Lead toxicity

Occurs after occupational or home exposure to lead. There is no threshold level for toxicity.

Anyone at risk of lead exposure requires screening with regular blood lead measurements. There is no 'normal' level, and interventions are initiated at the first sign of increased exposure.

Causes neurodevelopment dysfunction in children and a range of cardiovascular, renal, neurological, and haematological dysfunctions in adults.

The mainstay of treatment is removal of the source. Chelation therapy is given if blood levels exceed 2.1 micromoles/L (44 micrograms/dL) in a child or 3.4 micromoles/L (70 micrograms/dL) in an adult, or if the patient is symptomatic.

Acute lead encephalopathy is a medical emergency requiring aggressive chelation therapy in an intensive care setting.

Acute symptoms resolve with treatment, but neurological impairments and cardiovascular toxicities are irreversible.

Lead resides in bone for decades after exposure has ceased, and all patients therefore require long-term monitoring.

Lead toxicity is a multisystem disease produced by inhalation or ingestion of lead. It produces neurodevelopmental dysfunction in children and a range of cardiovascular, renal, neurological, and haematological dysfunctions in adults. Any detectable lead level is consistent with exposure to lead, but levels >0.4 micromoles/L (>9 micrograms/dL) in a child or >1.2 micromoles/L (>24 micrograms/dL) in an adult are currently considered to require active interventions. Toxicity occurs at lower levels, but prevention is the approach to preventing such toxicity in the absence of effective management options at such levels.