{"id":2197,"date":"2021-04-09T15:30:00","date_gmt":"2021-04-09T10:00:00","guid":{"rendered":"https:\/\/wisethalamus.com\/?p=2197"},"modified":"2026-09-22T20:20:18","modified_gmt":"2026-09-22T14:50:18","slug":"lead-poisoning","status":"publish","type":"post","link":"https:\/\/wisethalamus.com\/wise-redesign\/lead-poisoning\/","title":{"rendered":"That Water You Drink Might be Poisoning Your Family With Lead"},"content":{"rendered":"\n
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What will you learn in this article?<\/h2>\n\n\n\n

Lead is a known poison and lead poisoning is known as plumbism. Lead is highly versatile heavy metal. It is non-degradable. Lead easily gets accumulated in the body and remains undetected for a very long time, makes it a serious environmental health hazard. Medical science has proven that lead affects almost every part of the human body. Lead has irreversible effects on neurobiological development of young children and fetus, and its poisoning has lasting implications on the human life.<\/p>\n\n\n\n

Lead is universally present, thanks to industrialization. It\u2019s very easy for any of us to get exposed to this killer unknowingly. Many keep suffering from complications of plumbism for years, not really suspecting that its lead that is poisoning their lives.<\/p>\n\n\n\n

Hence, its critical for each one of us to be aware of this poison and protect us and our families from plumbism. This is the aim of my current post. In this post I would be outlining the symptoms, diagnosis, and treatment therapy for lead poisoning. This will be a detailed post that can used as reference by readers to drive a better understanding of the science entailing lead poisoning. Although this topic must be dealt with detailed science, I will try my best to keep explanations simple enough for even a layman to understand.<\/p>\n<\/div><\/div>\n\n\n\n

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Lead- A Metal of Antiquity<\/h2>\n\n\n\n

Since prehistoric times (till 13th<\/sup> century AD), humans had identified 7 metals<\/a> that were used extensively. These 7 metals- lead, gold, silver, copper, tin, lead, iron, and mercury- were known as the metals of antiquity<\/a>.<\/p>\n\n\n\n

\"Lead<\/figure>\n\n\n\n

The 7 metals of antiquity were so valued by human civilizations that they were incorporated in various mythologies<\/a> and were used for religious symbolisms. Alchemists and astrologers assigned planets and days to these 7 metals of antiquity. Universally silver was always associated with the Moon, and gold was always associated with the Sun. Iron, used always for making weapons, was associated with Mars. The soft, pliable metal copper was linked with Venus, and the chameleon like metal mercury had the same name as its planet.<\/p>\n\n\n\n

Metal<\/strong><\/td>Planet<\/strong><\/td>Day of week<\/strong><\/td><\/tr>
Gold<\/td>Sun<\/td>Sunday<\/td><\/tr>
Silver<\/td>Moon<\/td>Monday<\/td><\/tr>
Iron<\/td>Mars<\/td>Tuesday<\/td><\/tr>
Mercury<\/td>Mercury<\/td>Wednesday<\/td><\/tr>
Tin<\/td>Jupiter<\/td>Thursday<\/td><\/tr>
Copper<\/td>Venus<\/td>Friday<\/td><\/tr>
Lead<\/td>Saturn<\/td>Saturday<\/td><\/tr><\/tbody><\/table><\/figure>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n
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Lead- An Omnipresent Poison<\/h2>\n\n\n\n

So, lead was always a widely used metal since prehistoric times. For 6000 years man has been extensively using lead owing to its versatile properties such as malleability, ductility, poor conductibility, softness and resistance to corrosion. Lead has wide industrial and household applicability due to its obvious physiochemical properties, low cost and easy workability. Hence lead finds its use in over 900 occupations including smelting, mining, battery manufacturing etc.<\/p>\n\n\n\n

