Lead neuropathy

Michael T Pulley MD PhD (Dr. Pulley of the University of Florida, Jacksonville, received honorariums from Grifols for consulting work.)
Louis H Weimer MD, editor. (Dr. Weimer of Columbia University has received consulting fees from Roche.)
Originally released October 6, 1999; last updated August 27, 2016; expires August 27, 2019

Overview

The author reviews the clinical and laboratory manifestations of lead intoxication. This condition is extremely rare since the elimination of lead paints, and although commonly tested for in cases of motor neuron disease, has never been causally linked to that condition. Testing for lead is only needed in those who have potential exposure.

Key points

 

• Lead intoxication is extremely rare since the elimination of lead paints.

 

• Although commonly tested for in cases of motor neuron disease, it has never been causally linked to that condition.

 

• Testing for lead is only needed in those who have potential exposure.

Historical note and terminology

Exposure to lead has historically been a problem in many areas of everyday life. This includes the use of lead solder for metal food containers and drinking water pipes, the addition of tetraethyl lead to gasoline, and the addition of lead oxide to house paints, ceramic tableware, and toys (Feldman 1999). Although the most widely known sources of lead in the environment were leaded gasoline and lead paint, studies of the polar ice cap and peat bogs indicate that industrial emissions and coal burning have caused significant environmental contamination (Shotyk and Le Roux 2005). The elimination of lead-based paints and other environmental sources of contamination have dramatically reduced the frequency of lead intoxication. However, exposure may still occur, especially in the industrial setting (battery manufacturing, smelting plants, demolition, tile factories, and automobile radiator repair) (Goldman et al 1987; Karimooy et al 2010). Paint ingestion is still a source of lead toxicity (Feldman 1999; van der Klooster 2004) as is drinking "moonshine" whiskey (Whitfield et al 1972). Reports have also implicated working in indoor gun firing ranges (Landrigan et al 1975) and burning batteries for heat. A case of lead intoxication leading to quadriplegia was felt to be related to the use of lead-contaminated opium (Beigmohammadi et al 2008).

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