Tag Archives: lead poisoning

Straight, No Chaser: Prevention and Treatment of Lead Poisoning

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What you need to know about protecting yourself from lead poisoning and its effects is reducible to awareness, baseline testing, prevention and treatment.
We covered what you needed for awareness in the previous Straight, No Chaser.
However your goal really should be prevention via avoidance, as much as is possible. However, to prevent, you must have a level of awareness. Think about these things:

  • Do you have a child in your house between ages 6 months and 3 years old? If so, be reminded that children wander around putting things in their mouths.
  • Do you live in an old house or have old plumbing?
  • Do you live near a busy road or near bridges?

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If you are in a high-risk situation, your ideal level of awareness should include preventive considerations such as getting your home tested and your blood lead level checked. If anyone in the home has been found to have high lead levels, the entire household should be checked.
Whatever your level of exposure, you want to engage in preventive strategies to prevent further exposure that could lead to disease. Here are a few quick tips to do so:

  • Avoid dust in your home, because you just never know!
  • Wash everyone’s hands prior to eating.
  • Throw away old painted toys, unless you’re sure lead based paint was not used.
  • Use filters for your water, switch to bottled water for drinking and cooking, and/or let any tap water run for approximately one minute prior to drinking or cooking with it.
  • Avoid storing wines in lead crystal decanters for long periods of time.

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Treatment:
If you have been found to have any significant levels of lead in your blood, you have a role in your treatment. If your levels and symptoms are significant enough to be hospitalized, that will occur and you’ll receive medicine that facilitates the removal of lead from the body, called chelating agents. However, in the absence of that, your job likely will be to maintain a healthy diet that includes calcium, iron and Vitamin C, all of which help decrease lead absorption within the body.

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Prognosis:
As mentioned, you want to avoid lead poisoning. Each year in the United States, 310,000 kids aged 1-5 years old are found to have unsafe levels of lead in their blood. In these children, even mild lead poisoning can have a permanent impact on attention and IQ. Remember, the developing brain is more susceptible to the toxic effects of lead. Those with higher lead levels have a greater risk of long-lasting health problems and must be closely followed because of the potential damage to the brain, nervous system, muscles and other systems. Adults who have had mildly high lead levels often recover without problems, but in general, a complete recovery from chronic lead poisoning may take months to years.
If you suspect you may have lead paint in your house, get advice on safe removal from the U.S. Department of Housing and Urban Development (HUD) at 800-RID-LEAD, or the National Information Center at 800-LEAD-FYI. Another excellent source of information is the National Lead Information Center at (800) 424-5323.
If you suspect you or someone in your family is suffering from the effects of lead, call 911 immediately and/or call 1-800-222-1222 to speak with a local poison control center for further instructions while you await the paramedics to arrive.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, AmazonBarnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Straight, No Chaser In the News: Lead Poisoning

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In the news is the story of dozens of cases of lead poisoning in Flint, Michigan, resulting from elevated levels of lead in the city’s drinking water supply. This followed inadequate preventive treatment of the water supply, a necessary step in the provision of public health. It appears that the water had become contaminated from aging pipes in the Flint river, which became relevant after the city switched its water supply from Detroit sources in 2014. The number of poisonings has been so high the city has declared a state of emergency. In case you’re wondering, yes this could happen to you, but if you read on, we’ll tell you how to minimize your exposure.
What is lead poisoning? Why is it dangerous?
Lead is a chemical element (“mineral”) that is quite poisonous in humans. Swallowing or breathing lead dust can cause major health problems, both immediately (with a very high exposure), or more commonly, over time with ongoing exposures to low levels. The particular concern is in exposure to children. As is the case with head injuries or most any other type of insult to a developing child’s brain and nervous system, a significant risk to one’s mental development occurs. The younger the child, the more dangerous the exposure is; the highest risks are in the unborn.

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How does one get poisoned? What are the risk factors?
Lead used to be very common in gasoline and house paint in the U.S., but lead based paint was banned in 1978. It is estimated that approximately 4 million Americans are still significantly exposed to potentially toxic levels of lead, because lead basically is everywhere, including old house paint, new toys, dust, dirt and gasoline. Children living in cities with older houses are more likely to have high levels of lead.
Here’s a quick list of lead exposures (there are many other potential exposures):

  • Homes, toys and furniture painted in the US before 1978 and any toys made outside the US (no, the paint doesn’t have to be peeling);
  • Plumbing, pipes, faucets and the water flowing through them;
  • Soil contaminated by car exhaust (think near expressways or busy streets) or house paint scrapings (think old abandoned buildings); and
  • Storage batteries

Take these exposures seriously, because lead exposure comes from swallowing, touching and/or breathing objects containing lead particles. Once in the body and bloodstream, it spread, causing damage throughout. Two notable areas of concern are the effects of lead on blood cells (causing anemia) and on bones (preventing healthy, strong teeth and bone function due to reducing the absorption of calcium.
 

