Signs and symptoms of lead poisoning are not evident, unless large amounts of lead have been accumulated. Children and adults present with different signs of lead poisoning.

Children, who have developed lead poisoning, suffer from abdominal pain, hearing loss, irritability, developmental delay, loss of appetite, due to which weight loss sets in, fatigue and sluggishness. In addition, affected children would also exhibit learning difficulties, and can also suffer from constipation and vomiting [7].

Adults with lead poisoning suffer from abdominal pain, high blood pressure, muscle and joint aches, headache and decline in mental functioning, characterized by mood disorders, and memory loss. Adults also show signs of numbness, and tingling sensation in the extremities. Lead poisoning can also affect the functioning of the reproductive system in adults, which can cause poor sperm motility, decreased sperm count, and frequent miscarriages and premature birth [8].

• Anemia

  Motor neuropathy, anemia and all gastrointestinal symptoms disappeared. [ncbi.nlm.nih.gov]

  One of the first manifestations of lead toxicity is anemia. Lead-induced anemia manifests as a microcytic, hypochromic anemia. [usmle.biochemistryformedics.com]

• Fatigue

  The worker with highest exposure presented with clinical findings of crampy abdominal pain, constipation, normocytic anemia, fatigue, and reversible azotemia. [ncbi.nlm.nih.gov]

  The patients presented with abdominal cramps, nausea, anemia of varying severity, and fatigue. Most patients had basophilic stippling and a “Burton's line,” and. .. Franziska Busse, M.D. Leyla Omidi, M.D. Alexander Leichtle, M.D. [doi.org]

• Weight Loss

  A 25-year-old schizophrenic man presented with abdominal pain, nausea, vomiting, weight loss and anaemia. He was noted to be malnourished with generalised muscle atrophy. [ncbi.nlm.nih.gov]

  Children, who have developed lead poisoning, suffer from abdominal pain, hearing loss, irritability, developmental delay, loss of appetite, due to which weight loss sets in, fatigue and sluggishness. [symptoma.com]

  However, there is evidence that there are subtle effects even at lower levels Symptoms include weight loss, anemia, stomach cramps (lead colic), a bluish black line at the edge of the gums, and constipation. [medical-dictionary.thefreedictionary.com]

  In children, common symptoms include; developmental delay, learning difficulties, irritability or sluggishness and fatigue, hearing loss, seizures, loss of appetite and weight loss, abdominal pain, vomiting, and constipation. [nicklauschildrens.org]

  He also had dark urine, abdominal pain, nausea, vomiting and unquantified weight loss. Background: dyslipidaemia and 30 cigarettes/day. [ejhp.bmj.com]

• Pallor

  He returned 2 days later with a worsening illness; increasing pallor, vomiting, abdominal colic, and changes in consciousness were recognized in the emergency department as lead-induced anemia and encephalopathy, associated with a positive abdominal film [ncbi.nlm.nih.gov]

  The symptoms of this “colic” ranged, but they often included a “cadaverous-looking” pallor, tooth loss, fatigue, painful stomach aches, partial paralysis, and gout, a buildup of uric acid that causes arthritis—all of which resemble the symptoms of chronic [theatlantic.com]

  […] exposure include: Loss of short-term memory or concentration Depression Nausea Abdominal pain Loss of coordination Numbness and tingling in the extremities Fatigue Problems with sleep Headache Stupor Slurred speech Anemia "Lead hue" of the skin with pallor [floridahealth.gov]

  […] arthralgie (muscle pain and cramps), paralysie and encéphalopathie (a word he coined) but also described earlier manifestations: a blue-grey line on the gums, which he showed was due to lead sulphate; loss of weight; distinctive odour of the breath; and pallor [academic.oup.com]

  The lead pipes that were the vital arteries of ancient Rome were forged by smithies whose patron saint, Vulcan, exhibited several of the symptoms of advanced lead poisoning: lameness, pallor, and wizened expression. [web.archive.org]

