Lead poining

lead poisoning. plumbism, painter's colic. pica , gastric lavage,

1. LEAD POISONING
Dr. Kaleem Khan
Assistant Professor
Department of Forensic Medicine
1

2. Uses and Sources of LeadUses and Sources of Lead
Paint (until 1970)
Petrol (tetraethyl lead)
Household dust
Ceiling dust
Occupational
Solder
Ceramic glazes
Pesticide(Pb arsenate)
Cigarettes
Mines, smelters
TV's, Computer monitors
  Batteries, Bullets
Sinkers
Aviation
X-ray shields
Crystal-ware (high levels
in decanters)
Explosives
Non-stick linings of pots
(in the past)
Plastic colouring (wire,
blinds)
Pewter
2

3. S no. Compound Uses
1 Lead acetate Astringent, local sedative
2 Lead tetra oxide Sindoor
3 Tetraethyl lead Antiknock for petrol
4 Lead sulphide Surma
5 Lead carbonate paints
3

4. ◦Sugar of lead, lead sugar, salt of Saturn
◦Formula: Pb(C
2
H
3
O
2
)
2
◦White crystalline chemical compound with a sweetish taste
◦Solubility: Anhydrous and trihydrate are soluble in alcohol,
glycerol
◦LD
50
(median dose): 400 mg/kg (mice, oral)
4

5. White crystalline Packed
5

6. Bright Red or Orange Crystalline or Amorphous
Pigment, Chemically, Red Lead
Formula: Pb
3
O
4
6

7. Lead tetraoxide is most often used as a pigment for
primer paints for iron objects.
The combination of minium and linen fibres was also
used for plumbing,.
Currently it is mostly used for manufacture of glass,
especially lead crystal glass.
7

8. Lead tetraoxide For industries
8

9. Lead sulfide is an inorganic compound.
With the formula PbS,
Also known as galena,
the principal ore,
Most important compound of lead.
9

10. Crystalline Surma
10

11. 11

12. 
Lead goes down iron or calcium absorption pathway in GIT.
 Children absorb lead well orally (~50%) cf adults poorly
(~10%). Children also have more hand to mouth activity.
Lead absorption is enhanced if diet is poor in iron or calcium.
Pica is one of the worst risk factors.
Lead can be inhaled.
Tetraethyl lead can be absorbed via skin.
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14. 14

15. 
15

16. 95% long bones.
Binds into matrix.
Released during osteolysis.
4% brain,liver, kidneys.
1% blood.
Crosses placenta, foetal BBB is
open
16

17. 17

18. Pb + essential SH-groups of certain enzymes
Increase in permeability

Potassium leakage

19. INORGANIC Pb
exposure:-
Abd. Colic
obstinate constipation
Loss of appetite
Blue lines on gums
Stippling of red
cells
Anaemia
Wrist drop
Foot drop
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21. 21

22. 22

23. 23

24. Organic Pb compounds:- (toxic effect mainly on CNS)
Insomnia
Headache
Mental confusion
Delirium etc..

26. History
Clinical features
Laboratory diagnosis
a)Coproporphyrin in urine(CPU)
Normal- <150µg/L
b)Amino levulinic acid in urine(ALAU)
>5mg/L

27. c)Pb in blood and urine
(In urine Nl is 0.2-0.8mg)
In urine- >0.8mg/L
Indicates
In blood- >70µg/100ml Pb absorption
d)Basophilic stippling of RBC

28. 28

29. 29

30. Fatal dose
Lead carbonate:40 g
Lead acetate:20 g.
Fatal period: 1-2 days
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31. Aim
a)To prevent further absorption
b)To remove lead from soft tissues
c)To prevent recurrence

TREATMENT
 Saline purge (remove lead from the gut)
 d-penicillamine(promote Pb excretion in urine)

32. In a child with acute lead ingestion, consider placing an orogastric or
nasogastric catheter to enable whole-bowel irrigation (WBI) with
polyethylene glycol
Dimercaprol, also k/a BAL (British antilewisite), IM
CaNa2 EDTA
Succimer
32

33. a)Substitution
Pb compounds should be substituted by less toxic materials.
b)Isolation
Pb dust or fumes should be enclosed and segregated
c)Local exhaust ventillation
To remove dust & fumes

34. d)Personal protection
By approved respirators
e)Good housekeeping
f)In working atmosphere
Pb conc. Should be kept <2mg per 10cu.m of air
g)Periodic medical examination of workers
h)Personal hygiene (Hand washing)
i)Health education