Lead Poisoning

The initial treatment will depend on whether it is an acute case of lead poisoning (usually after ingestion of a lead-containing foreign body) or chronic lead poisoning (repeated small exposures - often from eating food or drinking water from lead-soldered dishes.)

Gastrointestinal decontamination using an adsorbent such as activated charcoal and a cathartic such as lactulose is instituted for acute lead poisoning but is usually of little value in chronic lead toxicity. An x-ray should be done to confirm the presence of metallic particles. Repeat s-rays should be performed to ensure that the metallic particles have been eliminated from the gastrointestinal tract.

Specific antidotes for lead poisoning should be administered for both acute and chronic lead poisoning. These are called chelating agents which bind circulating lead in the blood. These drugs include Calcium EDTA (given by injection), d-penicillamine (given orally) and more recently, Succimer (DSMA), also given orally.

Because these chlating agents, possibly with the exception of Succimer, only bind circulating lead in the blood, repeat courses may be required because lead is released slowly from soft tissues such as the brain back into the systemic circulation.

The testing kits for lead are called Lead Check Kits and are relatively inexpensive. In Canada, a kit contianing 2 test vials currently retails at $9.40 but is probably cheaper in the U.S.

Gillian Willis
willis@dpic.bc.ca