Needless to say, such widespread usage of lead for so many thousands of years has resulted in its wide distribution in the environment. Its very easy to find lead enter human body through various sources- many of them are so common and uninspiring that most of us will never suspect these sources to be the ones releasing lead into our body. Lead is non-biodegradable and body finds it very difficult to eliminate lead. Because of this, lead tends to accumulate in body.  Accumulation of even small quantities of lead leads lead poisoning. Lead poising, also known as plumbism, is extremely dangerous and lethal. And it is common.<\/p>\n\n\n\n

Dangers of lead poisoning has been known since ancient times. Hippocrates described a case of severe colic possibly due to lead poisoning way back in 370 BC. In the 2nd<\/sup> century BC Nicander described the relationship of constipation, colic, pallor and paralysis to the lead poisoning. Pliny (AD 23-79) talked about lead poisoning in his works. During his times lead workers would tie up their faces in loose bags \u2018lest they should inhale the pernicious dust\u2019.<\/em> Dioscorides (AD 100) knew that intake of lead compounds can cause colic, paralysis and delirium. Later Ramazzini wrote about potters working with lead that \u2018at first tremors appear in the hands, soon they are paralysed\u2019.<\/em><\/p>\n\n\n\n

\"lead<\/figure>\n\n\n\n

The earliest record of lead poisoning among white-lead workers in England was probably made by Vernatti in 1678. He noted that the general population could also be exposed to significant amounts of lead due to poorly glazed ceramic ware, the use of lead solder in the canning industry, high levels of lead in drinking water, the use of lead compounds in paint and cosmetics and by deposition on crops and dust from industrial and motor vehicle sources.<\/p>\n\n\n\n

In 1823 Benjamin Franklin lost 10 men of his team while trying return from the tragic expedition of the unexplored Hudson Bay. Bones and hairs of these dead men reveal toxic levels of lead deposition. This lead probably entered through the meat that was stored in tin cans- these tin cans<\/a> were soldered and sealed with materials containing high amounts of lead.<\/p>\n\n\n\n

Despite this knowledge about lead poisoning since thousands of years and despite the fact that there have been continues awareness campaigns globally since several decades, lead poisoning still continues to affect millions of adults and children worldwide<\/em><\/strong>.<\/p>\n<\/div><\/div>\n\n\n\n

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How Does This Poison Enter Human Body?<\/h2>\n\n\n\n

Lead is present in our environment and is considered a pollutant. Lead exists in two forms- inorganic and organic. Inorganic lead consists of lead oxides, metallic lead, and lead salts. Organic lead<\/a> includes the tetra-alkyl lead compounds mainly tetraethyl lead and tetramethyl lead which have been incorporated into gasoline as anti-knock additives.<\/p>\n<\/div><\/div>\n\n\n\n

Lead can enter human body through food, water, soil and air. For many, lead poisoning is a gift from their occupation that involves regular contact with lead. Such occupational exposure also puts the families of these individuals at risk due to the \u2018take home lead\u2019<\/a> with their clothes. This is especially true for miners since lead is a metal that is abundantly found in the earth\u2019s crust. Workers involved in occupations such as refining, smelting, battery manufacturing and recycling and car repair etc. are also exposed to lead.<\/p>\n\n\n\n

\"Lead<\/figure>\n\n\n\n

Lead pollution was at peak during the 20th century. One of the most important contributors to this was the rampant use of tetraethyl lead<\/a> (TEL) across the world. In 1920s General Motors identified TEL as an effective antiknock agent that prevented exhaust valve and valve seat wear. Tetraethyl lead (TEL), when mixed with gasoline, acted as \u201coctane rating booster\u201d that allowed engine compression to be raised substantially. This, in turn, increased vehicle performance and fuel economy. During 1970s usage of TEL in gasoline was at its peak. So wide was its usage that the worldwide production of TEL during 1970s was of the order of 500,000 tonnes. It is believed that the use of leaded gasoline alone deposited close to 4-5 million tonnes of lead in soil<\/a>, just in the United States. We do not know the extent of such deposition worldwide.<\/p>\n\n\n\n

