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Is Lead Poisoning Me? with Dr. Adam Blumenberg

A toxicologist discusses lead toxicity and how to prevent lead poisoning.

Is news about lead in water bottles or applesauce pouches a cause for concern? In this week’s episode, Dr. Adam Blumenberg, an emergency medicine physician and toxicology expert offers helpful context on lead poisoning. Dr. Blumenberg explains what lead is, how exposure might happen in our daily lives, and when treatment is needed.

Episode Transcript

Faith: Dr. Adam Blumenberg, thank you so much for joining us.

Dr. Blumenberg: Thank you for having me. It’s great to chat with you.

Faith: For many of us, what we know about lead poisoning is a terrible crisis in Flint, Michigan, but help us understand the basics. What is lead and why is it so dangerous?

Dr. Blumenberg: So lead is a metal and it’s an element, meaning it’s a very basic chemical. It can exist on its own. The way that it’s poisonous is it interferes with how our cells metabolize other chemicals, other nutrients, and it can cause various problems with different organ systems.

Like all poisons, it does depend on the dose, and it has to somehow get inside the body. So because it depends on the dose, there are degrees of lead toxicity. So just to kind of paint a picture of what does lead toxicity look like. In mild forms, In children, a relatively small exposure to lead is associated with a small decrease in IQ, which is unfortunate. It can actually have cognitive changes in, in someone who’s having a developing brain, which is one of the reasons that lead screening and lead exposure screening is so important for young children. In more severe cases, if someone has ingested more lead and there’s more lead into their body, in addition to those changes to someone’s ability to think and reason, which might start mild, it can cause problems with bone marrow, specifically leading to a condition called anemia, which is a low blood count. It causes problems with the body’s ability to carry oxygen. In the most extreme cases, which is very rare, but can happen, their brain develops a medical condition called cerebral edema, which means that the brain has swollen inside the tight space of the skull. This can be life threatening because not enough blood can get to the brain, and it can cause coma, it can cause seizures, and in rare cases it can be fatal. This is a very rare condition, but this is kind of the worst case scenario.

Faith: Is there a minute amount of exposure that’s considered safe?

Dr. Blumenberg: That’s a complicated question. The short answer is there’s not really a safe amount of lead exposure. There’s not really an amount of lead that’s considered acceptable to have in the body. That said, any substance, including lead, that exists in the Earth’s crust exists in our bodies in very small amounts.

Faith: Hmm.

Dr. Blumenberg: Practically, there’s always going to be a teeny tiny bit that we can’t really do much about and is honestly probably not harming us much at all. That said, when the amount of lead becomes detectable in the bloodstream, it’s a good idea to figure out how it’s getting there. It has to somehow get inside the body, usually through some kind of contaminated food or drink, or something else that the person actually ingests and gets inside their body.

One of the more common causes of lead poisoning is from old paint chips that have peeled off the wall. And those paint chips can collect at windowsills or on the floor next to walls. And little children, toddlers, sometimes will eat these paint chips because they taste good, they’re sweet. And so that’s one of the more common ways that little kids get exposed to lead. There are some other ways for example, pottery that has certain types of white glazes on it, that white pigment sometimes is lead. If it’s manufactured in the United States, that’s unlikely. It’s usually imported ceramics.

What I don’t want is people to worry needlessly, and also I don’t want people to have a health issue that goes undiagnosed. So all this is to say is talk with your doctor about the symptoms and make a determination if testing for lead is or is not appropriate.

In most adults, even who have some undiagnosed symptoms, chances are it’s not lead poisoning, but talking that over with your doctor is always a good idea. Most people in the United States have a very low likelihood of being exposed to lead.

There are some jobs, some professions, where people can become exposed to lead. An example is battery recycling or other kind of metal recycling. And it’s really, really important that the employer, that the workplace, make sure that the employees are safe from those exposures. There should be little to no exposure of hazardous substances to someone who’s at work. That’s a discussion to have with kind of the workplace safety officers.

