The problem.… Lead is a naturally occurring element of the earth.It is not biodegradable. It goes on accumulating, wherever it is deposited .
LEAD POISONING :protect your children
This post is a bit long you can go through this content list and jump to any section.
Management of toxic effect of lead poisoning
Lead can stay, in the soil, air, water your homes for years. It can enter your body through food , water, air..it can even be absorbed through your skin. Lead has zero need in the body.
There is no known level of lead that is needed by your body and studies show that any amount of lead is potentially Dangerous! Lead is a known xenobiotic element.
Continuously accumulating lead over years can poison generations of children and adults. All social economic and geographical boundaries are crossed by the poisoning effects of lead.
Due to its widespread usage in various industries , chronic lead poisoning is a very real public health hazard, specially in developing countries like our motherland. Lead is still widely used in most house paints used in India and is one of the very important source of exposure .
Pregnant women and children are at most risk from exposure to this metal. The controversy regarding high proportion of lead in Maggi noodles has brought into focus the the need for more awareness and stricter regulatory measures. Nestle,and it’s counterpart in India are world renowned companies, with long history of quality products.
If they , can’t keep a check on their products, I wonder about the quality of any packaged food ! There are more than enough, environmental sources of lead exposure without food items contributing to the chronic poisoning.
Individual , government and the corporate sector all need to work together to stop poisoning ourselves… because nobody’s safe. In the meantime educating yourself to keep you and your family healthy shouldn’t be delayed!
Shocking Statistics
According to CDC data , there are 4 million households in USA ,where children are being exposed to high levels of lead . Lead poisoning is the number one environmental disease affecting children in developing countries.
Lead Poisoning Sources
How do you get lead Poisoning?
- Leaded petrol
The majority of the countries have banned the sale & use of leaded petrol . Afghanistan, Myanmar, North Korea, Algeria , Yemen and Iran, 6 countries were still using leaded petrol as late as 2011(The LEAD group data).
Algeria and Iraq have promised to phase out its use of leaded petrol by 2015. Canada and USA were one of the first few countries to take up the difficult task of going against the petrol companies. Unfortunately India was one of those who still allowed leaded petrol till 2000, when good sense prevailed.
Tetra ethyl lead is an organic lead compound in petrol which has unimaginable notoriety and was responsible for decreased IQ and development of antisocial behaviour traits in children. It’s a blessing that the world woke up and stopped the use of this poison.
- Lead smelting
- coal combustion
- Lead paints
Paint companies unfortunately have questionable standards in self regulation of lead levels in paint. In countries were strict legislation is absent in this matter we find shockingly high lead levels in paint. USA &UK have banned lead usage in paints for painting homes.
But many countries including India, still don’t have adequate legal infrastructure to check & control lead levels in house paints. The major culprits are often small and medium sized paint companies of the unorganised sector. Yellow,green, red and white paints generally have lead pigments.
- Lead containing pipes,
- Lead based solder in water pipes
- Batteries
- Ceramics ; improperly glazed
- Plastics
- Food can soldering
- Drinking water systems
- Cosmetic and folk remedies
lead poisoning sources
Environmental exposure to paint, demolition of lead painted houses, bridges, stained glass, contaminated herbal remedies, candies, are some of the very common sources of chronic lead exposure. Top
Industries with high level
of lead usage include:
- Automobile
- Paint
- Ceramics
- Plastic
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How is Lead metabolised?
Absorption:
Ingestion Inhalation Dermally (organic lead)
Distribution of lead
in the body
Blood:
95% to 99% of lead may be stored in the red blood cells. You really need to measure your blood level of lead ( not serum) which helps to find out recent exposure .
Soft tissue:
Extensive storage with half life of 30 days.
Bone storage:
Upto 15% of exposure dose may be stored in the bones. An astounding 20 years is the half life of lead in bones.Bone lead levels shows the cumulative exposure of this ubiquitous element over several years.
Excretion:
Mainly in urine May also appear in other bodily fluids including breast milk.