Eventually, usage of TEL in gasoline was banned due to associated hazards to lead poisoning. The current production of TEL has reduced to ~4500 tonnes <\/a>(which means it\u2019s still produced and used!). In the United States the mean blood lead levels declined from 15.8 to 2.8 \u03bcg\/dl <\/a>between 1976 and 1991.<\/p>\n\n\n\n

Earlier lead used to be an important component of paints. So, the older buildings, with paint wearing off or those being renovated, generate lead dust and expose the people living in vicinity. PVC pipes used for sanitation and in the potable water supplies use lead as stabilizer. Such usage also poses a threat of lead toxicity due to leaching of lead from the linings.<\/p>\n\n\n\n

Several of the Ayurvedic and Chinese medicines contain lead. If used irrationally by an \u201cuntrained\u201d practitioner, these medicines can be a source of lead poisoning. Several \u201cinnocent\u201d looking items such kajal and surma (used as eye cosmetics in India and Arabic countries) contain lead. And so does cheap toys, which many parents might not even suspect as source of lead poisoning.<\/p>\n\n\n\n

In the 1980s, in just a few months, multiple cases of lead poisoning were diagnosed amongst numerous Arabs living in a specific area in Israel. These cases were admitted to Jerusalem hospitals. The source of lead contamination was finally traced to the domestic processing of flour<\/a> in a particular group of Arab villages.<\/p>\n\n\n\n

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In 2003 higher levels of lead were detected in certain districts of Washington DC<\/a>, especially in children. Investigations revealed that a change of disinfectant in the public water supply from chlorine to chloramine led to excessive leaching of lead from the inner lining of the water pipes.<\/p>\n<\/div><\/div>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n

Occupational<\/strong> Sources of Lead Poisoning<\/strong>
Lead mining and refining, plumbing and pipe fitting, auto repair, glass manufacturing, printers, battery manufacturing and recycling, construction work, firing-range, plastic manufacturing and gas stations<\/td><\/tr>
Environmental<\/strong> Sources of Lead Poisoning<\/strong>
Lead paint, soil or dust near roadways, lead-painted homes, plastic window blinds, plumbing, ceramic ware and lead-core candle wicks<\/td><\/tr>
Other<\/strong> Sources of Lead Poisoning<\/strong>
Traditional medicine, gasoline sniffing, costume jewelry, cosmetics, glazed pottery making, target shooting at firing ranges, lead soldering, preparing lead shot or fishing sinkers, stained-glass making, painting and car or boat repair<\/td><\/tr><\/tbody><\/table>
Common Sources of Lead Exposure and Poisoning<\/figcaption><\/figure>\n\n\n\n
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Who are more prone to Lead Toxicity?<\/h2>\n\n\n\n

Amount of lead entering our system depends on the route of entry. In case of adults, if lead is ingested, 20-70% of this lead will find its way into blood. <\/p>\n\n\n\n

But almost 100% of the inhaled lead directly gets absorbed into blood. <\/em><\/strong><\/p>\n\n\n\n

Absorption of lead is 3 times higher in children <\/a>compared to adults. Also children retain 30% of lead absorbed compared to 1% in adults. Thus children are more susceptible to lead poisoning. <\/strong>Young children (9 months to 3 years), especially, are most vulnerable groups. This is because of their exploratory behavior. The frequent hand-to-mouth activity of children belonging to this age group is 5 to 10 times more effective in delivering lead into their system. This is also the age of rapid development where lead can have significantly deleterious impact. <\/p>\n\n\n\n

\"Lead<\/figure>\n\n\n\n

The other high-risk groups include occupationally exposed workers and artisans and their families. Similarly, pregnant women along with the growing baby inside womb also have higher risk of lead toxicity. The amount of lead absorption is generally higher for patients having calcium, zinc or iron deficiency.<\/p>\n\n\n\n

In the body 95-99% of ingested lead is get collected into the RBCs erythrocytes. From there eventually lead gets transferred to other tissues across the body. Lead usually gets stored in bones and teeth. It also gets deposited in hairs and nails. The rate of deposition of lead in bones and teeth is almost 95% in case of adults while 70% in case of children. <\/p>\n\n\n\n