• Malnutrition

  Medical Activities Malnutrition More than 224 million children around the world last year suffered from malnutrition. It is the underlying contributing factor in nearly half of the deaths of children under five years of age. [msf.org]

  Meanwhile, other scholars have disputed the lead poisoning hypothesis, arguing that the root of Van Gogh’s distress was porphyria, malnutrition, and absinthe abuse. [theatlantic.com]

  Lead exposure can also cause small increases in blood pressure and may cause anaemia, malnutrition, abdominal pain and colic. High levels of lead can severely damage the brain and kidneys in adults and may cause death. [web.archive.org]

  Forrester and Abelardo I Aguilera, Socioeconomic factors associated with severe acute malnutrition in Jamaica, PLOS ONE, 12, 3, (e0173101), (2017). [doi.org]

• Abdominal Pain

  We present the case of a 35-year-old Asian male who presented with abdominal pain and constipation secondary to lead poisoning. [ncbi.nlm.nih.gov]

• Constipation

  He presented with abdominal pain, constipation, and irritability. The patient's liver function tests were significantly increased. Through chelation therapy, the blood lead concentration dropped markedly and clinical symptoms greatly improved. [ncbi.nlm.nih.gov]

• Vomiting

  We encountered three patients with lead poisoning in Iran, all of whom associated with presented with diffuse abdominal pain, which was at times colicky in nature, anemia, constipation, nausea, vomiting, and slightly abnormal liver biochemistries. [ncbi.nlm.nih.gov]

• Colic

  The lead poisoning is a public health problem especially in children, but its manifestation by a lead colic is rare and could simulate an acute abdomen table. [ncbi.nlm.nih.gov]

  Lead colic, anaemia, renal tubulopathies and motor neuropathies are well recognised. [doi.org]

• Nausea

  We encountered three patients with lead poisoning in Iran, all of whom associated with presented with diffuse abdominal pain, which was at times colicky in nature, anemia, constipation, nausea, vomiting, and slightly abnormal liver biochemistries. [ncbi.nlm.nih.gov]

• Metallic Taste

  Very high levels of lead in the blood may cause personality changes, headaches, loss of sensation, weakness, a metallic taste in the mouth, uncoordinated walking, digestive problems, and anemia. The diagnosis is based on symptoms and a blood test. [merckmanuals.com]

  Symptoms are a metallic taste in the mouth, vomiting, bloody or black diarrhea, and muscle cramps. Diagnosis is made by examination of the blood and urine. Treatment. [medical-dictionary.thefreedictionary.com]

  taste in mouth Ileus Renal Tubular damage Azotemia Gout Hematologic Affects blood synthesis Hemolysis RBC stippling Iron deficiency Musculoskeletal Muscle and joint pain Soft tissue Blue-black line in gum margins Endocrine Decreased stature Decreased [learningradiology.com]

  Symptoms of Lead Poisoning headaches muscle and joint weakness or pain excessive tiredness or lethargy behavioral problems or irritability difficulty concentrating loss of appetite metallic taste in the mouth abdominal pain, nausea or vomiting constipation [kids.niehs.nih.gov]

  Others may have symptoms like: headaches behavioral problems and trouble concentrating loss of appetite weight loss nausea and vomiting constipation a metallic taste in the mouth feeling tired muscle and joint weakness looking pale How Is Lead Poisoning [kidshealth.org]

• Hypertension

  The main symptoms and signs were severe abdominal pain, vomiting, and arterial hypertension. The clinical evolution was favorable under symptomatic treatment and chelation therapy. [ncbi.nlm.nih.gov]

  […] the bones and teeth while 99% of lead in blood is associated with erythrocytes. [ 1 ] Lead poisoning can cause nervous system toxicity and renal tubular dysfunction leading to irreversible interstitial nephrosis with progressive renal impairment and hypertension [patient.info]

  Pregnancy hypertension, blood pressure during labor, and blood lead levels. Hypertension 10:447-451 3653974. Google Scholar Rogan WJ, Dietrich KN, Ware JH, Docery DW, Salganik M, Radcliffe J et al.. 2001. [doi.org]

