Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM) 

Lead Toxicity
How to Use This Course

Introduction

The goal of Case Studies in Environmental Medicine (CSEM) is to increase the primary care provider’s knowledge of hazardous substances in the environment and to aid in the evaluation of potentially exposed patients. This CSEM focuses on lead toxicity.

Available Versions

Two versions of the Lead Toxicity CSEM are available.

• the HTML version http://www.atsdr.cdc.gov/csem/lead/ provides content through the Internet;
• the downloadable PDF version provides content in an electronic, printable format, especially for those who may lack adequate Internet service.

Instructions

To make the most effective use of this course, we recommend that you

• take the Initial Check to assess your current knowledge about lead toxicity.
• read the title, learning objectives, text, and key points in each section
• complete the progress check exercises at the end of each section and check your answers
• complete the Assessment Questionnaire and Posttest online at www2.cdc.gov/atsdrce/, and
• submit your evaluation and posttest responses if you wish to obtain continuing education credit.

Instructional Format

This course is designed to help you learn efficiently. Topics are clearly labeled so that you can skip sections or quickly scan sections you are already familiar with. This labeling will also allow you to use this training material as a handy reference. To help you identify and absorb important content quickly, each section is structured as follows:

Title

Serves as a "focus question" that you should be able to answer after completing the section

Learning Objectives

Describes specific content addressed in each section and focuses your attention on important points

Text

Provides the information you need to answer the focus question(s) and achieve the learning objectives

Key Points

Highlights important issues and helps you review

Progress Check exercises

Enables you to test yourself to determine whether you have mastered the learning objectives

Progress Check answers

Provides feedback to ensure you understand the content and can locate information in the text

Learning Objectives

Upon completion of the Lead Toxicity CSEM, you should be able to

What is lead?

Explain what lead is

Where is lead found?

Describe potential sources of lead exposure in the U.S. today

How are people exposed to lead?

Identify the most important routes of exposure to lead

Who is at risk of lead exposure?

Identify the populations most heavily exposed to lead

What are the US standards for lead levels

Identify the CDC’s level of concern for lead in children’s blood
Identify the OSHA blood lead level for first intervention from occupational exposure to lead
Describe the types of environmental standards in the U.S.

What is the biologic fate of lead?

Describe how lead is taken up, distributed, and stored throughout the body
Identify the half-life of lead in the blood

What are the physiologic effects of lead exposure?

Describe how lead affects adults and children
Describe the major physiologic effects of chronic/ low level lead exposure
Describe the major physiologic effects of acute high level lead exposure

How should patients exposed to lead be evaluated?

Describe the CDC’s recommendations for screening
Describe key features of the exposure history
Name the symptoms of low dose lead toxicity
Describe how exposure dose and symptoms can vary
Describe key features of the physical examination

What tests can assist with diagnosis of lead toxicity?

Name the most useful test for lead toxicity

How should patients exposed to lead be treated and managed?

Identify three steps that should be taken at blood lead levels between 10 and 19 µg/dL
Describe additional steps that should be taken for BLL 20-44 µg/dL, 45-69 µg/dL and 70 µg/dL and above

What instructions should be given to patients?

Identify steps patients with domestic exposures can take to reduce lead exposure
Identify steps patients with occupational exposures should take to reduce lead exposure