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How does lead poisoning get identified? What are the signs and symptoms?
Lead poisoning can affect many different parts of the body, and symptoms can range from nothing obvious to dramatic mental impairment. Symptoms are more prominent as blood lead levels get higher.
Lead is much more harmful to children than adults because it can affect children’s developing nerves and brains. The younger the child, the more harmful lead can be. Unborn children are the most vulnerable.
It’s important to reiterate that many with lead poisoning won’t have signs of illness early on. If you believe your environment poses a risk, you should ask to be checked. Symptoms are often nonspecific, but if you can remember groupings of symptoms, you’d be on the right track. Consider the following:

  • Behavioral problems may exist such as irritability, difficulty concentrating, sluggishness or fatigue.
  • Digestive tract problems may exist, such as loss of appetite, a metallic taste in one’s mouth, weight loss, nausea, vomiting, constipation and/or abdominal pain.
  • Neurologic problems may exist, such as headaches, muscle and joint weakness or pain, seizures.
  • Pale skin from anemia is also often a prominent finding.

Over the longer term, health problems include the following:

  • damage to the nervous system (such as poor muscle coordination, speech and language problems), kidneys, and/or hearing
  • decreased bone and muscle growth
  • developmental delay

The next Straight, No Chaser will address prevention and treatment strategies.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at www.jeffreysterlingbooks.com, iTunes, AmazonBarnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Go Eat Rocks? Discussing Pica

pica
What the what? Pica is a pattern of eating non-food materials. This pattern must be present for at least a month to make the diagnosis. Pica is not a single incidence of a foreign body ingestion. It is not the activity of infants exploring their universe. It is an intentional and repeated effort to consume certain substances not associated with human nutrition.
Who does this?

  • Pica can be seen in any age group, although it is more frequently seen in younger children.
  • Estimates suggest that up to a third of children below age six engage in this activity.
  • Pica is also seen disproportionately during pregnancy.

Why would anyone do this?
Some individuals can’t overcome cravings or the desire to feel a certain texture in their mouth. These cravings may result from nutritional deficiencies such as iron or zinc.
What type of things are people with pica eating?
Common substances include the following:

  • Clay or dirt
  • Feces
  • Hairballs
  • Ice
  • Paint or paint chips
  • Rocks
  • Sand

What’s done about this?
The approach should include three considerations: addressing the underlying cause, addressing the consequences of the ingestion and eliminating the desire to continue the activity.

  • Addressing the underlying cause: When pica occurs in malnourished individuals, iron and/or zinc replacement (preferably through improving regular nutrition) is important.
  • Addressing the consequences of the ingestion: Lead poisoning may occur if certain types of paint/paint chips are ingested. Infection may occur if soil, feces or other contaminants are eaten. These are serious considerations and must be addressed.
  • Elimination of the desire to continue the activity: Family education, proper nutrition, positive reinforcement for good behaviors and negative reinforcement (such as aversion therapy) for destructive behaviors are possible components of therapy. Additional medications to modify behavior may also be needed.

What happens as a result of this?
It stands to reason that either a positive or negative outcome could occur. The disorder can disappear on its own, particularly if it’s simply associated with nutritional deficiencies that are addressed.
Pica can be long-lasting and destructive if associated with developmental disorders and undiscovered. It may also be especially dangerous if the substance ingested is toxic (e.g., lead poisoning via paint chips). In these instances it may be discovered as part of an illness presenting and resulting from the abnormal ingestions.
Complications can include infection, intestinal obstruction, lead poisoning, malnutrition and a mass of indigestible material can become trapped in the stomach or intestines (known as a bezoar) The appearance of a hairball is shown on the X-ray below.

bezoar

What am I supposed to do about this?

That should be the easy part. If and when you notice anyone ingesting something abnormal on just one occasion, you should seek medical attention.

Feel free to ask your SMA expert consultant any questions you have on this topic.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress