Lead is a toxic heavy metal that is present naturally in the environment but has become more widespread due to its use in products. Children and pregnant women are most at risk of health effects from lead exposure, which can occur through inhalation, ingestion, or absorption. Common sources of lead exposure include lead-based paint, soil, water, hobbies, folk remedies and jobs involving lead. Low levels of lead in children have been linked to learning and behavior problems, lower IQ, slowed growth and anemia. In pregnant women, lead exposure can impact the developing fetus and result in preterm birth, low birth weight, developmental delays and miscarriage. Treatment involves chelation therapy or dietary supplements to remove lead from the body

1. Lead Poisoning
By
Yasmin Aziz badi
Higher deploma in Clinical and Environmental
Toxicology
Supervised by
Dr. Amar A. Hussian
Collage of pharmacy
Baghdad University

2. What is Lead?
Lead is a heavy metal that is present at low
levels in the earth’s crust but has become
pervasive in the environment because of its
use in products such as gasoline, paint,
jewelry, water pipes, lead solder, and lead-
acid batteries.
While it has some beneficial uses, it can be
toxic to humans and animals,
causing health effects.
The International Programme on Chemical
Safety of the World Health Organization
(WHO) has identified lead as one of the 10
chemicals of major public health concern.

4. Sources of Lead Exposure
Work environment
Soil
Ceramics
Folk remedies
Lead solder
Drinking water
Fishing tackle
Costume/toy jewelry
Curtain weights
Artist oil paint
Vinyl mini blinds
Pool cue chalk
Antique toys
Glassware (leaded crystal)
Kohl

6. Who is at Risk?
Children
1-Lead is particularly dangerous to children because
their growing bodies absorb more lead than adults do
and their brains and nervous systems are more
sensitive to the damaging effects of lead.
2- Babies and young children can also be more highly
exposed to lead because they often put their hands and
other objects that can have lead from dust or soil on
them into their mouths.
3- Children may also be exposed to lead by eating and
drinking food or water containing lead or from dishes
or glasses that contain lead, inhaling lead dust from
lead-based paint or lead-contaminated soil or from
playing with toys with lead paint.

8. Adults, Including Pregnant Women
Adults may be exposed to lead by eating and
drinking food or water containing lead or from
dishes or glasses that contain lead. They may also
breath lead dust by spending time in areas where
lead-based paint is deteriorating, and during
renovation or repair work that disturbs painted
surfaces in older homes and buildings. Working in
a job or engaging in hobbies where lead is used,
such as making stained glass, can increase
exposure as can certain folk remedies containing
lead. A pregnant woman’s exposure to lead from
these sources is of particular concern because it
can result in exposure to her developing
baby.

9. So the route of exposure is :
1- Inhalation (most rapid)
2- Ingestion (absorption is facilitated by
young age and diet deficient in calcium,
iron, and /or zinc) .
3-Transdermal (least efficient , but organic
inorganic absorption<absorption

10. Signs and symptoms :
Severe (whole blood lead level (BLL)
>100-150 mg/dl)
-encephalopathy (i.e., coma , seizures
,delirium , signs of increase ICP)
-foot/wrist droop
-abdominal pain (lead colic)
-vomiting
-anemia
-nephropathy

12. Moderate (BLL >80 mg /dl )
-headache
-memory loss
-fatigue
-irritability
-insomnia
-decreas in libido
-muscle pain/weakness
-abdominal pain
-anorexia
-weight loss
-nephropathy(if chronic exposure)
-mild anemia .

13. Mild (BLL > 40 mg/dl )
-fatigue
-moodiness
-hypertention
-dcreas in interest in everyday activities .

16. The Health Effects of Lead on Children
and Pregnant Women
Children six years old and younger are most susceptible
to the effects of lead.
Children
Even low levels of lead in the blood of children can
result in:
Behavior and learning problems
Lower IQ and Hyperactivity
Slowed growth
Hearing Problems
Anemia
In rare cases, ingestion of lead can cause seizures, coma
and even death.

18. Pregnant Women
Lead can accumulate in our bodies over time,
where it is stored in bones along with calcium.
During pregnancy, lead is released from the
mother's bones along with calcium and can pass
from the mother exposing the fetus or the
breastfeeding infant to lead. This can result in
serious effects to the developing fetus and infant,
including:
Cause the baby to be born too early or too small;
Hurt the baby’s brain, kidney’s, and nervous
system; Increase the likelihood of learning or
behavioral problems; and Put the mother at risk
for miscarriage.

19. Mechanisms of Toxicity
Lead exerts numerous adverse mechanisms of
toxicity.
1-Lead has a high affinity for sulfhydryl groups
which interfer with enzymes and stratural
proteins .
2-Many of lead’s toxic effects also result from its
inhibition of cellular function requiring
calcium(lead is chemically resembles calciume)
Lead binds to calcium-activated proteins with
much higher (105 times) affinity than calcium.
So interfer with calcium homeostasis and
calicume-dependent signaling and metabolic
bathways .

21. Treatment
1-Tow options are available, Chelation with
(CaNa2 EDTA) and dimercaprol (BAL) for sever
poisoning with encephalopathy or with succimer
(DMSA) PO for patients able to tolerate oral
medication .
2- Whole bowle irrigation with polyethyline glycol
if lead foreigen bodies can be visulalized in the
GIT on radiograph .
3- endoscopic removal is indicated if the lead is in
the stomach or esophagus
4-surgiacl removal is indicated if the lead object
poses the threat of prolonged retention .

22. Refereances
1- Toxicology Recall by christopher P.
Holstege .
2-medscape
3- EPA