Talk:Lead poisoning

From Wikipedia, the free encyclopedia

WikiProject Medicine This article is within the scope of WikiProject Medicine. Please visit the project page for details or ask questions at the doctor's mess.
B This page has been rated as B-Class on the quality assessment scale
High This article has been rated as High-importance on the importance assessment scale

This is the talk page for discussing improvements to the Lead poisoning article.
Article policies

Contents

[edit] Discussion

I'd like to see information on responses to Lead Poisoning. I found the article from a link from Vitamin C. It said it may be helpful to treat Lead Poisoning. I've also read that EDTA was used to help with lead poisoning during WWII but that the EPA stopped the practice to force better workplace conditions.

There is little evidence that chelating agents are usefult in treating lead poisoning (see work by Rogan et al and Dietrich et al from the Treatment of Lead Exposed clinical trial). In addition, children who receive chelation therapy (succimer or EDTA) tend to have rebounds in blood lead levels due to equilibration between the bone and blood lead compartments.

Now there is a discussion page. Feel free to post discussion here, not in the article itself. LegCircus 02:14, 9 November 2005 (UTC)


I understand that not everyone who visits Wikipedia would be a practitioner of homeopathy, but I think it worthwhile to mention that in that mode of healing there is a remedy specifically for lead poisoning, called "Alumina," as well as a more general remedy called "Causticum." I am therefore going to add this information, with reference to the book in which I found the information.


Since lead poisonning is somewhat of a major health problem and homeopathy is controversial, I think we should not advocate this as a therapeutic option, especially since chelating agents have few side effects aside from chelating minerals from the body (which, however, is their specific purpose and has no long term consequence) Duf_Sherby 15:16, 05 may 2006 (EAT)


Well, I see the validity of not advocating a therapy that is not officially advocated by the American Medical Association. But, since there's the caveat of homeopathy NOT being universally accepted as a useful mode of healing in the US, what harm can there be in allowing people to see the information? They can be curious, go to the link on homeopathy, learn about the history of the whole movement and decide for themselves if they're interested in it, just as they'll do for chelation therapy. I don't think we're endangering anyone's health by showing more than one modality for healing a very serious health threat. I'm sure that anyone truly seeking information on how to clear the body of lead will research all the leads given to them, and not go off treating themselves based on one paragraph they read on Wikipedia. Though homeopathy was rejected from US medicine while the medical professionals were organizing themselves on a national level, long ago, is it really our place to say that the mere mention of it is harmful to readers? Just as with chelation, there is in fact no harmful side effect from homeopathic remedies, which are given in what can only be described as miniscule doses. Anyway, I hope you don't decide to take the information off the page. I would certainly understand any further caveat you see fit to add to it, but taking away the option of the knowledge seems a bit much. User:Iris Anthe 21:50, 14 May 2006
If you're going to mention homeopathy then you need to mention that it does not work. People need to know that it is not effective in treating lead poisoning. They don't need to go throwing their money away on a product that will not help their child.
There is no evidence (besides anecdotal) that homeopathic remedies are useful in treating lead poisoning. The best treatment is prevention. The previous statement "Just as with chelation, there is in fact no harmful side effect . . ." is plain wrong. Again, see articles by Rogan and Dietrich. Chelation therapy is actually associated with decreases in cognition, possibly due to elimination of other essential divalent cations.

What about the use of Epsom salts (magnesium sulphate) in the treatment of lead poisoning? James Herriot mentioned it in treating lead poisoning in calves (All Things Bright and Beautiful, or All Creatures Great and Small, if I recall correctly) and certainly lead sulphate would be a precipitate. Iain marcuson 04:44, 22 March 2007 (UTC)

IIRC a suitable reference for the Franklin Expedition famous case might be "Frozen in Time", hardback, (1987?) by Owen Beattie and John Geiger.

As I recall one or both of Beattie/Geiger are forensic pathologists and the book was a pretty thorough albeit gruesome analysis of the fate of the expedition. Looking on Amazon I note that there are several more recent books with similar titles seemingly dealing with the same issue.

