Lead Acetate

CAS RN: 301-04-2

Health Effects

0.2.1 SUMMARY OF EXPOSURE
  • 0.2.1.1 ACUTE EXPOSURE
    • A) USES: Lead is a soft metal that is used in a variety of industrial processes. It has been used in paint and gasoline, but the use of lead in house paint and gasoline has been outlawed for decades in the United States (US). Folk medications may also contain large amounts of lead salts. Soil may have large amounts of lead contamination from industrial processes or old paint. Some products manufactured outside the US (eg, pottery, jewelry, toys, makeup) may contain lead.
    • B) TOXICOLOGY: Lead exerts its toxic effects through a variety of mechanisms and effects many organ systems. It binds sulfhydryl groups, impacting various enzymes, receptors and proteins. Lead interferes with metabolic pathways in mitochondria, and in systems that regulate cellular energy and metabolism. It causes activation/inactivation of many enzymes via its competing effects with other cations, notably calcium, ferrous iron, and zinc. Lead inhibits several enzymes involved in heme synthesis, and impairs erythrocyte membrane stability, causing anemia.
    • C) EPIDEMIOLOGY: There are several thousand cases of lead poisoning reported to poison centers in the US every year. However, severe toxicity is very uncommon and deaths are rare. In children with chronic lead poisoning, ingestion of lead paint chips and dust in older dilapidated housing is the most common source of exposure. Inhalational exposure is the most common cause of adult/occupational lead toxicity.
    • D) WITH POISONING/EXPOSURE
      • 1) MILD TO MODERATE TOXICITY: The primary concerns of mild to moderate toxicity from lead exposure in young children are neurodevelopmental, specifically lower intelligence quotient scores and behavioral problems. Population studies suggest that mild cognitive impairment develops at low levels of lead exposure (blood lead concentrations of 10 mcg/dL). Intermittent vomiting, anorexia and abdominal pain may also develop. In mild to moderate exposures in adults, concerns include hypertension, spontaneous abortion and sperm abnormalities, and more subtle neurocognitive effects. Fatigue, mild somnolence, headache, insomnia, abdominal pain, constipation, mild anemia, myalgias and arthralgias, and mild weakness may also develop.
      • 2) SEVERE TOXICITY: Acute ingestions of very large amounts of lead are rare, but may cause abdominal pain, nausea, vomiting, anemia (usually hemolytic), toxic hepatitis, and encephalopathy. In children, severe toxicity manifests as encephalopathy (ie, coma, seizures, ataxia, incoordination, cranial nerve palsies, increased intracranial pressure, bizarre behavior or altered mentation), persistent vomiting, and anemia. More severe subacute or chronic exposures in adults can lead to symptoms such as fatigue, malaise, irritability, anorexia, insomnia, weight loss, decreased libido, arthralgias, myalgias, hypertension, crampy abdominal pain, nausea, constipation or diarrhea (less commonly), impaired concentration, headache, diminished visual-motor coordination, tremor, encephalopathy, a peripheral motor neuropathy (especially affecting the upper extremities causing wrist drops), a normochromatic or microcytic anemia (the hallmark of which is basophilic stippling), nephrotoxicity (a reversible acute tubular dysfunction and chronic interstitial fibrosis), hyperuricemia, and associated gout.
  • 0.2.1.2 CHRONIC EXPOSURE
    • A) The hazard of exposure to lead is particularly serious in small companies or operations, often employing no more than three or four workers, engaged in radiator repair, leaded or stained glass production, laboratories, or ceramics.
    • B) Lead poisoning in adults is usually occupational or hobbies related due to inhalation of lead containing dust, fumes or vapors. Upon inhalation, absorption takes place easily from the respiratory tract and symptoms develop relatively quickly as compared to oral ingestion.
    • C) Subtle neurological/neurophysiological effects have been demonstrated in workers with blood lead levels below 60 microgram per 100 milliliter of blood.
    • D) The onset of symptoms of chronic lead poisoning often is gradual. The major organ systems affected are the nervous system, red blood cells, and kidneys.