Systemic Effects of Lead
Effects of lead poisoning in humans are manifold All the imp systems of the body may be affected.
Most seriously affected systems are:
Nervous system Hematopoietic system(Blood) Renal system(Kidneys) Hepatic system(liver)
What are the Symptoms?
Children are the most affected as their developing nervous system absorbs a larger amount of lead.
Children
Common nonspecific symptoms
Children appear inattentive, hyperactive or decreased activity, temperamental, irritable delayed developmental milestones, language delay.
Studies done by CDC have shown that even with low blood levels ( 3-4 microgram per decilitre) of lead the long term effect on cognition, learning abilities of children , is significant.
Symptoms needing urgent attention
- Loss of appetite,
- nausea,
- vomiting,
- abdominal pain
- Sleepiness,
- ethargy,
- ataxia,
- headache,
- stupor ,coma.
Adults
Nonspecific
- Mood swings,
- irritability,
- Sleep disorders
- Altered sex drive,
- headache,
- depression,
- even constipation
Though all these have a multitude of causes , chronic lead poisoning may have to be ruled out.
Acute high dose exposure symptoms include:
- wrist drop,
- Foot drop,
- delirium
- , hallucinations,
Both children and adults may present with neuropsychiatric problems,impaired cognition, learning difficulties, and antisocial behaviour. Top
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Management
- Treatment
- Prevention
- Public health education and awareness
Treatment;
What blood levels of lead need Treatment?
Whole blood lead levels (BLL) needs to be checked. CDC has some guidelines for treatment of lead exposure.
More than 70 microgram per decilitre of BLL is a medical emergency, even without neurological symptoms.
BLL greater than or equal to 45 micrograms per decilitre needs treatment. New guidelines of CDC indicate all children with blood lead levels greater than 5micrograms per decilitre need evaluation and active management.
Dietary guidelines
Lead is responsible for oxidative stress in the body.There occurs increased generation of free radicals due to oxidation of cellular proteins,DNA, RNA, which may even cause cancer. Antioxidants in the diet can help prevent lead toxicity (Garcia and Gonzalez 2008)
- Flavonoids , the natural polyphenols: present
in fruits, vegetables , tea.
- Vitamins B, C, E : Important to fight
the toxic effects of lead.The dietary sources of these antioxidants can be found here
- Alphalipoic acids : synthesised by the
body in small amounts, present in carrots, spinach,beet, potatoes, red meat are an important group of dietary antioxidant.
- Garlic : Allicin is its active agent
which is responsible for the odour and medicinal property (Sharma et Al 2010).The disease fighting property of garlic is well known.
- Curcumin : This is the principal active
component of turmeric with anti -inflammatory and antioxidant property.Along with chelating agents like DMSA, Curcumin has shown promise, regarding treatment of lead induced oxidative stress in rats( Saxena &Flora 2006)
Medicines
Symptomatic, highly exposed people :
Mainstay of treatment is chelation. The sulfhydryl group in chelating agents, bind the free lead in the blood and help in removing it from our body through the kidneys and liver.
As the blood levels of lead decreases the body stores of lead like in the bones become mobilised and there may occur rise in blood lead levels with toxicity including encephalopathy .
Chelation is to be done , definitely under a doctor’s supervision.
Oral agents include: DMSA (Succimer), and oral penicillamine. If acutely toxic, hospitalization with intravenous or intramuscular chelation with edentate calcium disodium (CaEDTA) may be needed. Dimercaprol is added to prevent encephalopathy.
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Action Plan:What you can do?
1) Stop the exposure: The most important thing about heavy metal poisoning is to stop the chronic exposure through various sources.
2) Get tested A simple blood test will help you decide regarding treatment. Definitely check whether the lab,can test for low blood levels of lead.
3) Decrease dietary fat. A high fat diet increases the rate of absorption of lead.
4)Increase dietary fibres This helps to decrease absorption of lead.
