Download Childhood Lead Poisoning

Albert Knapp, MPH Student
Walden University
PH 8165-1
Instructor: Dr. Jean Johnson
Spring, 2009






Lead is a earth element Pb++.
Lead is a malleable metal which has been used for
centuries as a structural additive in building
components.
Lead is also used as a sweetener in some foods.
Lead is used in paint as a surface protecting pigment.
Lead is used in medicinal uses in multi-cultural
communities.
US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health.
Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health
Promotion; 2000. Available at: URL:
http://www.healthpeople.bov/Documebnt/HTML/Volume1/08Environmental.hem#_Toc490564711:
Accessed 11/3/03





A continuous learning of the exposures of lead.
Toxic effects are being recognized at lower
levels that previous realized.
Effects of lead are irreversible
Lead is stored in bones for decades
US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health.
Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health
Promotion; 2000. Available at: URL:
http://www.healthpeople.bov/Documebnt/HTML/Volume1/08Environmental.hem#_Toc490564711:
Accessed 11/3/03










Irreversible brain damage may occur in people
subjected to prolonged chronic doses or very large
acute doses.
Death
Loss of reproductive potential (Sterility)
Damage to Nervous System.
Loss of motor functioning ability
Organ malfunction
Evidence of a significant correlation in lead poisoning
and increase in both low level crimes and violent crimes
Pranay Kathura, MD, MDDS, FACP, FASN (Feb 5, 2008). Lead Nephropathy. eMedicine, 1-11. Retrieved Oct 2008, from
http://www/emedicine.com/TOPIC1267.HTM
Wright, W.P., Dietrich N.K., Ris, M.D., Hornung, W. R., Wessel, S., Lanphear, P. B. Ho M., Rae, M.N. (July 25, 2008). Association of
Prenatal and Childhood Blood Lead Levels Concentrations with Criminal Arrests in Early Adulthood. Medscape, 1-11. Retrieved Oct
2008, from http://www.medscape.com/viewarticle/576717





Lead can enter the body in three ways.
Inhalation
Ingestion
Absorption
US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health.
Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health
Promotion; 2000. Available at: URL:
http://www.healthpeople.bov/Documebnt/HTML/Volume1/08Environmental.hem#_Toc490564711:
Accessed 11/3/03




Lead can be absorbed directly into the body by
inhaling the vapor of lead.
When smelting lead or by using lead came in
the manufacturer of stained glass windows the
vapor of lead can enter the body and stored in
the bones.
This method of transmission is the fastest way
lead can enter the body by being absorbed
from the alveoli into the bloodstream.
Emeka A. Nwankwo, Ibrahim Ummate: Environmental Lead Intoxication And Chronic Kidney Disease: A
Review. The Internet Journal of Nephrology. 2006. Volume 3 Number 1.





Children eating paint chips is the most
common form of lead poisoning when
categorized as ingestion.
Traditional medical remedies is a form of
ingestion usually in use with multi-cultural
medicinal practices.
Candy and other food items containing lead.
Lead dust in soils or on carpets or clothing is a
way children and adults can become poisoned.
Emeka A. Nwankwo, Ibrahim Ummate: Environmental Lead Intoxication And Chronic Kidney Disease: A
Review. The Internet Journal of Nephrology. 2006. Volume 3 Number 1.





Recent studies are showing that lead can be
absorbed through the skin
Eye liners
Lipstick
Mascara
Coluccio, Vincent PhD (Eds.). (2006).Non-Paint Sources of Lead Exposures. Albany: New York State Department
of Health.





Lead was used by the Romans as a
preservative in wine.
Historians cite the use of lead as a major
component in the fall of the Roman Empire.
Lead was smelted and used in weaponry.
Lead was used as a decoration in eye liners
among women and children. Pregnant women
using eye liner could transfer the lead to the
fetus.
Pranay Kathura, MD, MDDS, FACP, FASN (Feb 5, 2008). Lead Nephropathy. eMedicine, 1-11. Retrieved Oct
2008, from http://www/emedicine.com/TOPIC1267.HTM





Lead has been proven to be released during
pregnancy and lactation.
30 percent of lead is released from the mother
to the fetus during gestation period.
Mothers lead levels and umbilical cord lead
concentrations are highly correlated.
Low birth weight associated with maternal
lead levels.
Markowitz, Morri. MD (Eds.). (2007).Lead and Pregnancy. Albany: New York State Department of Health.




