Treating Lead Poisoning

When Is Treatment Needed?
The best treatment is prevention. This starts by identifying the sources of lead that might exposure children to lead poisoning and then diligent attention to the proper procedures for remediating all lead exposures.

For children who have experienced lead exposure, a simple blood test will determine if this has resulted in an elevated blood lead level (BLL). This is a simple test with the doctor taking a small blood sample from either a finger prick or a vein.

What is a Safe Blood Lead Level?
Because even small amounts of lead can have harming effects on young children there is no known safe blood lead level. However, the government publishes suggested guidelines.

For children, preventive actions are recommended with BLLs of 10 µg/dL or higher. With BLLs of 15-19 µg/dL, nutritional and educational interventions are recommended. With BLLs of 20 µg/dL or higher, medical evaluations and environmental interventions are recommended.¹

For adults with occupational lead exposure, the US Occupational Safety and Health Administration (OSHA) recommends a permissible exposure limit of 50 µg/m3 for an 8-hour, time-weighted average. Workers with BLLs of 60 µg/dL or higher must be removed from the workplace, and employees should be taken out of the workplace if the average of their last 3 BLLs is 50 µg/dL or higher. Any individuals with BLLs of 40 µg/dL or higher should undergo medical evaluation.¹

When Should Treatment Begin?
Lead poisoning treatment should start prior to too much damage occurring. It is therefore important to have children tested for their blood lead levels if you are aware of or suspect exposure to lead.

How Does Treatment Begin?
The most important first step is to prevent further exposure. Accurate assessment of environmental and occupational exposures is therefore essential. Modifying children’s behavior to decrease hand-to-mouth activity is also an effective prevention measure.¹

Can Diet Provide a Prevention Advantage?
A well-balanced diet is very important. Meals high in fats and oils should be avoided as these can cause the body to absorb higher levels of lead.²

Eating foods that are rich in vitamin C, calcium and iron reduce lead absorption in the body.² To a lesser degree, zinc and phosphorus can also lower the amount of lead absorbed by the body (helpful foods listed at bottom of this page).³

Can Diet Help Remove Lead From the Body?
There are dietary products which stimulate the body’s ability to excrete lead acquired from the environment.

For reducing blood lead levels, vitamin C, vitamin E, thiamine (B1), folate (B9) and iron have the strongest and most consistent blood lead links.³

For increasing lead excretion, vitamins B1 and B9 have widely demonstrated affects in animal studies.³ B1 (thiamine or thiamin) is shown to increase excretion from the brain and both B9 (folate or folic acid) and B1 are now compulsory additives in non–organic bread inside Australia.²

Vitamin C has a remarkable property because it binds with lead to create a secondary substance that is both biologically inert and easily expelled with bodily wastes.³ However, its impacts on excretion have not always been consistently demonstrated, particularly at higher lead levels.

Pectin and vitamin B6 are also linked to higher lead excretion, but questions have been raised as to its degree of effectiveness and so far there are too few studies from which to draw conclusions.²

While folate (vitamin B9) can actually increase lead absorption, it seems to increase excretion more than it increases absorption.⁴

Important Note:
A doctor should be consulted before resorting to dietary supplements of calcium or iron as excessive amounts of these (particular the latter) can have serious health effects of their own.

Are There Other Therapies for Removing Lead?
For people who have significantly high blood lead levels or who are experiencing symptoms of poisoning, chelation therapy (pronounced “key-lation”) is available.⁵ This is accomplished by administering a chemical agent either by injection or orally. The agent chemically binds with lead in the body to form a nontoxic compound6 that can be excreted in the urine up to 50 times the normal rate.⁷

Chelation therapy is used in cases of acute lead poisoning, severe poisoning,⁸ and encephalopathy,⁹ and is considered for people with blood lead levels above 25 µg/dL.¹⁰

While the use of chelation for people with symptoms of lead poisoning is widely supported, use in asymptomatic people with high blood lead levels is controversial.¹¹

