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Lead toxicity

Last reviewed: 17 Sep 2025
Last updated: 09 Jun 2023

Summary

Definition

History and exam

Key diagnostic factors

  • family history of lead poisoning or parental work with lead
  • cognitive impairment (children)
  • behavioral changes (children)
  • headaches (children)
  • clumsiness and agitation (children)
  • loss of appetite (children)
  • constipation (children)
  • somnolence (children)
  • altered mental state
  • cerebellar signs
  • seizures
  • coma
Full details

Other diagnostic factors

  • colicky abdominal pain (adults)
  • hypertension (adults)
Full details

Risk factors

  • age 9 to 36 months
  • housing with lead hazards
  • occupational lead exposure
  • lead-contaminated water supplies
  • low socioeconomic status
  • hobbies working with lead
  • pica
  • use of folk medications
  • fetal exposure
  • mineral-deficient and high-fat diets
  • bullet firing ranges
Full details

诊断性检查

首要检查

  • whole-blood lead level
  • complete blood count
  • serum ferritin
完整详情

Tests to avoid

  • post-chelator challenge urinary metal testing
  • hair or nail testing
  • heavy metal screening test
完整详情

需考虑的检查

  • 24-hour urine lead with chelation
  • abdominal radiographs
  • nerve conduction studies
完整详情

治疗流程

急症处理

all patients

撰稿人

作者

J. Routt Reigart, MD

Professor Emeritus of Pediatrics

Medical University of South Carolina

Charleston

SC

利益声明

JRR declares that he has no competing interests.

同行评议者

Howard Hu, MD, MPH, ScD

NSF International Chair

Department of Environmental Health Sciences

Professor of Environmental Health Sciences, Epidemiology and Internal Medicine

University of Michigan Schools of Public Health and Medicine

Ann Arbor

MI

利益声明

HH is an author of a reference cited in this topic. HH has received research funding greater than 6 figures USD.

Rose H. Goldman, MD, MPH

Chief

Occupational & Environmental Medicine

Cambridge Health Alliance

Associate Professor of Medicine

Harvard Medical School

Associate Professor of Environmental Health Sciences

Harvard School of Public Health

Boston

MA

利益声明

None disclosed.

Alison Jones, MD, FRCPE, FiBIOL, FRCP, FRACP

Dean

School of Medicine

Campbelltown Campus

University of Western Sydney

Australia

利益声明

AJ declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Centers for Disease Control and Prevention (CDC). Understanding blood lead levels. Adult Blood Lead Epidemiology and Surveillance (ABLES). National Institute for Occupational Safety and Health (NIOSH) workplace safety & health topics. Apr 2023 [internet publication].全文

Centers for Disease Control and Prevention (CDC). Blood lead levels: United States, 1988-1991. MMWR Morb Mortal Wkly Rep. 1994;43:545-548.全文  摘要

Harvey B, ed. Managing elevated blood lead levels among young children: recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention. Atlanta, GA: CDC; 2002.全文

Centers for Disease Control and Prevention (CDC). Adult blood lead epidemiology and surveillance - United States, 2008-2009. MMWR Morb Mortal Wkly Rep. 2011 Jul 1;60(25):841-5.全文  摘要

Mahaffey KR. Nutrition and lead: strategies for public health. Environ Health Perspect. 1995;103(suppl 6):191S-196S.全文  摘要

Nussbaumer-Streit B, Mayr V, Dobrescu AI, et al. Household interventions for secondary prevention of domestic lead exposure in children. Cochrane Database Syst Rev. 2020 Oct 6;10:CD006047.全文  摘要

Yeoh B, Woolfenden S, Lanphear B, et al. Household interventions for preventing domestic lead exposure in children. Cochrane Database Syst Rev. 2014;(12):CD006047.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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