For interest, a year or so back (on Australian ABC TV or SBS TV) there was a series of films dealing with the opening/exploration of the NW Passage and I think a couple of those dramatised the fate of the expedition. HTH. --220.233.87.42 21:04, 2 November 2006 (UTC)

In Symptoms and Effects, abdominal pain was mention twice. I removed one instance. Was there a reason that it was there? 138.163.160.42 10:20, 17 March 2007 (UTC)

[edit] Taken from Lead

This looks like a copyvio, but I didn't get a google hit. Edit into the article as you see fit:

Lead poisoning is a chronic disorder often seen in children who are near environmental exposure risk, such as ingestion of paint chips or putty or plaster from old buildings. Sources of lead include household dust, paint removal, and contaminated soil and water. Living in close proximity to lead production facilities increases the risk of lead poisoning. Exposure of lead may also occur from contaminated work clothes of a parent. Pipes may cause mild to moderate lead poisoning. Folk remedies, lead objects, like shot and fishing weights, and lead glazed pottery also contribute to lead poisoning. Presentaion and physical exam depend on bloodlead level and age of the child. Most have no symptoms and are picked up on routine screen. Anorexia, apathy, lethargy, anemia, decreased play activity, aggressiveness, and poor coordination may all be symptoms of lead intoxication. Symptoms of chronic exposure are apathy, nausea, vomiting, and coma and seizures. The elevated lead and elevated free eyrthrocyte protoporphyrin and elevated lead in the urine after giving Calcium EDTA makes the diagnosis. Minimum lead screening should be done for those that are 6 month to 6 years of age. Children at risk for lead poisoning should be screened by finger stick blood levels. Blood lead levels of > 10 are abnormal. The patient may have evidence of sideroblastic anemia. X-ray may show evidence of lead lines at the metaphysis of long bones and radiopaque foreign material within the small bowel. The goal of management is to elimanate or remove the child from the source of lead. Management of lead poisoning Lead Level 10 to 14 ug/dl repeat within 3 months, evaluate sources, education. Lead Level 15 to 19 Repeat in 2 months, evaluate sources, education, and department of health referral Lead Level 20 to 44 Repeat in 1 month all stated above Lead Level 44 to 70 treat with single drug, preferably DMSA Lead Level greater than 70 immediate hospitilization and two drugs: EDTA and DMSA/BAL without encephalopathy EDTA and BAL with encephalopathy

Josh Parris#: 01:09, 16 December 2005 (UTC)

Blood lead levels < 10 micrograms/deciliter in children are associated with neurodevelopmental delays and behavioral problems in children (see Canfield 2003, Lanphear 2005, Braun 2006).

[edit] Can someone defend this?

A smelter in Port Pirie in Australia lead to global genocide.

Smelters are apparently everywhere, and there has never been any "global genocide". It's hard to believe that any monster of world history can have his criminality pegged to one specific smelter. Even Hitler, Stalin, and Mao, evil as they were, never initiated 'global' genocides; nobody has yet connected their crimes to any effects of lead poisoning.

I have elected to delete the statement as vandalism. Someone who has a grudge against a business entity or a community should not vent on Wikipedia without solid evidence that the disparaging remarks are true and relevant. I question whether anyone could defend such a statement as the one that I have deleted. --66.231.41.57 04:24, 26 May 2006 (UTC)

[edit] Lead poisoning from gunshot wounds

"The term "lead poisoning" is sometimes used as a slang term for death or injury by firearm." Is it possible to get lead poisoning after beeing shot? 84.48.82.158 12:20, 16 September 2006 (UTC)a.s.

Personally I don't think it's very likely... I would be far more concerned about the gun shot wound myself. 220.239.88.91 02:36, 11 March 2007 (UTC)

You can be poisoned after being shot if the lead bullets or pellets remain in your body.
See: McQuirter JL, Rothenberg SJ, Dinkins GA, Norris K, Kondrashov V, Manalo M, Todd AC. Elevated blood lead resulting from maxillofacial gunshot injuries; Three case reports of ingested lead particles after gunshot injury to the face. J Oral Maxillo Surg 2003:61(5);593-603.
McQuirter JL, Rothenberg SJ, Dinkins GA, Kondrashov V, Manalo M, Todd AC. Change in Blood Lead Concentration to One Year after Gunshot Wounds with Retained Bullet. Am J Epidemiol 2004:159(7):683-692. Drlead 14:19, 25 July 2007 (UTC)

[edit] Asia Minor instead of Turkey

I changed Turkey to Asia Minor since Turkey did not exist as a state at that time period and the Turkish nation was not present in the area.