There are special situations where some people might be exposed to lead. If their home has lead based paint on the walls, if there’s a lead surface that can be touched or put in someone’s mouth. If they have, for example, fishing weights are often made of lead or shotgun pellets are often made of lead in the living environment, those could be sources of lead. If there are exposed circuit boards all over the place, it’s hard to imagine, but if that’s the case, if someone’s doing a lot of soldering, if they’re a hobbyist, you want to, you want to consider using a lead free solder. If you are not able to, you really want to be very careful with how you use the lead, so make sure you’re in a ventilated area. Make sure no children can be exposed to that material at all.

Those would be types of ways that someone in the United States could be exposed to lead.

Faith: Is the body able to clear lead exposure on its own?

Dr. Blumenberg: It is, but very slowly. So, a small amount of lead can be cleared safely. In cases where someone is more severely poisoned, we might have to remove that lead through a medical procedure called chelation, but that’s only in extreme and severe cases. Even mild and moderate cases of lead poisoning usually do not require chelation treatment.

Faith: And, and so how do you determine when someone crosses the line from lead exposure? Or even having a small amount to what you would diagnose as lead poisoning?

Dr. Blumenberg: One of the big differences between lead exposure and lead poisoning will be the types of symptoms or effects that the person is actually experiencing. An example of that might be if they develop anemia, which is that low blood count that’s caused by lead. Another example might be if they’re having neurological changes, meaning there’s something affecting how their mind is working, how they’re thinking, how they’re speaking, how they’re moving, that’s caused by lead.

Faith: Are there any everyday foods that expose us to dangerous levels of lead?

Dr. Blumenberg: There should not be any food that’s containing a significant amount of lead. The, the rare exception to that is if some product gets past our safety regulations. So for example, recently there was a fairly large batch of applesauce that was contaminated with cinnamon. That was spiked with lead and all that applesauce has been recalled.

That’s a rare event, but that happened There were people who ingested lead as a result of that massive food safety issue. That’s a big problem.

Faith: Is there lead around us in our daily lives that we just don’t need to worry about?

Dr. Blumenberg: Yes, there is a fair amount of lead around us in our daily lives that isn’t going to be harming us in any way. So one example is in a lot of electronics, the electronic components may be soldered to the circuit board using lead based solder. And as long as that lead stays contained, stays inside the device, and doesn’t get into our food or water, we don’t chew on it, we don’t ingest it in any way, there’s really no way for it to hurt us.

It can only become a problem if someone were to do something like that. You know, open up one of these devices and chew on the pieces. Exactly, exactly. Which, which I would never say never, but it’s just not an everyday thing. So it’s not a, it’s not something that I would worry about as a source of lead exposure.

Faith: To me the scariest notion is lead in pipes. That we might drink water out of. I mean, pipes are mysterious things in the buildings where we live that we don’t really lay eyes on. How, how often does that happen? And how do we, how do we keep ourselves safe?

Dr. Blumenberg: So the pipes that bring us drinking water tend to not be made of lead at all. They usually are other materials, most commonly copper. Now the reason that there’s any lead at all in the system is that when copper pipe is connected to copper pipe, it needs to be sealed. And that seal is with solder, which often times does contain a small amount of lead. So at those joining points where a copper pipe is connected to a copper pipe, there might be some lead. The amount of lead that actually leaches out of that into the drinking water is so small that it’s really not going to cause problems as far as I’ve experienced or read into or looked at.

It’s a potentially scary thing to hear that our drinking water has some contact with lead. I don’t like hearing that. But when you look at the actual amount of contact between our drinking water and lead, it’s, it’s so small that it’s really not picking up any meaningful amount.

Faith: How is lead poisoning diagnosed? Is it, is it a blood test?

Dr. Blumenberg: There’s a couple of different ways to do it. So, it’s done a little different in children and in adults. In children, we screen for lead. What that means is that just about all children should get their blood lead level checked, even if they don’t have any obvious symptoms. This is a, a routine screening for most small children. It, it varies a bit state to state, but in New York, all children are screened for lead. Sometimes if you’re just looking for lead and no other testing, it can be with a few drops of blood, and that could be a finger prick or a heel prick, just to get a few drops of blood, sometimes it can be to do an actual blood draw and remove a few milliliters or several drops of blood from the vein.