Lead concentrations as low as 5 ug/dl is
sufficient enough to alter the course of normal
development in fetal development
Lead exposures can lead to premature birth.
Cognitive abilities of the fetus can be damaged
by lead exposure in the womb leading to
irreversible damage for life.
Markowitz, Morri. MD (Eds.). (2007).Lead and Pregnancy. Albany: New York State Department of Health.




Research has shown that the brain of the fetus
in development has higher permeability
possibilities.
Storage of lead in the brain region remains high
and as a result reduce cognitive abilities.
Levels of lead concentrations increase in the
brain of the fetus as the gestational period
continues. Central Nervous Systems
neurotransmitter ability is severely
compromised.
Markowitz, Morri. MD (Eds.). (2007).Lead and Pregnancy. Albany: New York State Department of Health.




Prenatal Screening
Allows the pregnant women to understand the
risk of exposure.
Can determine high risk women and offer
dietary alternatives to help the fetus and
mother.
James R. Campbell and Peggy Auinger (March 2007). The Association between Blood Lead Levels and Osteoporosis
among Adults-Results from the Third National Health and Nutrition Examination Survey (NHANES III). Retrieved
Oct 2008, from http://www.ehponeline.org/docs/2007/9716/abstract.html






Does the mother live in a rural environment or
an urban environment.
What is the socio-economic status of the mother
What is the occupation of the mother
Is the residential composition one of an old
house, or complex that may harbor lead paint.
If there are any folk remedies associated with a
multi-cultural family
US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health.
Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health
Promotion; 2000. Available at: URL:
http://www.healthpeople.bov/Documebnt/HTML/Volume1/08Environmental.hem#_Toc490564711:
Accessed 11/3/03





Some cultures have lead prescribed by local
pharmacists as a healing agent.
Some remedies contain close to 100% lead.
Glazing and ceramics used in pottery and
tableware contain high concentrations of lead.
CDC. Lead poisoning-associated death from Asian Indian folk remedies-Florida. MMWR 1984;33;638,643-5.
Coluccio, Vincent PhD (Eds.). (2006).Non-Paint Sources of Lead Exposures. Albany: New York State Department
of Health.





Azarcon
Azarcon is given for Empacho which is an
intestinal illness.
Azarcon is near 100% by weight and is given as
a folk remedy to cure the intestinal illness.
Azarcon numbs the nerves and reduces the
pain of the illness. When the pain resurges
more lead is administered.
CDC. Lead Poisoning associated with use of traditional ethnic remedies-California, 1991-1992. MMWR 1993;
42:521-4.






Cosmetics
The cosmetic called Kohl
In India it is also called Kajal
Kajal is a fine powder that is used by mothers
and their daughters as an eye liner.
Kajal can be composed of lead from 2.9 to 100%
Coluccio, Vincent PhD (Eds.). (2006).Non-Paint Sources of Lead Exposures. Albany: New York State Department
of Health.




Leaded crystal in wine glasses
Lead is leached from the glass when wine is
introduced. The low acidic nature of the lead
increases the rate that lead leaves the leaded
crystal and enters the wine for human
consumption.
Some ceramic plates and cups have lead
glazing to seal them. The acidic nature of foods
and coffee have the same leaching potential as
the wines.
Coluccio, Vincent PhD (Eds.). (2006).Non-Paint Sources of Lead Exposures. Albany: New York State Department
of Health.




Prior to 1990 there was no standards to test for
paint, dust or soil.
No disclosure laws in property transitions and
no enforcement.
No support for funding in low income housing
in the abatement of lead based paint.
US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health.
Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health
Promotion; 2000. Available at: URL:
http://www.healthpeople.bov/Documebnt/HTML/Volume1/08Environmental.hem#_Toc490564711:
Accessed 11/3/03




Lead has a sweet taste and to a child or infant it
is tasteful.
Exposure of lead poisoning in housing units
begins when children or infants begin to chew
paint chips, surfaces that are coated with lead
paint.
Signs of exposure from the architectural
elements is teeth marks dictating a gnawing or
chewing effect.
US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health.
Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health
Promotion; 2000. Available at: URL:
http://www.healthpeople.bov/Documebnt/HTML/Volume1/08Environmental.hem#_Toc490564711:
Accessed 11/3/03





Lead is a positive ion similar to calcium.
The body absorbs lead just as readily as
calcium and stores the lead in the bones.
For decades lead remains in the bones before
the body releases it back in the bloodstream.
Once lead is released, especially in women and
the elderly, perforations exists leading to the
cause of osteoporosis.
Kordas, Katarzyna, PhD (Eds.). (2007).Lead Exposure and Nutrition-State of Research and Recommendations.
Albany: New York State Department of Health.




