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Lead Toxicity Human Health Effects

Lead Toxicity Human Health Effects . Board Council of Governments April 14, 2004 Washington, DC Georges C. Benjamin, MD, FACP Executive Director American Public Health Association. Where It Comes From?. Naturally occurring element in the environment

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Lead Toxicity Human Health Effects

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  1. Lead Toxicity Human Health Effects Board Council of Governments April 14, 2004 Washington, DC Georges C. Benjamin, MD, FACP Executive Director American Public Health Association

  2. Where It Comes From? • Naturally occurring element in the environment • 40% of US Homes have lead based paint • In these homes 25% are kids under age 6 • Dust, dirt & paint chips • Water (20%)* – Usually lead pipes or solder • Imported Lead glazed dishes, food cans • Some imported candy; some folk remedies *60% of exposure if heavy mixed formula used

  3. 1977 Public Health Success Story! • Unleaded Gas • Solders & pipe • House paint

  4. Where It Goes? • Gets into the body by ingestion or inhalation • Lead is confused by the body as iron, calcium etc • Calcium is an essential nutrient used for cellular function & strong bones • Absorbed lead goes to bones (years) where it is stored and into many types of cells where it disrupts cell function • Absorption increased during pregnancy • It can come back out of growing bones into the blood often during pregnancy, growth spurts, menopause

  5. What It Does? • Anemia • Developmental delay • Mental / cognitive disorders • Kidney dysfunction causing hypertension • Muscle aches • Miscarriages • Coma & death in doses No useful physiologic purpose

  6. Who Is At Risk? • No proven safe level • Infants & those <6y/o • Growing • Increased absorption • Everything goes to mouth • Pregnant women & fetus • Brest feeding women can pass to child if they have increased lead • Adults – especially some workers (battery, smelters, painters)

  7. How Do We Stop It? • Prevention – Flush pipes; filters • Lead abatement • Avoidance of high risk • Environmental testing & remediation – Water Action 15 ppb This is a preventable condition!!!!

  8. What Can We Do About It? • Detection • Universal vs. targeted; blood vs. risk questionnaires • Childhood blood screening (Vena puncture vs. finger stick) • Ages: 12 & 24 months • Symptoms • Reportable to public health authorities

  9. Treatment • Changing: better therapies/knowledge • <10 ug/dL blood level • >10 ug/dL - 25ug/dL blood level (2% in US) • 35 ug/dL – 50 ug/dL blood level (Symptoms) • > 70 ug/dL Medical emergency • Evaluate exposure • Environmental remediation • Remove from exposure • Medication - Chelation therapy • Older ones have side effects • Newer ones can often be given as outpatient

  10. Georges C. Benjamin, MD, FACP Executive Director American Public Health Association WWW.APHA.ORG “Public Health: Prevent, Protect, Promote”

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