Effects of Lead on Health Mehrdad Mostaghaci M.D.

Learning Objectives In this section you will learn: How lead enters the body How children are affected by lead How lead levels in the body are measured How lead poisoning can be prevented Slide 2. Introduce Chapter 2. Remember to keep medical jargon to a minimum. Keep it simple and explain/define acronyms. 2

Routes of Exposure to Lead Eating (Ingestion) Lead particles on hands transferred to food, drinks, cigarettes Breathing (Inhalation) Lead particles in the air Slide 3. Stress the importance of washing hands while on the abatement site before eating, drinking, smoking or putting fingers into mouths. Explain hand-to-mouth action commonly observed in children and how this increases their ingestion of lead. Mention that lead particles can also be emitted into the air through prohibited abatement practices such as flame burning or dry sanding. 3

How Lead Can Harm Your Body Heart and Blood System Lead attaches to red blood cells Prevents cells from carrying oxygen Damages the red blood cells Reduces ability to make more red blood cells May cause high blood pressure Slide 4. 4

How Lead Can Harm Your Body Kidneys 65% of lead in blood is filtered in kidneys Lead can damage kidneys Often damage is not detected until it’s too late Can cause kidney failure Slide 5. 5

How Lead Can Harm Your Body Nervous System Most affected by lead Damage can be permanent Lead can damage the brain and destroy brain cells Damage can result in depression, irritability, forgetfulness, clumsiness, learning disability High exposure can result in hallucinations, coma, and even death Slide 6. 6

How Lead Can Harm Your Body Bone Tissue Lead from blood is deposited in bones Prevents calcium release into blood Blocks production of new blood cells Bones and teeth store 95% of lead in body Stored in bone tissues for over 30 years Under stress, lead is released from bone tissue Slide 7. Define the “body burden” concept. Explain how lead can be released from the bone back into the blood when the body is stressed and how this can cause an increase in the BLL test result even if a person was not recently exposed to lead. 7

How Lead Can Harm Your Body Female Reproductive Health & Pregnancy Reduces fertility Affects menstruation and menopause During pregnancy, body absorbs blood lead more quickly (50% of inhaled/ingested lead) Lead passes through placenta to fetus May cause brain damage to fetus May cause miscarriage or premature birth May be released from bones back to blood Slide 8. 8

How Lead Can Harm Your Body Male Reproductive System Decreased libido Infertility Damage to sperm, decreased motility Increases spouses chance of miscarriage, premature birth, and birth defects in child Slide 9. 9

How Lead Can Harm Your Body Children Small doses of lead are dangerous Toddlers (1-3 years) especially at risk because they crawl on floors and put things in mouth May affect ability to learn Poor muscle and bone development Coordination problems Speech and language problems Slide 10. Emphasize that all children under 6 years of age are at risk, but those from 1-3 years are most at risk. 10

Testing for Lead in the Body Blood lead level - amount of lead in the blood Blood lead level (BLL) test Zinc protporphyrin (ZPP) test BLL test shows exposure within last 6-8 weeks (g/dL) ZPP is produced when lead blocks formation of blood (not as accurate as BLL test) Slide 13. 13

Understanding Units A microgram (g) is a measure of weight. 1,000,000 g = 1 gram (g) A penny weighs about 2 grams If a penny is cut into 2 million pieces, one piece would weigh 1 g A deciliter (dL) is a measure of volume. 1 dL = about 1/2 cup A person weighing 165 pounds has about 60 deciliters of blood Slide 14. Illustrating these units may be helpful to course participants. 14

Possible Health Effects Child Reactions to Lead Blood Lead Level Possible Health Effects 10 g/dL 20 g/dL 40 g/dL 50 g/dL 100 g/dL and over Slight loss in IQ; hearing and growth problems Moderate loss in IQ; hyperactivity; poor attention span; difficulty learning; language and speech problems; slower reflexes Poor bone and muscle development; clumsiness; lack of coordination; early anemia; decreased red blood cells; tiredness; drowsiness Stomach aches and cramps; anemia; destruction of red blood cells; brain damage Swelling of brain; seizures; coma; death Slide 16. 16

Preventing Lead Poisoning Abatement—remove the lead hazard permanently Interim controls—control the lead hazard until abatement Use safe work practices during a lead abatement project Don’t create a lead hazard while you work Eat a balanced diet Slide 17. Discuss how workers can contribute to lead poisoning prevention. Emphasize the importance of good hygiene habits on the jobsite. Workers can bring lead dust home to their families if work clothes are not left at the jobsite or are not properly decontaminated. Several videos may be useful to illustrate this point, including the National Demolition Contractor’s Association’s “Lead Safety in the Demolition Industry.” This video (available in both English and Spanish) can be obtained by contacting: The National Association of Demolition Contractors 16 North Franklin Street Suite 200-B Doylestown, PA 18901-3536 800-541-2412 17

Good Nutrition Diets high in iron and calcium can reduce lead absorption by the body Eat foods high in iron Cheese, fish, meat, eggs, spinach, beans, raisins, almonds, etc. Eat foods high in calcium Milk, cheese, ice cream, yogurt, bread, fish, meat, beans, broccoli, fruits, nuts, etc. Slide 18. Explain how certain vitamin deficiencies actually increase the amount of lead that is absorbed into the body. 18