PART III
ROUTES OF EXPOSURE
Lead poisoning can come from a number of sources. The more common ones are, lead in paint, in the glaze on dishes, in old lead lined water pipes, water tanks, and water coolers, in plumbing lead-solder joints, in dust contaminated from years of burning leaded gasoline, in industrial settings, in moonshine whiskey distilled in lead soldered auto radiators, and from the shooting range or the handling of ammunition. The last two are obviously the concern of this article, but it is important to remember that if you are exposed to lead from several sources it can add up quickly.
Lead can enter the body by breathing it in as a dust or vapor, by ingesting it, and to a lesser extend, by absorption through the skin. On the shooting range it tends to enter via all three routes. Every time you discharge a handgun a spray of lead erupts into the air around you. If you are shooting cast lead bullets, part of this lead is in the form of microscopic particles sheared from the bullet as it passes down the barrel. Down range, the bullet impacting on the armor plate emits a spray of fine lead particles. More importantly, the chemical commonly used in primers is lead styphnate, and detonating the primer discharges a cloud of molecular lead compounds. So the air on a shooting range -- even an extremely well ventilated range -- tends to contain a lot of lead, both as dust, and as gas. It settles in large amounts on the floor, and on other horizontal surfaces as well. Even if the range passes OSHA standards for airborne lead contamination (which many don't), you will still often find yourself standing in a cloud of lead filled gun smoke as the air currents eddy around you. All the while you are breathing in lead, about 30-50% of which will dissolve from your lungs into your bloodstream. If you have any doubts about this, just blow your nose when you leave the range after a lengthy shooting session. That black stuff in the mucous is the residue of gun smoke, and it contains a lot of lead.
The powder residue you get all over your hands also contains a lot of lead. Left on your hands, some of this can actually be absorbed directly through your skin. More importantly, if you eat with this residue still on your hands, you will contaminate your food with a significant amount of lead. You can also contaminate your food with residue from around your mouth, particularly if you have a mustache. Your breathing concentrates lead around your nose and upper lip, and a mustache will act as a filter to trap the particles and gases. Your sandwich or pizza will then carry those particles into your mouth. This is particularly important to realize, because although only about 10% of ingested elemental lead is absorbed, nearly 100% of ingested lead salts -- formed when you ignite the primer -- are absorbed. So ingestion is a very efficient way to absorb certain forms of lead.
Handling fired brass can result in the same problem. The powder residue on fired brass also contains a lot of chemical and particulate lead. The author knows of one individual who didn't spend much time on the range, but who regularly sorted brass while munching snacks, and gave himself serious lead poisoning in the process.
If you have small children, it is also important to realize that you can carry lead residue home and contaminate your living quarters and car. You will get the dust on your shoes, on your clothes, on your shooting gear, and in your hair. It will then be tracked into and settle on the floor of your home. Children, of course, live on the floor and put everything into their mouths. And as we noted before, they are extremely susceptible to lead poisoning. In the course of the research for this article, the author was told by a local health official of a case where the children of one particular family were found to have elevated blood levels of lead, and the family car was so badly contaminated (from the family's clothing) that it simply had to be gotten rid of.
DIAGNOSIS
Initial testing for lead poisoning is extremely straightforward. A blood sample is drawn and sent to the laboratory where the lead level is measured. A level above 40 mcg/dl is considered outside the normal range, and above 60 mcg/dl is considered lead poisoning. However, remember that 40 mcg/dl is not a magic number. Elevated levels below that will still have an effect, so the lower the better. The author personally would like to see his lead level remain well below 20 mcg/dl.
If the level is elevated or indicates lead poisoning, the physician may want to do some other tests since blood lead tests are not notoriously accurate. One follow up test is the zinc protoporphyrin test which determines whether the exposure to lead took place over a long period of time, or all at once. An elevated zinc level indicates that the exposure was chronic. This has important implications for how long it will take to recover, which will be addressed in the treatment and prevention section.
As noted above, one problem with diagnosing lead poisoning is that it mimics too many other disorders, particularly stress and psychological disorders. This actually makes victims reluctant to seek medical aid, since no one wants to admit to falling apart psychologically, or to being unable to cope with the stress of their job. Furthermore, it's just rare enough that physicians fail to test for it. If you suspect the possibility of lead poisoning, ask for a blood lead test.
TREATMENT AND PREVENTION
It's a lot easier to prevent lead poisoning than to treat it. But in most cases, the treatment consists of simply removing oneself from the source of exposure, and allowing the body to slowly eliminate the lead by excreting it in the urine.
Usually, the level drops quickly at first as the kidneys remove lead from the blood. However, lead is stored in the bones, liver, kidneys, and other internal organs, and is only slowly surrendered back to the blood. This means that the blood level can remain elevated for quite some time, and can vary considerably from day to day. It is the blood level, not the level stored in the tissues, that results in lead poisoning. People have been known to have acute episodes resulting from lead being released from their own tissues. (For instance, women who have been chronically exposed to lead, and who develop post-menopausal osteoporosis -- where the bones quickly lose a lot of mass -- are at risk of being poisoned by the lead being released from their own bones.) The longer one has been exposed to lead, the longer it will take to recover since the tissue level of lead is much higher and endures longer. Consequently, it can take weeks, months, or even years for one's blood lead level to return to normal.
In extreme cases, as noted above, chelation therapy is employed. This rapidly lowers the blood level of lead, and causes some lead to be leached from the bones and tissues. But it may still take a long time for the blood lead level to come down to normal.
Obviously, the sensible thing to prevent lead poisoning in the first place is to take the proper precautions. Exclusive use of jacketed bullets can prevent much of the lead contamination on shooting ranges (this was the original reason why the Nyclad round was developed), but this is more expensive than using cast-lead reloads, and may be impossible to enforce on many ranges. Furthermore, this still leaves the lead from the primer, and the down range impact spray. Federal Cartridge is developing a lead free primer, but it is not available yet. So one should assume that most indoor ranges are contaminated with significant amounts of lead, and will continue to be for quite some time. This leaves personal precautions as the only other course of action.