It is important to remember that lead thus deposited in bones and teeth is not always toxic. It is generally the presence of lead in blood that causes toxic effects. But we also need to remember that bones are not static. In children and pregnant women there is significant remodelling of bones<\/a>. During such remodelling, the lead from the bones and teeth gets released into the blood stream manifesting its toxic effects. And this can happen years after initial exposure. While, half-life of lead in blood is up to 30 days, its storage in bone can remain for more than 20 years.<\/strong> (Half life refers to how much time it takes for a substance to decrease to 50% of its original quantity).<\/p>\n\n\n\n

Blood lead level (BLL) a major criteria that is used to measure the extent of the lead poisoning. Another important criterion to measure lead toxicity is \u2018body burden of lead\u2019, which calculates the amount of lead which is deposited in the soft tissues and bones of the body. For a large period of time the toxic lead levels had remained undefined. As scientific evidences started accumulating regarding dangers of lead, scientific community\u2019s tolerance for lead kept going down with time. For example, between 1960 and 1990, \u2018blood lead level of concern\u2019 were lowered incrementally from 60 to 25 \u03bcg\/dl. In 1991, it was lowered to 15 \u03bcg\/dl. Until 2012, Centers for Disease Control (CDC), USA had set toxic BLL to be above 10 \u03bcg\/dl for all. But in 2012 CDC redefined the standards once again. The BLL was now set<\/a> at > 10 \u03bcg\/dl for adults but >5 \u03bcg\/dl for children.<\/p>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n

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Diagnosis of Lead Poisoning<\/h2>\n\n\n\n

In majority cases lead toxicity remains asymptomatic and goes unnoticed. Often most of the symptoms are similar to other disorders. Because of this, most often, lead poisoning remains undiagnosed and untreated. Hence general awareness and education regarding lead toxicity is really important.<\/p>\n\n\n\n

In case of children, the BLL needs to be determined along with proper examination to check possible growth retardation, language or speech dysfunction, anaemia and behavioural or attentional disorders. <\/p>\n\n\n\n

The primary test in all suspected lead poisoning cases is to estimate the BLL. <\/em><\/strong><\/p>\n\n\n\n

Microscopic examination of blood smears may show what is known as \u201cbasophilic stipplings<\/a>\u201d amongst the red blood cells (RBCs). These appear as numerous blue colored dots within the RBCs. Presence of \u201cbasophilic stipplings\u201d is considered as diagnostic of lead poisoning in cases where there is already some clinical suspicion of the same. \"Lead<\/p>\n\n\n\n

Basophilic stipplings suggest serious injury to bone marrow where RBCs are produced. This bone marrow damage also leads to aberration in the chemical reaction that is necessary for formation of hemoglobin in RBCs. This aberration leads to increased levels of chemicals such as urinary porphyrins, coproporphyrins, zinc protoporphyrin and erythrocyte protoporphyrin<\/a>(EP). <\/p>\n\n\n\n

Clinicians must remember that EP levels solely cannot be used for diagnosis of lead poisoning. EP also rises in iron deficiency which is quite prevalent in developing countries like India. <\/p>\n\n\n\n

The same dysfunction in formation of hemoglobin leads to excess of a compound called \u03b4-aminolevulinic acid (ALA)<\/a>. <\/p>\n\n\n\n

Increase secretion of ALA in urine is considered as an indicator of lead poisoning.<\/em><\/strong><\/p>\n\n\n\n

Patients suffering from long term lead poisoning often experience painful episodes that causes swelling of joints (especially at the big toe). This swelling happens because of deposition of needle shaped crystals of a compound called uric acid that is being excessively formed in lead poisoning. Excess uric acid formation indicates lot of cells are dying rapidly.  This gout is also known as \u201csaturnine gout<\/a>\u201d and has been known since many centuries. The term \u201csaturnine\u201d refers to lead\u2019s association with planet Saturn. During ancient times, lead poisoning was probably common among the upper classes of Roman society. Experts believe that the deaths of some Roman emperors and officials can be attributed to the addition of lead solutions to wine and port. Leaded water pipes were also rampantly used during those times. Skeletal remains of Romans<\/a> at Cirencester, England, show evidence of gout. “[Many] persons troubled with gout, dropsies and colics and the like\u2026who live upon prepared dainties\u201d<\/em>- this statement is from an eyewitness account was given by one Musonius <\/a>(20-90 AD) and refers to gout as being a common disease across during those olden times. It is likely that this \u201cpandemic\u201d of gout resulted from the excessive exposure to lead.<\/p>\n\n\n\n