[edit] Death?

theres no mention of whether or not lead poisoning can kill in this article

Blood lead levels >70 micrograms/deciliter can cause death or serious injury through seizures or coma. I would cite the Agency for Toxic Substances web page or the CDC webpage. I personally have heard from my colleagues that children with blood lead levels >100 mcg/dL have been walking around without any problems, while other children are hospitalized at those levels. There is incredible variation in the response to elevated lead levels.

[edit] picutures! needed!

need pictures. get some of the lead poisoned gums. also of a blood smear with the basophilic stip.

[edit] Lead Shot Ban in Wetlands

Would this Scottish legislatiion be an acceptable link to demonstrate this trend, for the citation request? http://www.opsi.gov.uk/legislation/scotland/ssi2004/20040358.htm -BlackTerror 21:36, 22 March 2007 (UTC)

added the metal taste, i'm not sure whether that's how it is called in english, but if anyone knows how to properly translate it, it's the "metally" taste that Pb leaves at relatively high blood concentrations.

[edit] Homeopathic Treatment

Is the homeopathic remedy here really appropriate. Homeopathy has no scientific basis and no study has ever proven its effectiveness nor has any prise ever offered by skeptics been cliamed and awarded. I dont mind the info being there but it should be kept as short as possible with any onformation going instead into the doctors page there linked instead: A one liner basically will do so as not to tilt the Treatment section of the article towards homeopathy which I think is not only wrong but misguided and potentially health threatening to those who read it and need real and scientifically validated treatment. 220.240.58.190 14:00, 23 April 2007 (UTC)

It is extremely dangerous to even suggest a therapeutic approach based on a pseudo-science. It could lead someone to try the homeopathic treatment which is not considered effective by modern science. By the way there is no serious study showing effectiveness in homeopathic treatment at all.

[edit] Edit war

The edit war between Yaf and 72.211.140.52/Burk8 made a hash of things. I reverted back to the last version before the edit war began. If I've counted correctly, neither editor can make another edit today (some, I'll discretely say, by a wide margin), so everyone go edit something else, and come back tomorrow.

I haven't reported anyone for 3RR yet. It looks like a bother, so I don't want to. But I will if it keeps up.

Believe it or not, from an outsider's perpective, you both have something legitimate to say. In particular, Yaf, I have to say that the three refs for that sentence are pretty weak if you actually read the linked abstracts. Consider the possibility that Burk8 has a point. Is it really too much to ask that you hash it out in here, rather than revert each other to death?

Silliness. --barneca (talk) 21:13, 16 May 2007 (UTC)

OK, there are three references provided by Mr. Bungle in [this version], which unfortunately is not the version I reverted to.
It’s hard for me to get the whole story from the three references provided by Mr. Bungle, since I can only see the full text of the first one, the abstract of the second, and the title of the third without a subscription to The Lancet and NEJM, and a working knowledge of Danish. Best to look at the first one, as it makes reference to the other two in its text. What I can glean is:
  • Ingesting lead pellets CAN cause them to get stuck in the appendix, but doesn’t mean they WILL.
  • One or two lead pellets in the appendix can double the “normal” lead concentration in the blood, but not to toxic levels.
  • There was a case of an Inuit ingesting lead pellets, of which 29 lodged in his appendix, and caused lead poisoning.
  • In 1991, the U.S. banned the use of lead shot in waterfowl hunting, but not in other types. Some European countries have gone further. Apparently, most developing countries have not.
My take, after looking at this, is that lead poisoning (not increased lead levels, but actual poisoning) is theoretically possible, but rare. My suggestion: If Burk8 can provide some verifiable reference showing that it is “very” rare (the definition of “very”, I guess, to be determined by good faith consensus), we leave it out completely. If not, I suggest we reword it to at least acknowledge the uncommon nature of the problem. Perhaps: “Exposure to lead may rarely come from ingesting a large number of lead pellets or fragments in game meat hunted with lead shot”
I've reverted twice today myself, so I hesitate to change it back to the way I think makes sense. Throwing stones in glass houses and all that. If no one objects significantly, I'll change it tomorrow. --barneca (talk) 22:32, 16 May 2007 (UTC)
Metallic lead ingestion can lead to lead poisoning, which is sometimes severe, see [1] and these case reports [2][3] [4] and even following ingesting lead after being shot in the face.[5] Actual lead poisoning usually only occurs when the lead object is retained in the gastrointestinal tract. I guess with the size of shotgun pellets being so small they are easily ingested without noticing and being small they are more likely to become trapped in the appendix and therefore slowly lead is absorbed into the body leading to an increase in lead levels. See the x-ray for an idea of how much lead was trapped in the NEJM case report[6] but lead poisoning can occur after the ingestion of a single retained shot[7]. Perhaps it wasn't worded the greatest but ingesting metallic lead can lead to an increase in lead levels potentially causing poisoning and even death.
Perhaps something like:
Exposure to metallic lead such as small lead objects or lead shot in game meat hunted with shotguns, can rarely lead to an increase in blood lead levels if the lead is retained in the gastrointestinal tract or appendix.
Mr Bungle 23:15, 16 May 2007 (UTC)