Are There Other Methods to Remove Lead?
When lead-containing materials are present in the gastrointestinal tract (as evidenced by abdominal X-rays), whole bowel irrigation, cathartics, endoscopy, or even surgical removal may be used to eliminate it from the gut and prevent further exposure.⁹

What is the Best Treatment?
When it comes to lead poisoning, prevention is the best medicine. The following list will aid in this effort:

1. Make sure that your children wash their hands and face before eating and sleeping.
2. Prevent your children from eating things other than food (eg, dirt, paint).
3. Make sure that all surfaces (floors, countertops, tabletops, etc) have been thoroughly cleaned with a detergent. This is especially important for toddlers since they crawl and lay on the floor and frequently put their hands in their mouths.
4. If your home was built prior to 1977, it is extremely important to remove any flaking or peeling paint in the house, since older homes frequently were painted with lead-based paint. Hire or consult a professional certified in lead paint abatement. Painting over lead-based paint, or applying wallpaper, are only temporary ways to control exposure, and are not acceptable means of control. Protective equipment and respirators must be worn in the removal of lead-based paint from walls and woodwork.
5. Make sure that your children receive the recommended daily allowance of multivitamins with iron. They should have well-balanced diets that include a combination of fruits, vegetables, grains, protein, and dairy products.
6. Do not use herbal or folk medicine (these may contain lead).
7. If you are not sure if your pottery has a lead glaze, use it only for decoration.
8. Store food in glass, plastic, or stainless steel containers, not in open cans.
9. Use water from the cold tap for cooking and drinking. Let it run for several minutes before collecting for use.
10. Be careful to keep materials for hobbies, such as those used for making ceramics or stained glass, away from children and areas where they spend time.

References

1. Lead Toxicity Treatment & Management, Pranay Kathuria & Tarakad S. Ramachandran, Medscape, http://www.health.state.mn.us/divs/eh/lead/faqs.html#Foods, retrieved December 22, 2014
2. Lead Poisoning Prevention / Frequently Asked Questions, Minnesota Department of Health, http://www.health.state.mn, Retrieved December 22, 2014
3. Fact Sheet: Nutrients that Reduce Lead Poisoning, Robert J. Taylor, Global Lead Advice & Support Service, http://www.lead.org, Retrieved December 22, 2014
4. Adult Lead Poisoning, Environmental Health Epidemiology Bureau of New Mexico’s Department of Health, http://nmhealth.org, Retrieved December 22, 2014
5. Poisoning and Drug Overdose,(5th ed.), Olson, McGraw-Hill Professional, 2006, p. 242
6. Heavy Metals / Katzung & Trevor’s Pharmacology: Examination & Board Review, (8th ed.), Trevor, Katzung & Masters, McGraw-Hill Professional, 2007, P. 480
7. Lead Poisoning / Oski’s Essential Pediatrics (2nd ed.), Crocetti, Barone & Oski, Lippincott Williams & Wilkins, 2004, pp. 221-222
8. Lead Toxicity, a Review of the Literature. Part 1: Exposure, Evaluation, and Treatment, L. Patrick, Alternative medicine review : a journal of clinical therapeutic 11 (1): 2–22, 2006
9. Lead / Pediatric Toxicology: Diagnosis and Management of the Poisoned Child, Erickson, Mycyk, Hryhorczuk & Amitai, McGraw-Hill Professional, 2005, p. 465
10. Principles of Toxicology / Goodman and Gilman’s Manual of Pharmacology and Therapeutics, Brunton, Goodman, Blumenthal, Buxton & Parker , McGraw-Hill Professional, 2007, p. 1131
11. Heavy Metal Intoxication and Chelators / Basic and Clinical Pharmacology, G.B Katzung, McGraw-Hill Professional 2007, p. 948
12. Food, Nutrition and Lead Absorption, Lead Action News, June, 2010.retrieved December 19, 2014 at http://www.lead.org.au/lanv10n2/LEAD_Action_News_vol_10_no_2.pdf.