What is Lead Poisoning?

Lead has been used for millennia and was once known as the ‘miracle metal’, as it has beneficial wide-ranging properties. Despite its usefulness, people were suspicious the metal caused ill health, even thousands of years ago. It was only around the time of the Industrial Revolution, when lead production increased, that the dangers became more apparent as people started to fall ill with lead poisoning.

Due to the increased awareness of the dangers, there was a phase-out of certain lead products in the late 19th and early 20th centuries, e.g. leaded petrol. Despite the bans, the historical uses of lead mean that lead products are still in circulation and there are contaminated areas from previous use. Many lead forms are still in use in many industries because of their valuable properties, and there are no viable alternatives in some cases. Therefore, there is still a risk of lead exposure at work or home, even today.

Exposure to lead can cause various symptoms, even at low levels. Lead poisoning is dangerous, as it can cause irreversible health effects and even death, especially in children and the vulnerable. While there are insufficient data on lead exposure outside of the workplace, there have been suggestions that some cases of lead poisoning in children are undiagnosed, especially in low and middle-income countries (David J Roberts, 2022). According to Unicef, up to a quarter of a million children in the UK have blood lead levels at or above 5μg/dL. Bear in mind that levels as low as 10 μg/dL are considered harmful. The Lead Exposure and Poisoning Prevention Alliance has more statistics on its website.

The Health and Safety Executive (HSE) collects data on lead exposure at work. In its latest statistics (2020/21):

There were 3,602 lead workers under medical surveillance in Great Britain.
The top five industries for males under medical surveillance were:
– Smelting, refining, alloying and casting.
– Lead battery manufacture.
– Working with metallic lead and lead-containing alloys.
– Demolition industry.
– Lead battery recycling.
The top five industries for females under medical surveillance were:
– Smelting, refining, alloying and casting.
– Working with metallic lead and lead-containing alloys.
– Lead battery manufacture.
– Scrap industry (including pipes, flashing, cables).
– Glassmaking (including cutting and etching).
Six lead workers were suspended from work due to excess blood lead levels. They did not have symptoms of lead poisoning.

There were no cases of workplace lead poisoning in the latest statistics report, including no data to suggest any lead-related fatalities at work over recent years. However, there are previous cases of high-level exposure and lead poisoning in the workplace. Therefore, we should not be complacent, as the risk remains while lead is still in use.

This article will cover what lead is, where people may come across it and the associated dangers. It will also look at lead poisoning, its symptoms, causes and prevention.

What is lead?

Lead is a heavy metal. It is soft and lustrous with a metallic bluish, silvery, white or grey colour.

The chemical symbol for lead is Pb, from the Latin plumbum (meaning lead). That is where the words plumbing and plumber originate, as the Romans used lead in water pipes and aqueduct linings.

Lead has wide-ranging beneficial properties, such as:

High density and compactness.
Malleability, i.e. it can be hammered or pressed into shape without breaking.
Ductility, i.e. it is stretchy.
A low melting point.
High corrosion resistance.
It is non-combustible.
It is a poor electrical conductor.

Even though it has beneficial uses, it is toxic to humans and animals.

Where is lead found?

Lead is a naturally occurring and ubiquitous chemical element in the Earth’s crust. It is extracted from ores dug from underground mines worldwide.

As lead is present in the natural environment and has been widely used for thousands of years, it is all around us. It is now commonly found in buildings and soil but also in the air and water. There are some places where there are higher concentrations than others, e.g. urban areas.

Lead is also present in many compounds, such as lead acetate, lead chloride, lead chromate, lead nitrate, and lead oxide. There are also lead alloys and lead alkyls.

The historical uses of lead mean it may be in (this list is not exhaustive):

Old lead paint in buildings before the 1980s (usually found on windows, windowsills, bannisters, doors, door frames, railings and porches).
Antiques.
Other items, e.g. food containers (lead-crystal/lead-glazed pottery), painted toys, jewellery and furniture.
Old plumbing systems, e.g. water pipes, tanks, fittings, and solder.
Contaminated soil from industrial pollution and past uses of leaded petrol.

Today, lead is still used for various purposes, but most likely to be found in:

Metallic lead

Ammunition (there are plans to phase lead ammunition out due to the environmental risks).
Storage batteries, e.g. lead-acid.
Cable sheathing.
Solders and steel products.
Bearings.
Radiation and x-ray shielding systems.
Computer and electronic equipment circuit boards.
Superconductor and optical technology.
Architecture, e.g. roofing materials.
Weights, e.g. lifting.

Lead compounds

Cathode ray tubes (CRT).
Colour pigments.
Enamels.
Ceramics.
PVC.
Crystal glass.

Some of the above may be in and around our homes, workplaces, other buildings, vehicles and everyday items, e.g. electrical.

