In light of the recent events in Flint, Michigan this poster will review lead poisoning and its long term effects. We will be covering the multitude of sources of lead poisoning, the mechanisms by which lead does its damage, detection methods, treatment options, and limitations therein. The issues in Flint have highlighted the flaws in current acceptable detection procedures as well as brought to light the dangers of lead. Public concerns about clean drinking water have brought these issues to the forefront

Bishop, Adam

Davis, Marvel

Flatt, Patricia

English

Western Oregon University: Digital Commons@WOU

Western Oregon UniversityDigital Commons@WOUAcademic Excellence Showcase Proceedings Student Scholarship2016-05-26Lead Toxicity and Flint, MichiganAdam BishopWestern Oregon University, abishop14@mail.wou.eduMarvel DavisWestern Oregon University, madavis13@mail.wou.eduPatricia FlattWestern Oregon University, flattp@mail.wou.eduFollow this and additional works at: https://digitalcommons.wou.edu/aesPart of the Chemistry CommonsThis Poster is brought to you for free and open access by the Student Scholarship at Digital Commons@WOU. It has been accepted for inclusion inAcademic Excellence Showcase Proceedings by an authorized administrator of Digital Commons@WOU. For more information, please contactdigitalcommons@wou.edu, kundas@mail.wou.edu, bakersc@mail.wou.edu.Recommended CitationBishop, Adam; Davis, Marvel; and Flatt, Patricia, "Lead Toxicity and Flint, Michigan" (2016). Academic Excellence ShowcaseProceedings. 42.https://digitalcommons.wou.edu/aes/42Oral chelation therapies are used to lower blood lead levels, howeverthey are not effective in removing lead from the bones, where lead canbe stored. The effectiveness of chelation therapies to help thoseexposed to lead over long periods of time have been debated, and atthe moment the only real effective treatment is to avoid exposure tolead altogether.Table: Lead Poisoning Severity and Treatment in ChildrenSource: https://s3.amazonaws.com/pharmacytimes/d_media/_upload_image/leadt2.pngThe Flint water crisis began in April of 2014 when local officials in thearea switched the city’s water source temporarily as a cost cuttingmove. The water source was switched from Lake Huron to the FlintRiver until the city could implement a new pipeline to Lake Huron.According to city officials the water piped from the river was to betreated at the local city water treatment plant, although the water didnot receive the necessary treatment to make it safe for consumption.For almost two years now locals have unknowingly been exposed tohigh levels of lead in their drinking water. In a recent study done by alocal pediatrician, the percentage of children tested and found to haveelevated lead blood levels (above 5 µg/dl) in Flint had doubled from2.4 to 4.9%. Recently the crisis in Flint, Michigan has come into thenational spotlight with the Federal government declaring a state ofemergency and the issue being a part of presidential debates. [9]Figure 7: The percentage of children in each region with elevated blood lead levels (>5 µg/dL) in each region before and after switching the cities water source to the Flint River. (WLL= Water Lead Levels)Source: Elevated Blood Lead Levels in Children Associated With the Flint Drinking Water Crisis: A Spatial Analysis of Risk and Public Health Response Authors: Mona Hanna-Attisha, MD, MPH, Jenny LaChance, MS, Richard Casey Sadler, PhD, and Allison Champney Schnepp, MDA major issue in Flint, which also occurs across the nation, is thatmodifications were made to the EPA water testing procedures to lowerthe lead levels reported. The EPA calls for a minimum 100 of the mostat risk homes be tested for lead in a city; in Flint the least at riskhomes were tested. The EPA procedures call for water samples to betaken from the first water to come out of the tap; in Flint, city officialscalled for the water to be run first to pre-flush the pipes beforesamples were taken. These modifications have made it so lead levelswere never reported to be above the maximum acceptable leveldespite outside testing showing that lead levels in some homes hadexceeded 10,000 ppb. [10]Figure 8: Getting The Lead InSource: https://ethicsalarms.files.wordpress.com/2016/01/how-lead-gets-injpg-1e9d798a1edee129.jpg?w=500&h=355Lead has the capability of passing theblood-brain barrier, causing edema.Intracellularly, lead replaces calciumas a second messenger, binding morereadily than calcium, altering theprotein’s conformation.Intracellular concentrations of Ca2+increase in two ways: opening thecalcium channels in the cellmembrane or release of storedcalcium. Lead has a high bindingaffinity even at low levels, oftenhigher than calcium its self.Figure 2: Pathway of Lead in the BrainSource: Brochin, Robert. The Cellular Effect of Lead Poisoning and its Clinical Picture. GeorgetownUniversity Journ Health Sciences (2008) Vol 5, No 2.Sebring, Ohio (2016) [8]Travis County, Texas  (2016) [6]New Jersey (2016) [7]Atlantic CityCumberland CountyEast OrangeElisabethIrvingtonJersey CityNew BrunswickNewarkPassaicPatersonPlainfieldSalem CountyTrentonFlint, Michigan (2015) [11]Jackson, Mississippi (2015)[8]North Carolina (2006) [8]DurhamGreenvilleColumbia, South Carolina (2005)[8]Tar Creek (1996) [12]Pitcher, Oklahoma Cardin, OklahomaDouthat, Oklahoma Treece, Kansas Figure 5: 18 Pennsylvania Cities with higher lead levels than flintSource: CBS - PittsburghMethods and MechanismsIn light of the recent events in Flint, Michigan this poster will review lead poisoning and its long term effects. We will be covering the multitude of sources of lead poisoning, the mechanisms by which lead does its damage, detection methods, treatment options, and limitations therein. The issues in Flint have highlighted the flaws in current acceptable detection procedures as well as brought to light the dangers of lead. Public concerns about clean drinking water have brought these issues to the forefront. AbstractAcceptable Limits• Water:10% of water tested must exceed 15 ppb [1]• Blood:10 µg/dl for Adults5 µg for Children [2]• Soil:400 ppm in play areas1200 ppm in non-play areas [3]Testing• Venous blood level (BLL) testing is therecommended diagnostic tool to identifypatient lead levels.