By Marilyn Mbi Walden University

 K.C, a 10 year old girl admitted to the ER less than an hour for ingesting 20 grams of lead nitrate equals to 12.6 grams of lead.  She presented with symptoms of nausea, abdominal pain,  Vital signs:  temp: 36.3 °C,  HR: 106/min  Breathing rate: 20/min  BP: 132/64 mmhg  Body weight: 30.5kg  PE: abdominal tenderness on deep palpation

 Serum lead level : 20.4 µmol/L

 Treatment:  Supportive therapy of a dose of 1g/kg of charcoal was administered to maintain urine output, orogastric tube and gastric lavage.\  chelation with calcium disodium ethylenediaminetetraacetic acid was started as a single agent in a dose of 1500 mg/m²/day in a continious infusion for 8 days

 The above case represents a clinical case of lead poisoning.  The scenario states that the 10 year old ingested lead nitrate however, there are other ways that this patient could have still been affected by lead toxicity.

 Lead was used as an additive to household paint, gasoline, stained-glass windows and shutgun pellets for years.  Today, tons of lead are produced yearly for use in batteries, alloys exterior red lead paints as well as ammunition.

 Employees of these industries as well as in mining, smelting, spray painting, recycling and radiator repair are exposed to lead.  Motor vehicles used to be the major contributor of lead emission to the air since tetraethyl lead was used as gasoline additive, thus polluting the air.

 Industrial processes of metals are the major source of lead emissions to the air, usually found near lead smelters.  Contaminants that are released from industrial facilities may end up in many sections of the environment and their capacity and composition will varies with time and the nature and extent of the facilities operation

 Cathode-ray tubes (CRTs), contain large amount of lead and they have been classified by EPA as hazardous waste.  The batteries and printed circuit boards contain lead.

AIRBORNE LEAD Deposition Soil Ingestion HUMANS Deposition And uptake Water DustSewage Ingestion Aquatic life Plants Inhalaion Animals Direct Inhalation

 Ingested lead is absorbed through the gastrointestinal tract which is then enhanced by calcium, iron or zinc deficiency.  The absorption is greater in children and infants thus making them more vulnerable to lead toxicity than adults  About 80% to 85% of absorbed lead is taken up by bone and developing teeth in children, about 5% to 10% is accumulated in the blood and the rest in absorbed by the soft tissues

 lead can affect the nervous system, kidney function, immune system, reproductive and developmental system as well as the cardiovascular system.  It also affects the oxygen carrying capacity of blood  The effects of lead most commonly encountered in the current population are neurological effects in children and cardiovascular effects in adults, with infants and young children being especially sensitive to even low levels of lead since it leads to behavioral problems, learning deficits and reduced IQ level

 As we saw in the introductory case report, infants and children and adolescent are especially vulnerable to lead toxicity.  CDC estimated that by the year 2000, approximately 454,000 children in the United States had blood lead levels greater than 10 µg/dl.  A recent study shows that even below this level, there is an inverse correlation between blood lead concentration and IQ scores

 A slightly elevated blood level of approximately 3 µg/dl in young girls can delay puberty.  Lead may also move from the maternal skeleton during pregnancy and crosses the placental barrier thus exposing the fetus to lead toxicity.

 It is very important for the health of the public to be protected.  Banning the use of lead paints indoors,  Respiratory protection  Doing periodic blood test for lead levels.

 Now is the time to take actions and measures to inhibit the emergence of risk factors in the form of  Environmental  Economic  Social  behavioral conditions  cultural patterns of living.

 This plea goes to  governmental agencies  all industries involved in any kind of production that generates lead poisoning  parents and school officials.  It is very vital that we all work as a team to prevent the risk that lead poisoning imposes on all of us especially our kids.

 Mikler, J, Banovcin, P, Jesenak, M, Hamizikova, J, & Statelova, D. (2009). Successful treatment of extreme acute lead intoxication. Toxicology & Industrial Health Retrieved from Academic Search Permier database.  Eason, C, O’Halloran, K (2002) Biomarkers in toxicology versus ecological risk assessment. Toxicology :  Moeller, D.W. (2005) Air in the home and community: Environmental health (3rd ed.). Cambridge, MA: Harvard University Press  Kumar, V, Abbas, A. K, Fauto, N. (2005). Environmental & Nutritional Pathology: Robins and Cotran Pathology Basis of Disease. (7 th ed.). Philadelphia, PA: Elsevier  Environmental Protective Agency (2009) Basic Information: Lead in Air. Retrieved July 18 th 2009 from  Macauley, M., Palmer, K., Shih, J.-S., Cline, C., and Holsinger, H., (2001). The Environment and the Information Age. Resources 145 (FALL), 6-9. Washington, DC: Resources for the Future  Environmental Protective Agency (2009) Health and Environment: Lead in Air. Retrieved July 18 th 2009 from