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Childhood Lead-Based Poisoning

Childhood Lead-Based Poisoning. Albert Knapp, MPH Student Walden University PH 8165-1 Instructor: Dr. Jean Johnson Spring, 2009. What is Lead. Lead is a earth element Pb++. Lead is a malleable metal which has been used for centuries as a structural additive in building components.

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Childhood Lead-Based Poisoning

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  1. Childhood Lead-Based Poisoning Albert Knapp, MPH Student Walden University PH 8165-1 Instructor: Dr. Jean Johnson Spring, 2009

  2. What is Lead • 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

  3. What are some challenges posed from lead exposures • 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

  4. What are some effects of lead poisoning • 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

  5. How Does Lead Enter the Body • 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

  6. Inhalation • 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.

  7. Ingestion • 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.

  8. Absorption • 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.

  9. Brief Historical Uses of Lead • 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

  10. Maternal and fetal exposure • 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.

  11. Lead Concentrations and Lethal Effects of Lead for the Fetus. • 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.

  12. Lead, Fetus, and the Central Nervous System • 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.

  13. How Do We Find Women At Risk • 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

  14. Risk Factors Identified in Lead Exposures • 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

  15. Focus on Multi-Cultural Folk Remedies and Non-Paint Source Exposures • 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.

  16. Mexico • 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.

  17. India • 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.

  18. Table ware in world wide applications • 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.

  19. Lead Based Paint Source for Exposure Poisoning • 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

  20. Housing and Lead Poisoning • 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

  21. How Lead Works Once it Enters the Human Body • 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.

  22. Nutritional Benefits in Removal of Lead from the Bones • 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.

  23. Calcium and Vitamin C • 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.

  24. How is Environmental Lead Treated • 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

  25. Benefits of Eliminating Lead from our Environment • 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.

  26. References • 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, 1991-1992. 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

  27. References Cont. 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. PranayKathura, 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

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