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Lead Pellet Ingestion in 3 Children: Another Source for Lead Toxicity

Becky Rozier, Erica Liebelt

    Pediatric Emergency Care
    |August 11, 2018
    PubMed

    Insights

    Ingesting lead ammunition can cause dangerous blood lead level increases in children, requiring prompt medical care. Emergency providers must recognize these alternative lead sources for timely evaluation and treatment.

    Area of Science:

    • Toxicology
    • Pediatric Emergency Medicine
    • Environmental Health

    Background:

    • Acute ingestions of spherical lead ammunition, like bullets and shot, pose a significant risk for elevated blood lead levels (BLLs) and acute toxicity.
    • Pediatric patients exhibit faster gastrointestinal (GI) lead absorption than adults, increasing their vulnerability to neurotoxicity and neurocognitive deficits.
    • Traditional lead sources like paint are well-known, but lead ammunition ingestion represents an underrecognized environmental hazard requiring emergency department (ED) awareness.

    Observation:

    • This article details three pediatric cases of lead ammunition ingestion.
    • All patients presented with significantly elevated BLLs and received gastrointestinal decontamination and chelation therapy.
    • Radiographs confirmed the presence of ingested lead pellets in all cases.

    Findings:

    • Ingested lead ammunition caused acute blood lead level elevations and clinical symptoms in pediatric patients.
    • Prompt gastrointestinal decontamination and chelation therapy were administered for elevated BLLs.
    • Failure of lead foreign bodies to pass necessitated interventions to prevent ongoing lead absorption.

    Implications:

    • Emergency health care providers must consider lead ammunition as an alternative lead source beyond paint.
    • Urgent evaluation and treatment are crucial for children ingesting lead ammunition to prevent irreversible neurotoxicity.
    • Awareness of these exposures is vital for effective pediatric lead poisoning management and prevention strategies.

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