Barneca, I can provide some verifiable references showing that lead toxicity is very rare from ingestion of lead shot in game meat.

The Encyclopedia of Toxicology (second edition) states that "exposure to lead through dietary intake by people living in an urban environment is estimated to be about 28 milligrams per day for adults and about 91 milligrams per day for children, all of which can be attributed to atmospheric lead dust". This is very interesting because the average weight of a # 71/2 lead bird shot is about 90.5 milligrams. So, about every three days, each of us is ingesting the equivalent of one # 71/2 lead shot pellet and our kids are ingesting the equivalent on one # 71/2 shot pellet each day. This is our background lead exposure. And even at this exposure level we do not see lead toxicity. I hope this makes it a bit easier to see how difficult it is to be poisoned by eating lead shot.

I got a copy of the Lancet article referenced by Mr. Bungle. I can send you the PDF of this article. In this article a man had 29 lead pellets in his colon and appendix. The patient stated that he ate a lot of game and regularly ingested lead shot. The authors state that, although the patient had known for years that he had lead shot in his gut, he showed no signs of chronic lead intoxication.

This article states "Lead poisoning from ingestion of shot, though recognized in veterinary literature, is very rare in man, particularly in an acute form". They further state "No case of lead poisoning with appendicular trapping has been reported in adults".

I wish to add that it is very rare that someone would knowingly eat lead shot over a period of years.

Mr. Bungle's references 1 and 2 above refer to ingestion of lead articles other than shot. This has nothing to do with lead shot or hunting or eating game meat hunted with lead shot.

Mr Bungle's reference 3 refers to an individual who "accidentally" ate 20 pieces of lead shot. This article has nothing to do with eating game meat that was shot by hunters with a shotgun.

Mr. Bungle's reference 4 refers to a 9 year old boy who had a metal fragment in his appendix. After removal of the appendix, the metal fragment was not identified as lead. The child's blood lead level was reported to be 16 micrograms per deciliter. However, many children of this age have blood lead levels that range as high as 28.5 micrograms per deciliter [8] Therefore it is not certain that the fragment was lead or that it caused an elevated blood lead level.

Mr. Bungle's reference 5 discusses people who were shot in the face and in the process ingested lead. Being shot in the face and thereby ingesting lead has nothing to with ingesting lead shot from game meat that was killed with a shotgun.

Mr. Bungle's reference 6 discusses the 73 year old Inuit woman who had a large amount of shot in her appendix. This article says absolutely nothing about lead toxicity or about elevated blood lead levels.

Mr Bungle's reference 7 discusses a "rare source of lead exposure" where a woman had ingested a huge 6mm diameter piece of lead shot. Take a look at the size of that chunk of lead shown in the reference. Do you think that you could "accidentally" eat that? The report states "The lead shot pellet was larger (diameter 6 mm) than those normally used for hunting in Sweden and was a type not allowed in the country". This article concludes that this is an unusual source of lead exposure.

I submit that, given the tens of millions of hunters who have taken game with lead projectiles every year throughout the last hundred years, it is very rare indeed to find a case of lead toxicity resulting from ingestion of lead shot from the meat of game taken with a shotgun. In addition, I have seen no evidence of lead toxicity from lead shot trapped in the appendix.

