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Lead Toxicity Human Health Effects

Lead Toxicity Human Health Effects. Board Council of Governments April 14, 2004 Washington, DC Georges C. Benjamin, MD, FACP Executive Director American Public Health Association. Where It Comes From?. Naturally occurring element in the environment

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Lead Toxicity Human Health Effects

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  1. Lead Toxicity Human Health Effects Board Council of Governments April 14, 2004 Washington, DC Georges C. Benjamin, MD, FACP Executive Director American Public Health Association

  2. Where It Comes From? • Naturally occurring element in the environment • 40% of US Homes have lead based paint • In these homes 25% are kids under age 6 • Dust, dirt & paint chips • Water (20%)* – Usually lead pipes or solder • Imported Lead glazed dishes, food cans • Some imported candy; some folk remedies *60% of exposure if heavy mixed formula used

  3. 1977 Public Health Success Story! • Unleaded Gas • Solders & pipe • House paint

  4. Where It Goes? • Gets into the body by ingestion or inhalation • Lead is confused by the body as iron, calcium etc • Calcium is an essential nutrient used for cellular function & strong bones • Absorbed lead goes to bones (years) where it is stored and into many types of cells where it disrupts cell function • Absorption increased during pregnancy • It can come back out of growing bones into the blood often during pregnancy, growth spurts, menopause

  5. What It Does? • Anemia • Developmental delay • Mental / cognitive disorders • Kidney dysfunction causing hypertension • Muscle aches • Miscarriages • Coma & death in doses No useful physiologic purpose

  6. Who Is At Risk? • No proven safe level • Infants & those <6y/o • Growing • Increased absorption • Everything goes to mouth • Pregnant women & fetus • Brest feeding women can pass to child if they have increased lead • Adults – especially some workers (battery, smelters, painters)

  7. How Do We Stop It? • Prevention – Flush pipes; filters • Lead abatement • Avoidance of high risk • Environmental testing & remediation – Water Action 15 ppb This is a preventable condition!!!!

  8. What Can We Do About It? • Detection • Universal vs. targeted; blood vs. risk questionnaires • Childhood blood screening (Vena puncture vs. finger stick) • Ages: 12 & 24 months • Symptoms • Reportable to public health authorities

  9. Treatment • Changing: better therapies/knowledge • <10 ug/dL blood level • >10 ug/dL - 25ug/dL blood level (2% in US) • 35 ug/dL – 50 ug/dL blood level (Symptoms) • > 70 ug/dL Medical emergency • Evaluate exposure • Environmental remediation • Remove from exposure • Medication - Chelation therapy • Older ones have side effects • Newer ones can often be given as outpatient

  10. Georges C. Benjamin, MD, FACP Executive Director American Public Health Association WWW.APHA.ORG “Public Health: Prevent, Protect, Promote”

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