Lead Poisoning (Plumbism)

All Australians should have a blood level <10 mcg/dL. Levels above this are associated with adverse neurocognitive defects.

Children at risk of elevated blood lead:

• aged 9–48 mths living in or visiting older houses with peeling paint

• those with pica

• those living in lead-contaminated areas (e.g. heavy traffic, lead mining, battery breaking yards)

Symptoms, which are now rare, include:

• bad taste in mouth

• lethargy/fatigue

• musculoskeletal aches and pains

• abdominal discomfort

• irritability/abnormal behaviour/cognitive defects

• bowel disturbances

Consider lead toxicity in children presenting with developmental delay or behaviour problems and in those with unexplained iron-deficiency anaemia. Active management needed if blood level is >40 mcg/dL. Treatment involves chelation with sodium calcium edetate, succimer or dimercaprol in hospital. Penicillamine or succimer are oral preparations which can be used.