Therefore, I request that any reference to ingestion of lead shot in game meat and to hunting and shotguns be removed from the discussion of lead poisoning.

--Burk8 10:04, 17 May 2007 (UTC)

In my mind, this seems to quite reasonably show the rarity of lead poisoning by lead shot. I think describing the possibility of being poisoned by lead shot in would be giving it Undue weight; we might as well mention the risk of finding a cache of old lead pencils and eating the lead. I thought about nuking the whole sentence, but I think i can safely revise Mr. Bungle's last proposal to read:
Exposure to metallic lead such as small lead objects, can rarely lead to an increase in blood lead levels if the lead is retained in the gastrointestinal tract or appendix.
I'm going to go ahead and change it; feel free to revise, especially to add one of the references. Just glad to be doing it calmly. --barneca (talk) 15:48, 18 May 2007 (UTC)
The new sentence seems appropriate, basically my point was (hence the varied references}: ingest metallic lead objects and you can get lead poisoning, whether it be toy necklaces, entire lead bullets, bullet fragments after actually being shot, lead fishing weights, lead air gun pellets, or large or small lead shot. Sure 1 small (90.5 milligrams) shot is probably not going to cause lead poisoning but the literature shows that people often have much more than 1 stuck in their appendix after eating game (the NEJM article xray shows an appendix full of lead), toxicity is always dependant on dose. The NEJM article mentions that "Blood lead levels almost twice those of controls may be found after sequestration of just one or two shot pellets in the appendix" so not a huge dose is required to effect blood levels.
The Lancet article also states "lead poisoning was confirmed by high lead levels found in blood and urine. Treatment by enema and EDTA salt brought about obvious clinical and biological improvement". As Burk8 said 'it is very rare indeed to find a case of lead toxicity resulting from ingestion of lead shot from the meat of game taken with a shotgun', very rare, not impossible, and I don't think a brief mention in one section of the article is giving it undue weight. I may add to the sentence in the future reflecting this.
Mr Bungle 21:00, 18 May 2007 (UTC)

[edit] Goya trivia

Saying Goya was unremarkable before he painted the Caprices is perhaps overstating it? I'm not sure what the source thats cited after that 'fact' has to say about the matter, but I find it a little hard to believe

[edit] Problematic sentences - difficult to understand and likely inaccurate

These sentences seem to me unreliable, as well as difficult to understand:

"Contrary to former medical belief, lead can not be inhaled causing the person inhaling to become lead poisoned. Lead found in paint has been known to powderize and be inhaled but this is still a form of direct contact, pure molten (liquid) lead can not be inhaled because it is not free floating as a powder lead mixed with light free floating paint. Often this is confused."

Any lead vapor, smoke from lead-containing materials, or lead powder that becomes airborne can certainly be inhaled. It seems clear this inhaled lead can then cause lead poisoning. I believe the above sentences are misleading, and should be removed. I am removing them. 208.100.198.164 13:28, 14 June 2007 (UTC)

[edit] persistence of lead paint

Could someone explain why people still manufacture lead paint? What is so attractive to manufacturers that they still use the stuff? --75.46.218.170 02:48, 22 August 2007 (UTC)

See lead paint for technical details.
I'm sure it's cheaper to use lead for the pigments needed for paint than to use other materials. Of course, it's "cheaper" only in a narrow sense - across all of society, not just within the accounting records of a company, there are extra costs for damages to health, IQ, behavior, etc. So lead paints gets manufactured and used, today, only where companies (and individuals) either aren't legally liable for using lead in paint, or decide that they're unlikely to be held accountable for it. -- John Broughton (♫♫) 19:35, 26 August 2007 (UTC)


Lead is used in paints as a stabilizer to help the paint bind to the surface being painted. It is also used because it dries faster than most paints. —Preceding unsigned comment added by 69.134.123.20 (talk) 21:30, 9 September 2007 (UTC)

[edit] Lead regulation

There should be a whole article about Lead regulation. Until then, all we seem to have are Lead poisoning and Restriction of Hazardous Substances Directive. The main Lead article does not give us figures on total global production/use; we don't know how it is changing annually, over decades. We have been using this known poison for thousands of years. In the US, lead plumbing is still in use, and we are so negligent as to use it to balance the wheels on our cars. How does Europe compare? What organizations are most active against lead hazards?-69.87.200.233 18:52, 4 September 2007 (UTC)

[edit] Contact danger?