Why is lead dangerous?

Lead, its alloys and compounds are dangerous as they are toxic, which means they can cause damage to a person’s health, even at low levels. In fact, according to the World Health Organization (WHO), there is no level of lead exposure that is known to be without harmful effects.

Lead is dangerous as it:

Is stored in the teeth and bones for many years.
Can cause cumulative poisoning (i.e. it accumulates in the body as it stays there for many years).
Is a neurotoxin, which can cause damage to a person’s nervous system.
Interferes with the uptake of iron resulting in anaemia.
Can cause environmental damage.

If a person is continually exposed to lead, they could get lead poisoning. It is especially harmful to unborn babies and young children as it hinders their development.

Poisoning is when a person is exposed to a substance that can damage their health or endanger their life (NHS). Lead is one such substance that can poison people, as it is toxic and can build up in the body over time if they are repeatedly exposed. Poisoning can also occur more quickly if large amounts of lead enter the body.

Lead poisoning is also known as plumbism and saturnism. A person does not have to be exposed to large amounts of lead. If exposure occurs over time, it can be stored in the body and reach toxic levels.

Fortunately, lead poisoning is uncommon in the UK due to the ban on certain lead products and tight legislative controls. However, the risk of exposure remains, which could result in poisoning in some cases.

Is lead poisoning dangerous?

Yes, if an individual has lead poisoning, it means they have high levels of lead in their body. If untreated, it can cause permanent damage to a person’s vital organs, brain and central nervous system. In severe poisoning cases, it can be fatal.

Some are more susceptible to the harmful effects of lead and are at a higher risk from lead exposure, e.g.:

Workers in high-risk occupations – lead manufacturing, smelting/casting, recycling/recovery, plumbing, blasting, spray painting, construction, paint stripping, roofing, etc.
Children/young people – lead can adversely affect physical and mental development.
Women of reproductive capacity – lead exposure can cause infertility and can cause complications if the woman becomes pregnant.
Pregnant women – lead can pass from the mother’s blood to the baby’s blood and from the mother to the baby during breastfeeding. It can also cause genetic defects and increase the risks of miscarriages, stillbirths, low birth weights and premature births.

Healthy adults can also get lead poisoning.

Is lead poisoning fatal?

Lead poisoning can be fatal if exposure continues and individuals do not get appropriate treatment promptly. Children are particularly at risk of fatal lead poisoning, as they can absorb higher levels than adults.

What can cause lead poisoning?

Lead poisoning usually occurs when a person is exposed to small amounts of lead over a period of time, and it builds up in the body. For it to cause ill health, the toxic substance has to come into contact with the body and enter in some way. The health effects will depend on how the lead enters the body and its form, for example:

Lead dust, vapour or fume – can be inhaled.
Lead powder, dust, paint or paste – can be ingested.
Lead alkyls (petrol additives) and lead naphthenate – can be absorbed through the skin. The metallic form of lead is not absorbable.

Lead poisoning is rare in the UK, but the following may result in exposure to lead:

Drinking tap water from a building (usually built before 1970) with old lead plumbing, e.g. lead pipes, water tanks, solder or fittings.
Putting food in lead-lined containers.
Inhaling lead dust, fume or vapour from removing old paintwork when doing DIY or renovating.
Work processes.
Ingesting lead from not washing hands and face before eating, drinking, smoking and biting nails. Lead poisoning cases have occurred where children have eaten flakes of lead paint that have deteriorated on walls and woodwork.
Children playing with lead-containing items and putting them in their mouths (hand-mouth behaviour), e.g. old painted toys.
Eating food that has been grown in lead-contaminated soil.
Importing and buying items (e.g. cosmetics, medicines, remedies and pottery) from developing countries, as the laws are not as strict.

What are the symptoms of lead poisoning?

Symptoms of lead poisoning are often difficult to pinpoint, as they are similar to other conditions. They will also differ between children and adults.

Exposure to lead can pose a severe health risk and affect nearly every system and organ in the body. As lead levels become high, they can have acute and chronic effects.

Acute effects – exposure to high levels of lead over a short period can cause symptoms of acute poisoning, e.g.:

Metallic taste in the mouth.
Stomach pains.
Nausea.
Tiredness and fatigue.
Headaches.
Irritability.
Joint and muscle pain.
Vomiting.
Constipation
Diarrhoea.
Poor concentration.
Memory loss.
Hallucinations.
Appetite loss.
Convulsions.
Kidney and brain damage (severe cases).

Chronic effects – exposure to lower levels of lead over a long period (continued uncontrolled exposure) can cause symptoms of chronic poisoning, e.g.:

Weight loss.
Severe abdominal pain.
Psychological issues, e.g. depression.
Anaemia.
A blue line around the gums.
Nerve and brain damage.
Kidney damage.
Infertility (males and females).
Miscarriages, stillbirths and premature births.
Hearing difficulties.
High blood pressure.
Foot and wrist drop.
Cancer (suspected but not confirmed).
There may also be the same symptoms as acute effects.

