paint chips is low. Since this was a one-time exposure, rather than a chronic exposure over months or years, their son would likely be fine. 

Case 2. A 6-year-old girl ingested a lead fishing sinker. Since she had no symptoms initially, her parents waited several hours before calling Poison Control. The poison center specialist informed the parents that their daughter was at risk for lead toxicity and recommended they take her to the emergency department. In the emergency department, she complained of mild abdominal pain. An x-ray was performed which showed the fishing sinker beyond the stomach and in the intestines. Poison Control recommended giving a large volume of polyethylene glycol electrolyte solution to flush the sinker out of the digestive tract. Blood was drawn to assess her blood lead level. Several hours later, the sinker was flushed out. The blood lead level was elevated, so the girl was treated as an outpatient with an oral chelator for several weeks until her blood lead level decreased significantly.  

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References

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Check that imported toys, toy jewelry, and cosmetics do not contain lead.
  • Pay attention to public health alerts and recalls related to lead.
  • Do not store food in lead-glazed ceramic containers.
  • If you live in an old house, have the paint and water tested for lead.
  • Inspect and maintain all painted surfaces in your home.
  • Keep your home clean and dust-free.
  • If you are remodeling, take precautions to avoid lead dust exposure. 
  • If you work with lead, remove contaminated work clothes before entering the house.
  • Do not let children eat soil; wash hands after playing outdoors.

This Really Happened

Case 1. A family was visiting friends who lived in an old house, where their 2-year-old son swallowed a few paint chips. He was still playing and had no symptoms. The parents were concerned about lead toxicity and called Poison Control. The poison center specialist informed them that the amount of lead in a few paint chips is low. Since this was a one-time exposure, rather than a chronic exposure over months or years, their son would likely be fine. 

Case 2. A 6-year-old girl ingested a lead fishing sinker. Since she had no symptoms initially, her parents waited several hours before calling Poison Control. The poison center specialist informed the parents that their daughter was at risk for lead toxicity and recommended they take her to the emergency department. In the emergency department, she complained of mild abdominal pain. An x-ray was performed which showed the fishing sinker beyond the stomach and in the intestines. Poison Control recommended giving a large volume of polyethylene glycol electrolyte solution to flush the sinker out of the digestive tract. Blood was drawn to assess her blood lead level. Several hours later, the sinker was flushed out. The blood lead level was elevated, so the girl was treated as an outpatient with an oral chelator for several weeks until her blood lead level decreased significantly.