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]

  Doctors may detect anemia, and upon inspection of a patient’s red blood cells might find characteristic basophilic stippling. [medicallessons.net]

• Fatigue

  Definition of lead poisoning : chronic intoxication that is produced by the absorption of lead into the system and is characterized especially by fatigue, abdominal pain, nausea, diarrhea, loss of appetite, anemia, a dark line along the gums, and muscular [merriam-webster.com]

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

  Lead poisoning can be subtle; common symptoms are fatigue and poor concentration. Doctors may detect anemia, and upon inspection of a patient’s red blood cells might find characteristic basophilic stippling. [medicallessons.net]

• 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]

  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]

  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]

  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]

  No optic nerve pallor was appreciated. 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]

  […] 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]

• Moonshine

  Lead-contaminated moonshine whiskey and folk remedies are possible sources. Occasionally, lead foreign objects are in the stomach or tissues (such as bullets or curtain or fishing weights). [msdmanuals.com]

  […] recycling Auto repair Cable splicing Hobbies Casting bullets or fishing sinkers Home remodeling Target shooting at firing ranges Lead soldering Auto repair Stained glass making Glazed pottery making Substance Use Some folk remedies Some "health foods" Moonshine [floridahealth.gov]

• 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]

• 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]

• Loss of Appetite

  Definition of lead poisoning : chronic intoxication that is produced by the absorption of lead into the system and is characterized especially by fatigue, abdominal pain, nausea, diarrhea, loss of appetite, anemia, a dark line along the gums, and muscular [merriam-webster.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]

  Centers for Disease Control and Prevention Poisoning due to absorption or ingestion of lead or one of its salts; symptoms include loss of appetite, weight loss, colic, constipation, insomnia, headache, dizziness, irritability, moderate hypertension, albuminuria [icd9data.com]

  Signs of poisoning like irritability, loss of appetite, and learning problems usually don't appear until unsafe amounts of lead have built up. Small amounts of lead can do lasting damage to babies and young children and symptoms may not be obvious. [urmc.rochester.edu]

  When this happens, a person may feel: Abdominal pain Constipated Tired Headachy Irritable Loss of appetite Memory loss Pain or tingling in the hands and/or feet Weak Because these symptoms may occur slowly or may be caused by other things, lead poisoning [web.archive.org]

• 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. [msdmanuals.com]

  There are multiple metallic foreign bodies in the bowel (black arrows) including a nail in the region of the cecum. This is pica. Anytime one sees evidence of pica, look for lead lines. [learningradiology.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]

• Hypertension

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

  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]

  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]

• 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]

  [ID:nPEK331271] A child exposed to heavy concentrations of lead can develop anaemia, muscle weakness and brain damage, and a rash of reported poisonings across several Chinese provinces has raised pressure on officials and companies to deal with the problem [reuters.com]

  A child who swallows large amounts of lead may develop anemia, severe stomachache, muscle weakness and brain damage. Even low levels of lead are linked to lower iq scores. [icd9data.com]

  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]

• 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]

• 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]

• 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

  Discussion Toxic optic neuropathies typically present with a gradually progressive, bilaterally symmetric, painless vision loss affecting central vision and causing a central or cecocentral scotoma. [revophth.com]

• Aggressive Behavior

  Over time, children who aren't treated for lead poisoning may have: Low intelligence, difficulty learning, and aggressive behavior Seizures Long-lasting belly pain Anemia (low number of red blood cells) Adults with lead poisoning may have: Changes in [msdmanuals.com]

  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]

• 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

  These are also found to cause headaches, nausea, weakness in short-term. [news.biharprabha.com]

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

  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]

  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. [msdmanuals.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]

  The younger the child, the more damaging the lead poisoning can be and exposure to very high levels can lead to coma, seizures and death. [news-medical.net]

  They may have symptoms like: Throwing up Clumsiness and trouble walking Sleepiness and confusion With severe poisoning, children will have seizures (convulsions) and go into a coma. [msdmanuals.com]

• 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]

  Increased exposure is also associated with neuropsychiatric disorders such as attention deficit hyperactivity disorder and antisocial behavior. [doi.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]

• Confusion

  Aware of the numerous pressures that academics face, from the pursuit of open inquiry in the midst of culture wars, to confusion and controversy over the ownership of ideas, to the scramble for declining research funds and facilities, he explores the [books.google.com]

  He was restless, violent and confused in the night. On 12th day after the exposure to TEL, the condition bacame worse with marked agitation, delirium, convulsion, fever and coma. He died on 18th day after the exposure to TEL. [doi.org]

  Lead Poisoning symptoms include abdominal pain, confusion, headache, anemia, irritability, and in severe cases seizures, coma, and death. [news.biharprabha.com]

• Tremor

  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]

  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]

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 red blood cell basophilic stippling occurs; however, sensitivity and specificity are limited. [msdmanuals.com]

• Central Scotoma

  Discussion Toxic optic neuropathies typically present with a gradually progressive, bilaterally symmetric, painless vision loss affecting central vision and causing a central or cecocentral scotoma. [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.