Lead poisoning is a preventable condition that results from environmental exposure to lead. This exposure, indicated by elevated blood lead levels, can result in permanent health damage, especially among children. According to the Centers for Disease Control and Prevention (CDC), about 310,000 children in the United States between the ages of 1 and 5 years have blood lead levels that are higher than the safe level of 10 micrograms per deciliter.

Lead is a soft, corrosion-resistant metal that is present in small quantities throughout the environment. Prior to 1978, it was a major ingredient in household paints and gasoline, used in water pipes, used to solder canned foods, and put into pesticides that were used in orchards. While these uses have been banned in the United States and lead is much more carefully controlled, it is still used in more than 100 industries and a variety of hobbies.

Small particles of lead enter the body primarily through inhalation or ingestion of lead-laden dust. From the lungs or intestinal tract, the lead travels to the bloodstream and to organs throughout the body. The body then gradually moves lead from the blood and organs to the bones and teeth, where it may be stored for decades. About 94% of the lead in adults and 73% of that in children is eventually stored in the bones. To rid itself of lead, the body slowly takes it back out of the bones and excretes it in the urine and feces. Lead can also sometimes re-mobilize, moving back into the blood and organs when a bone is broken or during pregnancy. It can be passed from a mother to her unborn child and to an infant during breastfeeding. Women whose fetuses are exposed to lead may miscarry or have a premature delivery.

Lead poisoning can affect almost all parts of the body, but its effects are most pronounced in the central nervous system and kidneys. In children especially, it impairs cognitive development, which can lead to learning disabilities and behavioral problems. Acute lead exposure can cause encephalopathy (brain dysfunction), severe abdominal pain, vomiting, diarrhea, coma, seizures, and in some cases death. Chronic exposure can cause weakness, prolonged abdominal pain, anemia, nausea, weight loss, fatigue, headache, and loss of cognitive function, especially in children. Chronic, low-level lead exposure can be asymptomatic until kidney function starts to deteriorate. The CDC, American Academy of Pediatrics (AAP), and other agencies and organizations recommend that children’s blood lead levels be less than 10 micrograms per deciliter. Below this concentration, toxic effects of lead are unlikely to be present.

The degree to which a person experiences lead poisoning depends on their age, the amount they are exposed to, the time period they are exposed to excessive amounts, and their own health and nutritional state. Patients who are iron deficient or malnourished, for instance, are more vulnerable to increased lead absorption.

Children can be exposed to lead present in houses that were built prior to 1978. Prior to 1978, virtually all paint products contained large amounts of lead. Interior paint deterioration causes chips of paint to fall off, which contributes to lead-contaminated house dust that children ingest or inhale. Soils outside the house can also contain lead particles and be a source of exposure. According to the CDC, about 24 million housing units in the United States have leaded paint and lead-contaminated house dust. Of these, about 4 million homes have one or more young children living in them.

Most adult lead exposure comes from a person’s occupation or hobby. If they carry lead home with them on their clothes, then it can also contaminate their vehicle and home and expose their children and spouses to lead. Some hobbies may also expose people to potentially high levels of lead.

Work settings where lead exposure is possible

Hobbies where lead exposure is possible

Some folk remedies, health foods, nutritional supplements, cosmetics, costume jewelry, toys, and canned foods imported from other countries may contain lead. Doctors should consider screening people, especially children, who are immigrants, refugees, or who are adopted from other countries as they are at an increased risk for excessive lead exposure.