  His family history was significant for hypertension. He does not smoke, uses occasional alcohol and has never used illicit drugs. [revophth.com]

• Hearing Impairment

  impairment as a basis for adverse neurocognitive outcomes. [ncbi.nlm.nih.gov]

  impairment, mucosal ulcerations, abdominal pain, poor appetite and renal failure. [revophth.com]

  Lead and minor hearing impairment. Arch Environ Health 46:300-305 1953038. Google Scholar Tong S, Lu Y. 2000. Identification of confounders in the assessment of the relationship between lead exposure and child development. [doi.org]

• Muscle Weakness

  We report a case of total hyperpigmentation of the skin, severe itching, muscle weakness and thrombocytosis. [ncbi.nlm.nih.gov]

  Neurological signs of acute poisoning typically are: paraesthesiae, pain, muscle weakness, encephalopathy (rare) with headache, convulsions, delirium, and coma. [doi.org]

  A child who swallows large amounts of lead may develop anemia, severe stomachache, muscle weakness, and brain damage. Even at low levels, lead can affect a child's mental and physical growth. [fpnotebook.com]

  These include: severe abdominal pain and cramping vomiting muscle weakness stumbling when walking seizures coma encephalopathy, which manifests as confusion, coma, and seizures If someone has symptoms of severe lead exposure, call 911 or local emergency [healthline.com]

  weakness, seizures, or coma. [nlm.nih.gov]

• Arthralgia

  Both patients exhibited colic, arthralgia, and anemia. Blood lead levels were 73.1 microg/dl and 96.3 microg/dl. Intravenous CaEDTA chelation therapy was therefore performed. [ncbi.nlm.nih.gov]

  […] gingival tissue Reproductive Effects Miscarriages/Stillbirths Reduced sperm count & motility Abnormal sperm Heme Synthesis Anemia Erythrocyte protoporphyrin elevation Renal Effects Chronic nephropathy with proximal tubular damage Hypertension Other Arthralgia [health.ny.gov]

• Myalgia

  Linear regression analysis showed log of BLL was significantly associated with abdominal pain, myalgia and anorexia. CONCLUSIONS: The study unravelled an increase in opium-related Pb poisoning in the Kerman province. [ncbi.nlm.nih.gov]

  […] tissue Reproductive Effects Miscarriages/Stillbirths Reduced sperm count & motility Abnormal sperm Heme Synthesis Anemia Erythrocyte protoporphyrin elevation Renal Effects Chronic nephropathy with proximal tubular damage Hypertension Other Arthralgia Myalgia [health.ny.gov]

• Muscle Cramp

  Symptoms are a metallic taste in the mouth, vomiting, bloody or black diarrhea, and muscle cramps. Diagnosis is made by examination of the blood and urine. Treatment. [medical-dictionary.thefreedictionary.com]

• Blurred Vision

  He also complained of blurred vision, lethargy, and tremor. On the basis of these data it appeared that these infarcts were attributable to lead poisoning. [ncbi.nlm.nih.gov]

  Presentation A 57-year-old male presented to the neuro-ophthalmology clinic at Wills Eye Hospital with the complaint of blurred vision in both eyes. [revophth.com]

• Central Scotoma

  Goldmann visual fields showed a dense central scotoma in the right eye and a dense cecocentral scotoma in the left. A multifocal electroretinogram (mfERG) was ordered and is shown below (See Figures 1 and 2). [revophth.com]

• Aggressive Behavior

  It damages children’s brains, erodes intelligence, diminishes creativity and the ability to weigh consequences and make good decisions, impairs language skills, shortens attention span, and predisposes to hyperactive and aggressive behavior. [time.com]

  Signs of repeated lead exposure include: abdominal pain abdominal cramps aggressive behavior constipation sleep problems headaches irritability loss of developmental skills in children loss of appetite fatigue high blood pressure numbness or tingling [healthline.com]

  behavior Anemia Constipation Difficulty getting pregnant Difficulty sleeping Headaches Hearing loss Irritability Loss of previous developmental skills (in young children) Low appetite and energy Reduced sensations Very high levels of lead may cause vomiting [nlm.nih.gov]