In children, lead can:

Interfere with a child’s nervous system development.
Cause learning and behavioural difficulties.
Lower their IQ if exposed in early years.
Cause skeletal changes.

Children can exhibit the following symptoms:

Abdominal pain.
Vomiting.
Constipation
Appetite loss.
Weight loss.
Fatigue.
Irritability.
Hearing loss.
Learning difficulties.
Physical and mental development delays.
Seizures.
Eating non-food items (pica).

When lead levels are very high, it can cause seizures, unconsciousness and death.

If in doubt, it is always best to err on the side of caution and speak to a doctor if exhibiting any lead poisoning symptoms, especially if there is a risk of exposure, e.g. old plumbing systems and lead paint.

How to prevent lead poisoning

As lead is ubiquitous, exposure is not always preventable, as it is all around us. However, there are things we can do at home and in the workplace to prevent lead poisoning.

The most important thing to do to prevent lead poisoning is to remove the source of contamination. If this is not possible, then there are ways to reduce the risk, for example (this list is not exhaustive):

Drinking water

Identify if older properties (built before 1970) have lead piping. Water suppliers usually have guidance to help homeowners identify if this is the case. There is also some guidance from WaterSafe on how to check.
Have samples taken from drinking water tap sources to identify if lead is present. Again, water supply companies can advise.
Replace any lead piping where possible, but this can be costly.
Use short-term measures while waiting for a remedy from the water supply company or the Local Authority environmental health team, such as:
– Only use the cold water from the kitchen tap for drinking and cooking, and not from the bathroom.
– Run cold water taps for at least two minutes to flush the system.
– Use water filters that remove lead traces (check they are suitable for lead).
– Use bottled water for drinking and cooking if lead is detected in tap water.

Remember, lead is not absorbed through the skin, so it is ok to bathe and shower.

Old lead paints

Identify if any paint contains lead. Properties built before 1960 could have old paintwork containing lead and paint applied before 1980. Some tests and surveys could confirm its presence, but there would be a fee.
Keep children and animals away from flaking or damaged paint that they could knock or ingest accidentally.
Where possible, seal lead paint with a coat of modern paint rather than remove it. It will not create inhalable lead dust, fume or vapour if it is not disturbed.
If the paint cannot remain, it is important to use methods that do not create dust, fume or vapour. There is advice on removing lead paint in older homes from DEFRA.

Other precautions

Only buy products from overseas guaranteed as lead-free.
Do not use lead containers for storing food or drinks.
Wash hands regularly and avoid eating, drinking, smoking or biting nails after touching anything suspected of containing lead, including contaminated soil.
Wear suitable personal protective equipment (PPE) during DIY on older properties.
Use non-lead shot alternatives if shooting. Staff working at an indoor shooting range were treated for lead poisoning, highlighting the risk of using lead ammunition (BBC News).
Wash any own-grown vegetables thoroughly before eating, especially if the property is older and close to a road.

Further guidance on prevention is on the LEAPP Alliance.

At work

In workplaces, employers have a legal duty under the Control of Lead at Work Regulations 2002 (CLAW) to prevent or, where this is not reasonably practicable, to control employee exposure to lead. Self-employed people also have duties. Further guidance on preventing lead exposure at work is on the HSE’s lead webpage.

How to treat lead poisoning

If someone suspects they, or their children, have lead poisoning, they should seek immediate medical advice and inform their doctor. Delays in treatment can result in irreversible health effects and can even be life-threatening. Doctors usually request a blood test to establish if a person has lead poisoning.

According to the LEAPP Alliance, the half-life of lead in blood is about 30 days. Therefore, it is important to remove the contamination source to prevent any further exposure to lead or reduce the risk by taking some of the precautions we have looked at in this article.

Treatments for high lead exposure usually consist of chelation therapy (intravenous or tablet drugs). This requires admission to the hospital under supervision.

Summary

Even though lead poisoning cases are relatively rare in the UK due to the legislative bans on high-risk sources, it is crucial to be aware that the risk of exposure still exists. Historical and current uses of lead mean that it is not going away soon. Therefore, people should keep themselves and their children safe and healthy by understanding what lead poisoning is, the symptoms and what to do if they suspect they are suffering from lead poisoning.

With lead poisoning, prevention is better than cure. Once lead is in the body, it is difficult to remove and can have lasting adverse health effects. Symptoms can be very unpleasant and may quickly become life-threatening without prompt treatment. In most cases, lead poisoning is preventable by removing the sources of contamination and reducing the risk by taking sensible precautions around the home and work.

What is Lead Poisoning?