• Handheld X-ray Fluorimeter can be used todetect lead in paint on walls• X-ray Fluorimeters can be used to detect leadin soilFigure 4: Adverse Health Effects ofLead ExposureFigure Source: Canadian Environmental Health AtlasTesting and Acceptable LimitsFlint, MichiganCities AffectedTreatment OptionsLead Toxicity and Flint, MichiganAdam Bishop, Marvel Davis, Patricia FlattIn conclusion, we found that there are many hidden sources of lead inand around the house which can contribute to lead toxicity. We alsofound that there is limited testing available for lead toxicity and theacceptable lead limits in water are at a rate which that signs andsymptoms of lead toxicity are already beginning to appear.Surprisingly toxically high levels of lead found in the blood of childrenare all over the United States dating back into the 1990s, with 29 morecities with higher rates than Flint showing up this year alone.Lead passes through the blood brain barrier via the calcium channelcausing a multitude of symptoms to occur due to its higher affinity ofbinding to the substrate than calcium. Since studies have shown thateven low levels of lead cause a degree of toxicity, often beforesymptoms occur, signs and symptoms are often the last sign thattoxicity has occurred.The crisis in Flint, Michigan should be a teaching moment for all of us.City officials had knowingly modified the procedures for testing leadlevels in water so as to artificially lower the levels they reported to theEPA. This is a shocking trend that is being seen across the country incities that are strapped for cash. If lead testing procedures arecontinually allowed to be modified, we will continue to see high leadlevels across our country. The best course of action would be forlegislation to be passed creating a standardized procedure for leadtesting that cannot be modified by individual citiesConclusions1. CDC - http://www.atsdr.cdc.gov/csem/csem.asp?csem=7&po=82. - http://www.cdc.gov/nceh/lead/acclpp/blood_lead_levels.htm3. EPA - http://www.epa.gov/dwreginfo/lead-and-copper-rule4. Mayo Clinic - http://www.mayoclinic.org/diseases-conditions/lead-poisoning/basics/symptoms/con-200354875. Medscape - http://emedicine.medscape.com/article/2060369-overview#a36. MSNBC - http://kxan.com/2016/01/27/data-high-lead-levels-detected-in-travis-county-waters/7. New Jersey News   - www.nj.com/news/index.ssf/2016/02/11_cities_in_jersey_have_more_lead-affected_kids_t.html8. NY Times - www.nytimes.com/2016/01/21/us/flint-michigan-lead-water-crisis.html9. - www.nytimes.com/2016/02/09/us/regulatory-gaps-leave-unsafe-lead-levels-in-water-nationwide.html10. Scientific American  - http://www.scientificamerican.com/article/q-a-what-really-happened-to-the-water-in-flint-michigan/11. Washington Post - www.washingtonpost.com/news/morning-mix/wp/2016/02/04/untold-cities-across-america-have-higher-rates-of-lead-poisoning-than-flint/12. Tulsa World - http://www.tulsaworld.com/news/state/million-settlement-approved-in-tar-creek-class-action-case/article_dfc67b78-d1e5-5e6f-a0e1-c92ee21d3cfd.html13. CBS - http://pittsburgh.cbslocal.com/2016/02/04/report-18-cities-in-pennsylvania-with-higher-lead-exposure-than-flint/14. Toxic Substances - CDC - http://www.atsdr.cdc.gov/toxprofiles/tp.asp?id=96&tid=22• Folk remedies and supplements/herbal treatments• Ceramics• Lead pipes/water• Antique toys• Lead paint• Soil• Occupation• Cheap toys• Some Mexican candies• Leaded crystal• Kohl: A Traditional CosmeticSource: Holstege, Chris Pathology and Etiology of Lead Toxicity. Medscape [5] Figure 3: Sources of LeadFigure Source: Diet.comSources of Lead ExposureReferencesSymptomsChildren• Developmental delay• Learning difficulties• Irritability• Loss of appetite• Weight loss• Sluggishness and fatigue• Abdominal pain• Vomiting• Constipation• Hearing lossNewbornsExposure before birth:• Learning difficulties• Slowed growthAdults• High blood pressure• Abdominal pain• Constipation• Joint pains• Muscle pain• Declines in mental functioning• Pain, numbness or tingling of the extremities• Headache• Memory loss• Mood disorders• Reduced sperm count, abnormal sperm• Miscarriage or premature birth in pregnant womenSource: Mayo Clinic. Lead Poisoning: Symptoms [4]ToxicityBy the time signs and symptomsappear people are typically alreadyat toxic levels.Children• 1.98 μg/dL – greater peripheralresistance response to stress• PbB >20 μg/dL - Anemia• 60-100 μg/dL - Colic• 33-120 μg/dL - DecreasedVitamin D levelsAdults• >10 ppm increased risk of highblood pressure [14]Figure 6: Symptoms of Lead Poisoning and ToxicitySource: https://en.wikipedia.org/wiki/Lead_poisoningSymptoms and Toxicity

Lead Toxicity and Flint, Michigan

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Lead Toxicity and Flint, Michigan

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