  Journal of the American Veterinary Medical Association 189:1115–1117 Google Scholar Janssens E, Dauwe T, Van Duyse E, Beernaert J, Pinxten R, Eens M (2003) Effects of heavy metal exposure on aggressive behavior in a small territorial songbird. [doi.org]

  Chronic lead poisoning in children may cause intellectual disability, seizure disorders, aggressive behavior disorders, developmental regression, chronic abdominal pain, and anemia. [merckmanuals.com]

• Delusion

  We can’t know whether the delusions, depression, and gout many Renaissance masters experienced can be attributed to their paint or just their physiologies. [theatlantic.com]

  The poet describes a frothing mouth, asperity of the tongue, and dry throat, together with dry retching, chills, delusions, and overwhelming fatigue. But if lead poisoning had been endemic, it presumably would have been remarked upon at the time. [penelope.uchicago.edu]

• Headache

  The three patients had similar clinical manifestations including: severe abdominal pain, headache, pale appearance and fatigue. Liver function tests were abnormal. [ncbi.nlm.nih.gov]

  Neurological signs of acute poisoning typically are: paraesthesiae, pain, muscle weakness, encephalopathy (rare) with headache, convulsions, delirium, and coma. [doi.org]

  Adults with lead poisoning suffer from abdominal pain, high blood pressure, muscle and joint aches, headache and decline in mental functioning, characterized by mood disorders, and memory loss. [symptoma.com]

  Adults who are exposed to lead at work typically develop symptoms (such as personality changes, headaches, abdominal pain, and damage to nerves, with numbness and loss of sensation in the feet and legs) over several weeks or longer. [merckmanuals.com]

• Seizure

  The effects of lead are well known and range from delayed and adversely affected neurodevelopment to severe health outcomes including seizures, coma, and death. [ncbi.nlm.nih.gov]

  Cases of acute lead encephalopathy in children still occur and can result in severe neurological damage, seizure disorders, depressed school function and learning disabilities. [patient.info]

• Hyperactivity

  Elevated BLLs in childhood are associated with hyperactivity, attention problems, conduct problems, and impairment in cognition. [ncbi.nlm.nih.gov]

  In children, lead exposure can cause damage to the brain and nervous system, behavioral problems, anemia, liver and kidney damage, hearing loss, hyperactivity, developmental delays, or even death in large enough doses. [stormlake.org]

  Symptoms of lead poisoning in children include: Cramps Hyperactivity (restless, fidgets, talks too much) Learning problems Changes in behavior Headaches Vomiting Fatigue Anemia (not enough hemoglobin in the person's blood) Cleveland Clinic News & More [my.clevelandclinic.org]

  It damages children’s brains, erodes intelligence, diminishes creativity and the ability to weigh consequences and make good decisions, impairs language skills, shortens attention span, and predisposes to hyperactive and aggressive behavior. [time.com]

  This includes a lower IQ, hyperactivity and delinquent behavior. [theleadcoalition.org]

• Confusion

  Symptoms include abdominal pain, confusion, headaches, irritability and can result in seizures, coma and death. [dailymail.co.uk]

  Confusion Tremors, seizures Encephalopathy Chronic exposure is known to adversely effect IQ and behavioral development. Can cause peripheral motor neuropathy (i.e., wrist drop). [pedemmorsels.com]

  If children eat something with a lot of lead — like a bunch of lead paint chips — and therefore have a high level of lead in their blood, they may have noticeable symptoms such as headache, constipation, vomiting, or confusion. [health.harvard.edu]

  These include: severe abdominal pain and cramping vomiting muscle weakness stumbling when walking seizures coma encephalopathy, which manifests as confusion, coma, and seizures If someone has symptoms of severe lead exposure, call 911 or local emergency [healthline.com]

