What are the signs of lead poisoning (plumbism)?

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Last updated: May 28, 2025View editorial policy

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From the Guidelines

Signs of lead exposure can vary depending on the level and duration of exposure, and immediate medical attention should be sought if exposure is suspected to prevent long-term health consequences, especially in children with blood lead levels above 5 micrograms per deciliter 1. The most common symptoms of lead exposure include abdominal pain, constipation, fatigue, headaches, irritability, memory problems, and difficulty concentrating. In children, lead exposure may cause developmental delays, learning difficulties, loss of appetite, weight loss, and behavioral problems like hyperactivity. Physical signs can include a metallic taste in the mouth, pale skin due to anemia, and in severe cases, seizures or coma. Some key points to consider when evaluating signs of lead exposure include:

  • Blood tests are the most reliable way to detect lead exposure, with levels above 5 micrograms per deciliter considered concerning, especially in children 1.
  • Lead exposure often occurs through contaminated water, old paint in homes built before 1960, certain occupations involving lead, and some imported products or folk remedies 1.
  • Lead is particularly dangerous because it can accumulate in the body over time, affecting multiple organ systems including the nervous system, kidneys, and blood-forming tissues.
  • The American Academy of Pediatrics recommends that children with blood lead levels above 5 micrograms per deciliter receive immediate medical attention and environmental investigation to identify and remediate any lead hazards 1.
  • The Centers for Disease Control and Prevention (CDC) also recognizes that lead exposure is a preventable risk that exists in all areas of the United States, and that children's physical and mental development can be affected at blood lead levels below 10 micrograms per deciliter 1.

From the Research

Signs of Lead Exposure

  • Clinical signs and symptoms of lead toxicity are well-documented, particularly concerning for children six years of age and under, as brain development is rapid and therefore, is likely to be affected by even low levels of lead 2
  • Lead poisoning can cause acute abdominal pain, constipation, and diarrhea, with abdominal pain being a predominant symptom in some cases 3, 4, 5
  • Severe abdominal colic due to lead poisoning is an uncommon condition in adults, and diagnosis is often delayed, with abdominal pain mistaken for acute abdomen 4
  • Gastrointestinal manifestations of lead poisoning include:
    • Abdominal pain
    • Constipation
    • Diarrhea
    • Nausea and vomiting
    • Anemia
  • Blood lead levels can be measured by various methods in laboratories, and history, presentation, and laboratory testing methodologies are crucial in diagnosing lead poisoning 2, 5
  • A thorough history, including specific questioning regarding the use of over-the-counter and traditional/herbal remedies, is necessary in cases of suspected poisoning or drug toxicity 3
  • Occupational history is also important, as lead poisoning can occur due to exposure to lead in certain industries, such as pottery glazing 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Lead poisoning: Clinical and laboratory considerations.

Advances in clinical chemistry, 2023

Research

Lead poisoning and recurrent abdominal pain.

Industrial health, 2007

Research

Gastrointestinal Manifestations of Lead Poisoning: A Brief Report.

Iranian journal of medical sciences, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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