How dangerous is it to touch lead objects? What is the best way to wash it off?-69.87.200.233 19:04, 4 September 2007 (UTC)

[edit] Chinese children

It is nice that US children are being protected from lead, but what about Chinese children, and the other billion children around the world? How many children are getting poisoned by lead, and what countries do they live in?-69.87.200.233 19:07, 4 September 2007 (UTC)

T'aint our place to pester, at least not much. China is its own country, separate from ours, and in some ways separate from the west. They'll pretty much do as they please. Also, they aren't all that wealthy, and I've heard air pollution is more of a concern in China than lead poisoning for now. Kevin 03:21, 5 September 2007 (UTC)

Our WP duty is to be Neutral, and tell the (whole) truth. Aside from that, as long as poor countries are poisoning their own children, there will always be inevitable "mistakes", mix-ups that result in hazards to children elsewhere.-69.87.203.198 11:31, 5 September 2007 (UTC)

[edit] Pencil Lead

"Late last week, Canada announced it was recalling thousands of pencils made in China because of fears they were coated with too much lead."[9]

There may not be any lead in modern pencils -- but there can still be lead in the paint on the pencils, all the better to chew on.-69.87.203.198 11:35, 5 September 2007 (UTC)

[edit] Production pollution

There must be pollution, danger, and toxicity associated with lead mining and production, currently. But there does not seem to be any info in WP about this. Please add such information.-69.87.203.198 11:59, 5 September 2007 (UTC)

[edit] Living with old lead paint

An interesting story about how to live in a house with old problem lead paint and young children: http://www.oldhousechronicle.org/archives/vol02/issue12/technical/lead1.html -69.87.204.246 00:57, 9 September 2007 (UTC)

[edit] Split off regulation

Let's split off "lead regulation" into a separate article -- there is much more to say about the subject, world-wide, and it is too much for this article.-69.87.204.240 23:53, 13 September 2007 (UTC)

You are the person who lately seems to have the most interest in this topic -- both lead poisoning and the notion of a separate article on regulation. It is entirely within your power to make this happen. But please read the how-to material. Be sure to read and follow Help:Contents/Policies and guidelines before creating new text. Help:Contents/Editing Wikipedia will give you some useful info on how to edit. I also have a useful cheat-sheet at User:Karlhahn/usefulLinks. Also please make sure you learn the proper way to create references. I have been cleaning up behind you on the references you have added to this article. Look at what I've done to your edits to see examples of how it is supposed to be done. To create a new page, simply go to the search-box, enter the name of the new article, and press "go". Then click on the red "create this page" text. Then take the text from this article that you want to split off and paste it into the new article. Also please be sure to follow the example in this article on the general construction of an article. That is, be sure to add all the necessary headers, especially a references header with the <references/> or {{Reflist|2}} tag just below it. One more thing -- please consider creating a user account. It will make it much easier for other Wikipedians to communicate with you. Karl Hahn (T) (C) 00:16, 14 September 2007 (UTC)

[edit] Cosmetic Dangers?

What are the true dangers of the amount of lead found in cosmetics. http://www.reuters.com/article/topNews/idUSN1140964520071011 —Preceding unsigned comment added by 152.20.171.187 (talk) 23:57, 11 October 2007 (UTC)

[edit] An Interesting Idea

What's with the line in the article that reads "an interesting idea" and then has two citations? Interesting is an opinion, like my opinion that encyclopedias shouldn't have opinions of their own. How can you externally support the claim that something is interesting?

I think those three words need to be removed. While I have not checked the sources, if they support the preceding sentence they should just be left on that sentence -- after "an interesting idea" is removed. Mbarbier (talk) 17:22, 13 February 2008 (UTC)

[edit] Recent addition

I have just moived into this article material recently added to that on Lead, as it provided excessive detail. I have tried to improve the grammar, but have no particular view of its value, save that it should not be where it was. I hope others can do better. Peterkingiron (talk) 18:11, 10 March 2008 (UTC)