Recent studies have shown a correlation with
calcium supplements, vitamin D, and the
replacement of bone loss due to lead poisoning
In the supplementation of calcium and Vitamin
D during pregnancy, the umbilical cord Blood
Lead Level was reduced significantly.
It appears that the supplementation works to
reduce binding between bone tissue and lead.
Kordas, Katarzyna, PhD (Eds.). (2007).Lead Exposure and Nutrition-State of Research and Recommendations. Albany:
New York State Department of Health.




In an effort to not have chelation therapy to
reduce the amount of lead in bones Vitamin C
coupled with calcium seems to be very hopeful.
Vitamin C has an affinity to work with calcium
to reduce lead in the bone tissue.
This process is in favor over chelation therapy
because of the harmful after effects of chelation
therapy has on patients.
Emeka A. Nwankwo, Ibrahim Ummate: Environmental Lead Intoxication And Chronic Kidney Disease: A
Review. The Internet Journal of Nephrology. 2006. Volume 3 Number 1.




Lead can be removed by using lead abatement
techniques in which the lead is physically
removed from buildings
Encapsulation can be used to cover the lead but
this is used for temporary remedial uses. This
technique us used as an interim approach until
abatement can be utilized.
In all respects lead is treated as a hazardous
material.
US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health.
Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health
Promotion; 2000. Available at: URL:
http://www.healthpeople.bov/Documebnt/HTML/Volume1/08Environmental.hem#_Toc490564711:
Accessed 11/3/03




Children would be born healthier.
Mother’s would not be harmed or harming
their children through random exposures of
lead.
In current research that describes the crime rate
with the lead exposures, crime in certain
respects would be eliminated.
The cruel effects lead has in removing all of the
cognitive abilities from people at such early
ages would be eliminated.

Reference:
CDC. Lead poisoning-associated death from Asian Indian folk remedies-Florida. MMWR
1984;33;638,643-5.
CDC. Lead Poisoning associated with use of traditional ethnic remedies-California, 19911992. MMWR 1993; 42:521-4.
Coluccio, Vincent PhD (Eds.). (2006).Non-Paint Sources of Lead Exposures. Albany: New York
State Department of Health.
Emeka A. Nwankwo, Ibrahim Ummate: Environmental Lead Intoxication And Chronic
Kidney Disease: A Review. The Internet Journal of Nephrology. 2006. Volume 3 Number 1.
James R. Campbell and Peggy Auinger (March 2007). The Association between Blood Lead Levels
and Osteoporosis among Adults-Results from the Third National Health and Nutrition
Examination Survey (NHANES III). Retrieved Oct 2008, from
http://www.ehponeline.org/docs/2007/9716/abstract.html
Kordas, Katarzyna, PhD (Eds.). (2007).Lead Exposure and Nutrition-State of Research and
Recommendations. Albany: New York State Department of Health.
Markowitz, Morri. MD (Eds.). (2007).Lead and Pregnancy. Albany: New York State Department
of Health.
Pranay Kathura, MD, MDDS, FACP, FASN (Feb 5, 2008). Lead Nephropathy. eMedicine, 1-11.
Retrieved Oct 2008, from http://www/emedicine.com/TOPIC1267.HTM
US Department of Health and Human Services. Healthy People 2010: Understanding and
Improving Health. Washington, DC: US Department of Health and Human Services,
Office of Disease Prevention and Health Promotion; 2000. Available at: URL:
http://www.healthpeople.bov/Documebnt/HTML/Volume1/08Environmental.hem#_
Toc490564711: Accessed 11/3/03
Wright, W.P., Dietrich N.K., Ris, M.D., Hornung, W. R., Wessel, S., Lanphear, P. B. Ho M.,
Rae, M.N. (July 25, 2008). Association of Prenatal and Childhood Blood Lead Levels
Concentrations with Criminal Arrests in Early Adulthood. Medscape, 1-11. Retrieved Oct
2008, from http://www.medscape.com/viewarticle/576717