\"Lead<\/figure>\n\n\n\n

Patients will lead poisoning will have reduced total hemoglobin, low red blood cell count and low thyroid hormones (T3 and T4) while their white blood cell (WBC) count will remain fairly unaffected for a long time. Sudden exposure to high levels of lead (known as \u201cacute\u201d lead poisoning) can cause a devastating anemia called haemolytic anaemia <\/a>where RBCs start getting killed rapidly. In case of chronic lead poisoning (where there is exposure to lead for over a long period of time), RBCs don\u2019t get killed so rapidly. But these RBCs turn out to be immature with low amount of hemoglobin and with size that is either smaller than normal or normal (Doctors call this as normocytic\/microcytic hypochromic anaemia with reticulocytosis<\/a>). <\/p>\n\n\n\n

BLL is good test for screening lead poisoning. <\/p>\n\n\n\n

But one must understand that BLL is just an indicator of recent lead exposure. BLL does not reflect upon the total \u201cbody burden of lead\u201d. <\/em><\/strong><\/p>\n\n\n\n

In order to determine the total body burden, doctors generally use a radiological technique involving X-ray fluorescence<\/a>. This is a non-invasive method to measure whole body lead in bones. Abdominal X- rays often help revealing lead containing foreign materials such as paint chips that have accumulated in the gastrointestinal tract. However, such abdominal X-ray is useful only in cases of acute ingestion of lead or when there unusually long persistence of high BLL. X-rays of long bones such as those of arms (eg. humerus) and thighs (eg. femur) can show \u201clead lines<\/a>\u201d. These lines represent increase in density around the \u201cgrowth\u201d segment of the bone. Their presence indicates growth retardation of the affected bones due to lead poisoning. Although I must mention here that identifying \u201clead lines\u201d is not a routine procedure to identify lead poisoning. But \u201clead lines\u201d indicate a definite case of chronic exposure to lead. <\/p>\n\n\n\n

\"Lead<\/figure>\n\n\n\n

Burton’s line might be an important clue that can help diagnosis of lead poisoning. It is a very thin, black-blue line visible along the margin of the gums, at the base of the teeth in patients with chronic lead poisoning. It is caused by a reaction between circulating lead with sulphur ions released by bacteria in the mouth. This reaction causes deposition of the \u201cblack-blue colored\u201d lead sulphide at the junction of the teeth and gums. This clinical sign was first described in 1840 by Henry Burton. However, it\u2019s not a sign reliably present in all patients. But, when present, Burton\u2019s line can be important for clinicians to suspect lead poisoning.<\/p>\n\n\n\n

\"Lead<\/figure>\n\n\n\n
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Why is lead considered so poisonous to us?<\/h2>\n\n\n\n

How does lead cause damage?<\/h3>\n\n\n\n

Oxygen is life for us.  One must imagine oxygen as the \u201cfuel\u201d for life to continue. We need oxygen to generate energy.  But the same oxygen that fuels the fire of life also has the ability to burn cells and cause damage. Each time any cell utilizes oxygen, it leads to formation of highly damaging set of molecules known as reactive oxygen species (ROS). ROS is the unwanted residual fire that must been extinguished to protect cellular components from getting damaged.<\/p>\n\n\n\n

ROS molecules are extremely dangerous. Damage to DNA by ROS is the most important reason why cancer happens. It is the accumulating damage from ROS that causes ageing<\/a>.  The whole gamut of chronic diseases such as diabetes, hypertension, rheumatoid arthtritis etc end up destroying organs only because of excessive release of ROS for a long period of time.  <\/p>\n\n\n\n