Adults generally do not need to be checked for lead, unless they have symptoms that really suggest that they might have lead poisoning.

Faith: What should people know about environmental factors and potential dangers? You know, we all want to be vigilant, but we also don’t want to live in a state of, you know, hyper paranoia.

Dr. Blumenberg: The way I see it is we take a lot of risks within our daily lives, but we also know how to be reasonable and thoughtful about these risks. An example I often think about is just being in a car. I think we all have a sense that a car accident could happen. Anytime we get into a car, it’s a possibility.

But to minimize those risks, we wear our safety belts, we’re vigilant when we’re behind the wheel, we follow traffic laws, and we’re careful. And sure, something could happen, but the risk is low enough that we go forward and live our lives and enjoy our lives. I think it’s similar with a lot of these toxic substances you mentioned.

We know that people in general are living longer, healthier lives than hundreds of years ago. And even though there are a lot of new substances and new toxins in our environment, generally speaking, human beings are healthier than we have been in the past. So, going forward, we should definitely, definitely learn more about these substances, everything that’s in our environment.

If something turns out to be more dangerous than we realized, we need to do something about it, either ban it or heavily regulate it, or avoid it. We need to be thoughtful about what we’re eating, make sure that it’s a food, make sure it’s a reputable food source or a drink source, um, and to generally use good judgment.

Faith: Coming from an awareness of toxicity in our environment, are there some everyday things that maybe we don’t talk about as much, but we should all be aware of?

Dr. Blumenberg: Yes. So an important point to be aware of is air pollution. Essentially, car exhaust, industrial air pollution, things like that, which are a big problem, especially for people who have lung diseases like asthma. In parts of cities where there’s a lot of car traffic, people who live around highways, people who live where there’s a lot of car traffic, are much more likely to have asthma flare ups, or even asthma itself. And so I think that’s a big, big problem in our society as well. Avoiding air pollution is generally a good thing to do. Of course, that can become complicated if that’s where you live. There are some masks that can help filter the air. If you’re particularly sensitive to air pollution, getting an indoor air filter like a HEPA filter might be a good idea. Those types of things can make a difference.

Faith: When it comes to treating poison, or if you’re concerned about toxic exposure, what are the best resources for people to consult? Where should we go for good information?

Dr. Blumenberg: There are a lot of great resources out there if you have questions about poisoning. So the best place is to talk with your primary care doctor or your child’s pediatrician, or to call the Poison Center. which is a toll free number where you’re connected with a specialist who knows what they’re talking about and knows how to give you high quality answers to your questions.

And they’re available 24/7, any time of day. You can call them at 1 800 222 1222. If you’re looking up information about poisons on the internet, just be cautious because there’s so much false information on the internet and even some lies, I’m sorry to say. So when doing research online, it’s just important to get high quality sources. Generally speaking, the CDC, the Center for Disease Control, has some good quality information. Pediatrician associations will also publish some general advice about these topics, which can be high quality as well.

Faith: Thank you so much, Dr. Blumenberg, for, for explaining all this to us.

Dr. Blumenberg: Thank you so much for having me.

Our many thanks to Dr. Blumenberg. I’m Faith Salie.

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Dr. Blumenberg: If someone has a hobby that involves lead, for example, fishing using fishing weights, hunting with shotgun pellets which contain lead, soldering with lead based materials, the best thing to do…

Faith: Or cosplay dressing up as Queen Elizabeth the first, perhaps?

Dr. Blumenberg: That’s a, that’s a great example.

Faith: Thank you.

Dr. Blumenberg: Yeah, cosplay. Yes, I like that.

Faith: Just asking for a friend, Dr. Blumenberg.

Dr. Blumenberg: Of course, of course. So if you’re going to do cosplay and dress as Queen Elizabeth the best thing to do, if possible, is to find a lead free substitute for the materials you need for that hobby.

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