• Tremor

  He also complained of blurred vision, lethargy, and tremor. On the basis of these data it appeared that these infarcts were attributable to lead poisoning. [ncbi.nlm.nih.gov]

  The Emperor Claudius who ruled from 41 to 54 A.D. was reported to be dull-witted and absent-minded, and suffered from disturbed speech, weak limbs, an ungainly gait, tremor, fits of sudden laughter - indicators of lead poisoning and gout. [upi.com]

  A 48-year-old man, on 2nd day after the exposure to TEL complained of chills, tremors, marked nausea and vomiting which persisted all night. Next morning he was admitted to another hospital. [doi.org]

Lead poisoning can be detected by blood tests, to check for levels of lead in the blood. Based on the criteria, lead levels beyond 5µg/dl are known to be dangerous for children, and they should be closely monitored. Those children with high levels of lead, of more than 45µg/dl or more should receive prompt treatment.

Countries with high lead exposure should have the children aged 1 to 2 years be regularly monitored for the blood levels of lead. Such a practice could prevent the irreversible damages of lead from developing [9].

• Microcytic Anemia

  Anemia Leukocytosis Urine microscopy of sediment or renal biopsy Acid-fast inclusion bodies in tubular nuclei Pathognomonic for lead poisoning Free Erythrocyte Protoporphyrin (FEP) 0.6 umol/L Imaging findings Cerebral edema in acute lead intoxication [learningradiology.com]

  Creates a microcytic anemia, with basophilic stippling Often seen concurrently with iron deficiency (GI transporters will more avidly uptake heavy metals in this situation). [pedemmorsels.com]

  Normocytic or microcytic anemia suggests lead toxicity, particularly when the reticulocyte count is elevated or RBC basophilic stippling occurs; however, sensitivity and specificity are limited. Diagnosis is definitive if PbB is 5 μg/dL. [msdmanuals.com]

• Central Scotoma

  Goldmann visual fields showed a dense central scotoma in the right eye and a dense cecocentral scotoma in the left. A multifocal electroretinogram (mfERG) was ordered and is shown below (See Figures 1 and 2). [revophth.com]

For mild cases of lead poisoning, reducing the exposure to lead can significantly bring down the blood levels. In case of severe poisoning, the following measures can be adopted to treat the condition:

• Chelation therapy: In this method, affected individuals are given medication that would bind with the lead, which would help in its excretion through urine.
• EDTA therapy: It is a treatment of choice in cases, when the blood levels of lead have reached beyond 45µg/dl. In such cases, individuals are chemically treated with compound a named ethylenediaminetetraacetic acid.

Based on the blood levels of lead, individuals may require combination of treatment, to prevent further damage to the body. However, it is seldom possible to reverse the effects of lead [10].

If children are affected by lead poisoning, then it can have debilitating complications. It can lead to permanent irreversible damages on brain functioning of the children. In adults, mild levels of lead poisoning can get corrected by themselves.

In severe cases, adults suffer from poor functioning of the nerves and muscles. Complete recovery may take several months or years, and certain individuals may even suffer permanent damage to brain functioning [6].

Lead is naturally found in earth’s crust, and is also widely used in pottery, solder, batteries, pipes, roofing materials and certain cosmetics. In the past, lead was a major component in paint and gasoline [2].

In addition, the various other sources of lead include soil, water, household dust, traditional cosmetics and toys. Traditional remedies such as Daw tway, Ba-baw-san, Litargiro, Ghasard and greta also contain lead in them, which when consumed, can cause lead poisoning [3].

According to the Center for Disease Control and Prevention, for adults and children, the elevated blood levels have been given to be about 10µg/dl and 5µg/dl of whole blood respectively. As per the statistics provided by the National Institute of Occupational Safety and Health (NIOSH), about 3 million workers in US are exposed to lead in workplace [4]. It was also revealed that about 9% of children, between the age group of 1 to 5 years had blood levels of lead more than 10µg/dl.