More the release of ROS, more will be the damage. Faster the release of ROS, faster will be damage. And if the quantity and rate of ROS formation crosses body limits, the damage done is usually permanent.<\/em><\/strong><\/p>\n\n\n\n

\"Lead<\/figure>\n\n\n\n

The unavoidable unlucky part is, ROS is produced each and every second in every cell in ay living body. Luckily all our cells are equipped with a set of chemicals known as antioxidants which act as \u201cfire- extinguishers\u201d. These antioxidants neutralize any ROS that is being formed due to utilization of oxygen. So long as ROS is completely neutralized, little damage will happen. And even that little damage will get completely taken care of by our body\u2019s repair systems. However, as we grow older our capacity to produce antioxidants <\/a>keep diminishing and our repair systems also keep getting weaker. This leads to small amount of cellular damage accumulating on a continuous basis- the extent of damage increasing with time and not getting repaired. We call this process as aging.<\/p>\n\n\n\n

Lead, when introduced in human body, immediately starts producing reactive oxygen species (ROS)<\/a> molecules such as hydro peroxides, singlet oxygen, and hydrogen peroxide. In ideal scenario, these ROS molecules would be deactivated by the cellular antioxidants. But that depends on how much ROS is produced, since we don\u2019t have unlimited reserves of antioxidants. <\/p>\n\n\n\n

And now what if I say lead deactivates antioxidants as well? <\/p>\n\n\n\n

Lead has a unique chemistry <\/a>with 82 electrons of which 4 are valence electrons. If you are na\u00efve to chemistry, its ok. What you just need to understand is that lead loves to combine with Sulphur<\/a>. Lead also easily interacts with zinc. Sulphur is a very important component<\/a> of our cellular antioxidants. Similarly for antioxidants to work, zinc is needed. So, when a small amount of lead enters our body it starts combining with all the sulphur present within the antioxidants in each cell. Similarly this lead also goes on to replace the zinc ions which are needed to activate<\/a> antioxidant system.<\/p>\n\n\n\n

The result is devastating. Antioxidants get paralyzed. The \u201cfire- extinguishers\u201d are no longer functioning. Lead itself produces high amounts of ROS. And with no antioxidants to counter, these ROS molecules go unchecked and create havoc. The extent and pace of devastation depends of how fact and what amount of lead has gone in.<\/p>\n\n\n\n

Lead poisoning leads to production of reactive oxygen species (ROS) and deactivation of anti- oxidants. The unrestricted damage caused by ROS is the main mechanism of lead poisoning.<\/em><\/strong><\/p>\n\n\n\n

\"Lead<\/figure>\n\n\n\n

Studies conducted in past 20 years have confirmed that lead is poisonous and has lethal effect on the general population. The Second NHANES study<\/a> conducted in 4292 individuals in 1976-1980 evaluated health care outcomes for various lead levels in blood. These individuals were followed up until 1992.This study showed that individuals with blood lead levels of 20-29 \u03bcg\/dl (15% of the U.S. population at that time) had 46% higher deaths (due to any cause), 39% higher deaths due to heart diseases and 68%  higher deaths due to cancer. The Third NHANES study<\/a> that was conducted during 1988-1994 in 13,496 individuals showed that lead is hazardous for heart even when blood lead is < 10 \u03bcg\/ dl.<\/p>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n

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Toxic effect of Lead on Blood System<\/h3>\n\n\n\n

Hemoglobin is what makes your blood red. Hemoglobin is present inside red blood cells (RBCs) and is necessary to carry oxygen from lungs to all the cells across the body. Lead poisons the chemicals required for production of hemoglobin in blood. The ROS produced by lead also damages the cell membrane of RBCs. This severely disrupts RBCs\u2019 capacity to carry oxygen. This condition is known as anemia.<\/p>\n\n\n\n

As discussed in an earlier section, lead poisoning results into two forms of anemia<\/a>:<\/p>\n\n\n\n