The Poison Lab
Episode #2- The Other Problem With Bullets (Lead and Lead Poisoning from Bullets)
Episode Summary
Get ready for a HEAVY subject, literally. Ryan and Toxo talk about the toxic mechanisms, signs of poisoning, and treatment of one of the worlds most ubiquitous poisons. This is a long, but interesting one, consider listening in chunks.
Episode Notes
- Excellent review of sources, clinical effects, and management
- Clinical Case from today's show
- History
- Lead in society - Great review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522252
- Lead Paint, up to 50% lead until 1940, tens of millions of houses still have lead paint which crumbles and creates lead dust
- Soil, from tetra ethyl leaded gasoline contamination, added to gasolone by Thomas Midgley https://interestingengineering.com/thomas-midgley-jr-the-man-who-harmed-the-world-the-most
- Lead piping- https://www.epa.gov/sites/production/files/2016-10/documents/508_lcr_revisions_white_paper_final_10.26.16.pdf
- The 1986 amendment to the Safe Drinking Water Act required lead-free solder, flux, fittings, and pipes as of June 1988.
- The Lead and Copper Rule originally required replacement of the public and private service pipelines; however, the rule was revised in 2000 to allow for only partial service line replacement in the publicly owned sectors
- Older homes, higher soil lead burden, and unjust housing discrimination have led to disparities in lead racial/ethnic and socioeconomic disparities in lead exposure https://scholar.harvard.edu/files/alixwinter/files/sampson_winter_2016.pdf
- https://pubmed.ncbi.nlm.nih.gov/22752852/.
- Other lead sources
- "Lead crime hypothesis"- https://pubmed.ncbi.nlm.nih.gov/27035924/
- Lead and the economy
- Clinical effects from
- "Ben Franklins dangles and bellyach(gripes) https://pubmed.ncbi.nlm.nih.gov/22910081/
- Lead colic/constipation (gripes)
- Neuropathy (dangles)
- Easy to access origiinal letter on lead from Ben Franklin- https://bit.ly/2Yqgoze
- Neurocognitive/Behavioral, especially in exposed young- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3909981/
- Lower IQ
- Visual spatial effect
- Processing speed reduction
- Irritable affect
- May contribute to cognitive and behavioral disorder
- Chronic kidney and vascular disease- https://www.atsdr.cdc.gov/toxprofiles/tp13-c2.pdf
- Hematologic- https://www.atsdr.cdc.gov/toxprofiles/tp13-c2.pdf
- Hemolytic anemia- From fragility due to decreased calcium/magenisum ATPase acitivity
- Basophillic stippling- Pyrimidine 5 nucleotidase inhibtion causes RNA clumping
- Build up of zinc and erythrocyte Protoporphyrin (ZPP/EPP) from ferrochetalase inhibition of heme synthesis
- Muscoloskeletal
- Toxic mechanism- (gold franks)
- Binding of sulfhydryl groups
- Appearance as a divalent cation
- Good resources for broad overview and some nitty gritty info on mechanisms and effects
- Treatment
- Chelators
- What to do with your lead level (if its a capillary blood lead make sure you confirm it with venous blood lead!)
If you have an elevated blood lead level- call your toxicologist or poison center. Thanks for listening!