Correspondence

Lead Poisoning in Adolescents Who Are Competitive Marksmen

N Engl J Med 1999; 341:852September 9, 1999

Article

To the Editor:

Lead poisoning clusters among select groups, particularly children in the first four years of life, adults with occupational exposures, and those who renovate old homes. In adolescents it is unusual. I report here the cases of four adolescent girls, 14 to 16 years old, who within a three-week period were found to have lead levels of 18, 19, 20, and 28 μg per deciliter. One patient had an initial finger-stick lead level of more than 100 μg per deciliter. All the patients were competitive marksmen at a single indoor firing range. Safety measures recommended by the range, including hand-washing and clothing changes, had reportedly been followed. The young woman with the highest lead level had a level of 20 μg per deciliter after one month. All the patients were asymptomatic; none were treated with chelation therapy.

Kinetically, lead diffuses slowly from the blood into the soft tissues before being deposited in bone. In young adults, skeletal lead includes both a large trabecular-bone pool that is readily mobilized as well as a more inert cortical-bone depot.1,2 Consequently, women poisoned with lead during their childbearing years are at risk for exaggerated mobilization of lead during pregnancy, with increased exposure to the fetus and then to the newborn during lactation.3,4

Lead poisoning has long been associated with firearms use and has been reported among firing-range instructors.5 The prevalence of lead poisoning among adolescents who are competitive shooters is unknown. However, the sport has become increasingly popular, and thus there should be heightened concern and education about the hazards of lead exposure at firing ranges.

Michael Shannon, M.D., M.P.H.
Children's Hospital, Boston, MA 02115

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Citing Articles (1)

Citing Articles

1. 1

   Elke Ochsmann, Thomas Göen, Karl-Heinz Schaller, Hans Drexler. (2009) Lead – Still a health threat for marksmen. International Journal of Hygiene and Environmental Health 212:5, 557-561
   CrossRef