Lead

Lead (plumbum; Pb) is a heavy metal found in the body in small amounts. All forms of lead are toxic (poisonous).

It can be absorbed through the respiratory tract, the gastrointestinal tract, and the (mucous) skin.

Acute poisoning can be distinguished from chronic poisoning.

In acute lead poisoning, the following symptoms may occur:

  • Respiratory disturbances
  • Gastroenterocolitis – inflammation of the gastrointestinal tract.
  • Colic
  • Hemolysis – destruction of erythrocytes (red blood cells).
  • Hepatic coma (liver failure)
  • Paresis (paralysis)

Chronic lead poisoning may cause the following symptoms:

  • Hypochromic sideroachrestic anemia (anemia).
  • Lead colic
  • Circulatory disorders (lead pallor)
  • Reduction of intelligence, including frequent emotional disorders or behavioral problems (in children).
  • Encephalopathy – pathological changes in the brain.
  • Joint pain (“galena”)
  • Cachexia
  • Cephalgia (headache)
  • Fatigue
  • Nephropathy – pathological changes in the kidneys leading to functional impairment (“lead shrunken kidney“).

The procedure

Material needed

  • EDTA blood
  • 24h collection urine

Preparation of the patient

  • Not necessary

Disruptive factors

  • Not known

Normal values blood – women (of childbearing age), children

Unloaded <10 μg/dl
Clinically insignificant load 10-30 μg/dl
Potentially toxic > 100 μg/dl

Biological occupational tolerance level (BAT): 45 μg/dl

Normal values blood – women (not of childbearing age), men

Unloaded <10 μg/dl
Clinically insignificant load 20-40 μg/dl
Potentially toxic > 100 μg/dl

Biological occupational tolerance level (BAT): 70 μg/dl

Normal values urine

Unloaded 0.3-1.8 μg/dl
Potentially toxic > 25 μg/dl

Biological occupational tolerance level (BAT): > 25 μg/dl

Indications

  • Suspected lead poisoning

Interpretation

Interpretation of lowered values

  • Not relevant to disease

Interpretation of elevated values

  • Occupational exposure (painting companies; battery manufacturing) – recognition as occupational disease!