5) Correct dietary deficiency of iron
6)Prevent and treat osteoporosis. Correct dietary deficiency of calcium Osteoporosis causes mobilization of bone stores of lead and may precipitate acute symptoms. 600 IU vitamin D3 is adequate for prevention. We need a minimum of 1000mg of calcium as daily requirement for our nutritional needs. Treatment of osteoporosis needs much higher doses, of both vitamin D and calcium.
7) Increase dietary sources of Vitamin B, Vitamin C , Vitamin E and other dietary antioxidants Vitamin C is a naturally occurring weak chelating agent. Upto 1000mg of Vitamin C may be taken per day.
8) Avoid flaking paint in the house.
9) Regularly clean surfaces and children’s play area . Children’s typical hand to mouth habits are responsible for a large percentage of environmental exposure to lead from lead contaminated dust.
10) Avoid using lead containing cosmetics. Many leading brands have high amount of lead in their products and price has little to do with it.Research the product well before buying and definitely never forget to remove makeup at night
11) Open shoes outside the front door. If this not possible keep your shoe rack, mudroom close to the entryway to prevent mud tracking indoors. Outdoor soil is a very common source of lead indoors.
12) Choose lead free paint to paint your home. Nerolac in India offers lead free paint options.
13) In India you can contact InSLAR ,for testing a product for lead in their lab .
Indian Society for Lead Awareness & Research – InSLAR
inslar.org/
14)cOnly buy idols painted with Lead free paint or better yet buy
brass/silver idols.
Along with treatment and prevention certain Public health strategies may be able to influence a larger population more effectively.
Public health strategies
Guidotti and Ragain (2007):
2 important strategies
1) Prohibition of setting up industries with lead close to habitable areas
2) Complete banning use of lead, where appropriate replacement is available. Top
Take home message
1)Get your blood tested for lead
2)Stop the exposure
3)Diet rich in vitamin,B,C,D,E, Calcium,iron,natural antioxidants 4)Make your home lead free
5)Use unleaded gasoline .
Children are the future.Unfortunately they are also most at risk.Make your homes safe, practice good housekeeping and above all educate yourself ,your family, your neighbours … anybody who will listen!
Your awareness will go a long way in making the authorities make the much needed changes.
Do you suffer from any of the effects of Lead poisoning? Have you ever tested your blood lead levels?
Write to me at dramrita@healthwealthbridge.com
(Disclaimer: this article is meant to educate and cannot be a replacement for a doctor’s consultation.
Reference:
1)Harrison’s Principles of Internal Medicine 2)CDC lead poisoning 3)The George Foundation 4)Toxicity of lead: A review with recent updates Gagan Flora,
Deepesh Gupta, and Archana Tiwari
8)Can antioxidants be beneficial in the treatment of lead poisoning? Gurer H, Ercal N Free Radic Biol Med. 2000;29:927–945.
9) The effect of oral administration of Allium sativum extracts on lead nitrate induced toxicity in male mice. Sharma V, Sharma A, Kansal L. Fd Chem Toxicol. 2010;48:928–936.
10). Changes in brain biogenic amines and haem biosynthesis and their response to combined administration of succimers and Centella asiatica in lead poisoned rats. Saxena G, Flora SJ J Pharm Pharmacol.2006;58:547–559.
11) Nutritional antioxidants mechanisms of action, analyses of activities and medical applications.Vaya J, Aviram M. Curr Med Chem-Immunol Endo Metabolic Agents. 2000;1:99–117.
12) Toxic effects of perinatal lead exposure on the brain of rats: Involvement of oxidative stress and the beneficial role of antioxidants. Garcia MTA, Gonzalez ELM. Fd Chem Toxicol. 2008;46:2089–2093.
13) Fruits and vegetables:Nature’s multivitamins
14 https://pubmed.ncbi.nlm.nih.gov/15764522/
15)Why Lead Poisoning May be Causing Your Health Problems
16 90% of paint samples tested contain lead above permissible limits in India: Study
17 https://www.researchgate.net/publication/23414139_Lead_content_in_household_paints_in_India
19 Evaluation of blood lead among painters of buildings and cars
