From the Guidelines
Elevated lead levels in a 57-year-old person are likely due to occupational exposure, environmental sources, or hobbies, and require immediate attention to remove the source of exposure and prevent long-term health risks, as recommended by the medical management guidelines for adult lead exposure 1.
Common Sources of Lead Exposure
Some common sources of lead exposure include:
- Occupational exposure from construction work, battery manufacturing, auto repair, mining, and metal work
- Environmental sources such as older homes with lead paint, contaminated soil near industrial sites, or lead water pipes
- Hobbies like shooting at firing ranges, making stained glass, pottery glazing, refinishing furniture, and using lead solder
- Less common sources include certain folk remedies, imported spices or cosmetics, and retained bullet fragments from old injuries
Health Risks of Lead Exposure
Lead exposure can cause a range of health problems, including:
- Neurological problems
- Hypertension
- Kidney damage
- Cognitive impairment
Medical Management of Lead Exposure
According to the guidelines for medical management of adult lead exposure, individuals with elevated lead levels should be removed from occupational lead exposure if a single blood lead concentration exceeds 30 µg/dL or if two successive blood lead concentrations measured over a 4-week interval are ≥ 20 µg/dL 1.
Recommendations for Removing the Source of Exposure
A thorough environmental and occupational history is essential to identify the specific source of lead exposure in any individual, and removing the source of exposure is the first priority, followed by appropriate medical management which may include chelation therapy in severe cases 1.
From the Research
Sources of Elevated Lead Levels
- Older adults, such as a 57-year-old person, may have elevated lead levels due to cumulative exposure over their lifetime 2
- Possible sources of lead exposure include:
- Occupational exposure to lead-polluted ambient air
- Ingestion of traditional remedies containing lead
- Environmental exposure to lead in daily life
- Past exposure to lead-based products, such as paint or ceramics
Health Effects of Lead Exposure
- Elevated lead levels have been associated with various health problems, including:
- Hypertension
- Renal insufficiency
- Cognitive impairment
- Bone resorption, which can cause lead to reenter the bloodstream and exert delayed deleterious effects 2
Chelation Therapy for Lead Poisoning
- Chelation therapy, such as with succimer (DMSA), can be effective in reducing blood lead concentrations and increasing urine lead excretion 3, 4, 5, 6
- DMSA is generally well-tolerated, but may cause adverse effects such as skin reactions, gastrointestinal symptoms, and increased urine copper and zinc excretion 3, 4