Lead is introduced into the body through the method of inhalation and ingestion. In rare cases, the metal also gains entry into the body through skin contact. Studies have reported that in about 35 to 40% of cases, the lead that is inhaled through dust, gets deposited in lungs, and in 90% cases, the lead enters the blood stream. Lead creates radically active chemicals, which damage the DNA and cell membranes. Such sequence of events interferes with various body processes, causing severe damage to the functioning of the nervous system, and other body organs [5].

The following measures can be taken to prevent lead poisoning [11]:

• Washing hands after handling dust, or after outdoor play, is recommended to avoid contamination with lead dust.
• Appropriate cleaning of dust surfaces is recommended.
• The older plumbing fittings, which are loaded with lead, should be used with caution. It is recommended, that the residents should run cold water for some time, prior to using the water directly. Mothers are advised against using of direct hot water from pipe for preparation of baby formula.
• Consumption of a healthy and nutritious diet can help prevent, as well as negate the effects of lead.

Lead is a type of metal which is a source of strong poison. Lead poisoning develops when an individual either accidentally, or deliberately, consumes objects containing lead, or breathes in lead dust. This causes lead to get accumulated in the body, which gradually causes poisoning to set in. Young children aged below 6 years are more prone to contract this condition [1].

Definition: Lead poisoning is a condition, defined as more than 45µg/dl of lead in the blood. Such a type of condition can gravely interfere with the function of various body organs and nervous system. If the condition is not promptly treated, it can cause irreversible damages.

Cause: Exposure to lead either through inhalation, or ingestion, can cause lead poisoning to develop. The various sources of lead include contaminated water, soil, pottery, dust, traditional cosmetics and painted toys.

Symptoms: Symptoms of lead poisoning include headache, abdominal pain, developmental delay in children, poor functioning of the nervous system, tingling sensation in the extremities, constipation, weight loss, hearing loss and fatigue.

Diagnosis: Lead poisoning is diagnosed through blood tests, to check the levels of lead. In addition, other tests may also be performed, to assess the functioning of the body organs that have been affected.

Treatment: Mildly elevated levels of lead seldom require any treatment. In severe cases, lead poisoning is treated through chelation therapy, and EDTA therapy. Certain individuals may require combination of therapies to treat the poisoning.

1. Warren C. Brush with Death: A Social History of Lead Poisoning, The Johns Hopkins University Press, Baltimore 2000. p.32
2. Gottesfeld P, Pokhrel AK. Review: Lead exposure in battery manufacturing and recycling in developing countries and among children in nearby communities. J Occup Environ Hyg 2011; 8:520.
3. Elevated Lead in D.C. Drinking Water - A Study of Potential Causative Events, Final Summary Report. EPA; August 2007
4. CDC. US Department of Health and Human Services, National Institute for Occupational Safety and Health; 2013. Adult Blood Lead Epidemiology and Surveillance (ABLES).
5. Struzyńska L, Walski M, Gadamski R, et al. Lead-induced abnormalities in blood-brain barrier permeability in experimental chronic toxicity. Mol Chem Neuropathol 1997; 31:207.
6. Dietrich KN, Berger OG, Succop PA. Lead exposure and the motor developmental status of urban six-year-old children in the Cincinnati Prospective Study. Pediatrics. Feb 1993;91(2):301-7. 
7. Bellinger D, Sloman J, Leviton A, et al. Low-level lead exposure and children's cognitive function in the preschool years. Pediatrics 1991; 87:219.
8. Robins TG, Bornman MS, Ehrlich RI, et al. Semen quality and fertility of men employed in a South African lead acid battery plant. Am J Ind Med 1997; 32:369.
9. Thomson RM, Parry GJ. Neuropathies associated with excessive exposure to lead. Muscle Nerve 2006; 33:732.
10. Association for Occupational and Environmental Clinics: Medical management guidelines for lead exposed adults. 
11. Flora SJ. Lead exposure: health effects, prevention and treatment. J Environ Biol. Jan 2002;23(1):25-41.