    • E) Signs and symptoms include: 1. Abdominal tenderness 2. Anemia 3. Anxiety 4. Disturbance of the gastrointestinal tract (includes constipation, anorexia, and rarely excruciating colic) 5. Facial pallor 6. Forgetfulness and/or poor concentration 7. Glomerular sclerosis 8. Hypotension 9. Insomnia 10. Interstitial fibrosis 11. Irreversible vascular sclerosis 12. Lassitude 13. Motor weakness (which may lead to paralysis of the extensor muscles of the wrist and ankles) 14. Pallor of the eye grounds 15. Tubular cell atrophy 16. Weight loss and/or malnutrition
    • F) Lead poisoning diagnosis is supported when lead content of blood is greater than 50 mcg/dL, and if urine is greater than 80 mcg/dL.
    • G) Lead poisoning has been misdiagnosed as chronic fatigue syndrome in some patients, due to the presenting signs and symptoms.
    • H) PEDIATRIC: Children have been considered a risk group for lead toxicity, mainly due to the neurophysiological or neuro-cognitive deficits that may result.
    • I) Signs and symptoms for children include weight loss, weakness, and anemia. Encephalopathy occurs frequently in children who have ingested inorganic lead compounds.
0.2.3 VITAL SIGNS0.2.20 REPRODUCTIVE HAZARDS
  • A) Lead is transferred across the placenta. It can affect reproduction in males and females, and affects neurodevelopmental milestones in children with both prenatal and postnatal exposure.
0.2.21 CARCINOGENICITY
  • 0.2.21.1 IARC CATEGORY
    • A) IARC Carcinogenicity Ratings for CAS7439-92-1 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) IARC Classification
        • a) Listed as: Lead, organic compounds
        • b) Carcinogen Rating: 3
      • 1) The agent (mixture or exposure circumstance) is not classifiable as to its carcinogenicity to humans. This category is used most commonly for agents, mixtures and exposure circumstances for which the evidence of carcinogenicity is inadequate in humans and inadequate or limited in experimental animals. Exceptionally, agents (mixtures) for which the evidence of carcinogenicity is inadequate in humans but sufficient in experimental animals may be placed in this category when there is strong evidence that the mechanism of carcinogenicity in experimental animals does not operate in humans. Agents, mixtures and exposure circumstances that do not fall into any other group are also placed in this category.
      • 2) IARC Classification
        • a) Listed as: Lead
        • b) Carcinogen Rating: 2B
      • 1) The agent (mixture) is possibly carcinogenic to humans. The exposure circumstance entails exposures that are possibly carcinogenic to humans. This category is used for agents, mixtures and exposure circumstances for which there is limited evidence of carcinogenicity in humans and less than sufficient evidence of carcinogenicity in experimental animals. It may also be used when there is inadequate evidence of carcinogenicity in humans but there is sufficient evidence of carcinogenicity in experimental animals. In some instances, an agent, mixture or exposure circumstance for which there is inadequate evidence of carcinogenicity in humans but limited evidence of carcinogenicity in experimental animals together with supporting evidence from other relevant data may be placed in this group.
      • 3) IARC Classification
        • a) Listed as: Lead compounds, inorganic
        • b) Carcinogen Rating: 2A
      • 1) The agent (mixture) is probably carcinogenic to humans. The exposure circumstance entails exposures that are probably carcinogenic to humans. This category is used when there is limited evidence of carcinogenicity in humans and sufficient evidence of carcinogenicity in experimental animals. In some cases, an agent (mixture) may be classified in this category when there is inadequate evidence of carcinogenicity in humans and sufficient evidence of carcinogenicity in experimental animals and strong evidence that the carcinogenesis is mediated by a mechanism that also operates in humans. Exceptionally, an agent, mixture or exposure circumstance may be classified in this category solely on the basis of limited evidence of carcinogenicity in humans.
0.2.22 GENOTOXICITY
  • A) Exposure to lead has been reported to cause chromosome aberrations in humans, rats, and monkeys, but mixed exposures were involved in the human study.
  • B) Varying results of genotoxicity tests with lead and its compounds may be due to differing solubilities, different specificities of the tests, or possible indirect genotoxic mechanisms. The potential genotoxicity of lead remains unclear.
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