Table of contents : TOXICOLOGICAL PROFILE FOR LEAD......Page 1 CONTENTS......Page 10 DISCLAIMER......Page 2 UPDATE STATEMENT......Page 3 FOREWORD......Page 4 QUICK REFERENCE FOR HEALTH CARE PROVIDERS......Page 6 CONTRIBUTORS......Page 8 PEER REVIEW......Page 9 LIST OF FIGURES......Page 14 LIST OF TABLES......Page 15 1.1 WHAT IS LEAD?......Page 17 1.2 WHAT HAPPENS TO LEAD WHEN IT ENTERS THE ENVIRONMENT?......Page 18 1.3 HOW MIGHT I BE EXPOSED TO LEAD?......Page 20 1.4 HOW CAN LEAD ENTER AND LEAVE MY BODY?......Page 22 1.5 HOW CAN LEAD AFFECT MY HEALTH?......Page 24 1.6 HOW CAN LEAD AFFECT CHILDREN?......Page 25 1.7 HOW CAN FAMILIES REDUCE THE RISK OF EXPOSURE TO LEAD?......Page 26 1.9 WHAT RECOMMENDATIONS HAS THE FEDERAL GOVERNMENT MADE TO PROTECT HUMAN HEALTH?......Page 29 1.10 WHERE CAN I GET MORE INFORMATION?......Page 32 2.2 DISCUSSION OF HEALTH EFFECTS BY ROUTE OF EXPOSURE......Page 34 2.2.1.1 Death......Page 37 2.2.1.2 Systemic Effects......Page 50 2.2.1.3 Immunological Effects......Page 80 2.2.1.4 Neurological Effects......Page 83 2.2.1.5 Reproductive Effects......Page 108 2.2.1.6 Developmental Effects......Page 113 2.2.1.7 Genotoxic Effects......Page 127 2.2.1.8 Cancer......Page 128 2.2.2.1 Death......Page 130 2.2.2.2 Systemic Effects......Page 131 2.2.2.3 Immunological Effects......Page 137 2.2.2.5 Developmental Effects......Page 138 2.2.3.1 Death......Page 139 2.2.3.2 Systemic Effects......Page 141 2.2.3.3 Immunological Effects......Page 187 2.2.3.4 Neurological Effects......Page 189 2.2.3.5 Reproductive Effects......Page 198 2.2.3.6 Developmental Effects......Page 202 2.2.3.8 Cancer......Page 208 2.3 TOXICOKINETICS......Page 210 2.3.1.1 Inhalation Exposure......Page 212 2.3.1.2 Oral Exposure......Page 213 2.3.1.3 Dermal Exposure......Page 218 2.3.2.1 Blood and Other Soft Tissues......Page 219 2.3.2.2 Bone......Page 226 2.3.3 Metabolism......Page 227 2.3.4 Excretion......Page 228 2.3.5 Physiologically Based Pharmacokinetic (PBPK)/Pharmacodynamic (PD) Models......Page 230 2.3.5.1 Summary of Physiologically Based and Classical Pharmacokinetic Models.......Page 234 2.3.5.2 Lead PBPK Model Comparison and Discussion......Page 238 2.4.1 Pharmacokinetic Mechanisms......Page 254 2.4.2 Mechanisms of Toxicity......Page 260 2.5 RELEVANCE TO PUBLIC HEALTH......Page 273 2.6 CHILDREN’S SUSCEPTIBILITY......Page 307 2.7 BIOMARKERS OF EXPOSURE AND EFFECT......Page 311 2.7.1.1 Lead in Soft Tissues......Page 312 2.7.1.2 Lead in Bones and Teeth......Page 317 2.7.2 Biomarkers Used to Characterize Effects Caused by Lead......Page 319 2.8 INTERACTIONS WITH OTHER CHEMICALS......Page 323 2.9 POPULATIONS THAT ARE UNUSUALLY SUSCEPTIBLE......Page 331 2.10 METHODS FOR REDUCING TOXIC EFFECTS......Page 335 2.10.2 Reducing Body Burden......Page 336 2.11 ADEQUACY OF THE DATABASE......Page 338 2.11.2 Identification of Data Needs......Page 339 2.11.3 Ongoing Studies......Page 357 3.2 PHYSICAL AND CHEMICAL PROPERTIES......Page 371 4.1 PRODUCTION......Page 380 4.2 IMPORT/EXPORT......Page 381 4.3 USE......Page 384 4.4 DISPOSAL......Page 387 5.1 OVERVIEW......Page 389 5.2 RELEASES TO THE ENVIRONMENT......Page 390 5.2.1 Air......Page 394 5.2.3 Soil......Page 397 5.2.4 Paint......Page 398 5.3.1 Transport and Partitioning......Page 400 5.3.2.1 Air......Page 405 5.3.2.3 Sediment and Soil......Page 406 5.4 LEVELS MONITORED OR ESTIMATED IN THE ENVIRONMENT......Page 407 5.4.1 Air......Page 408 5.4.2 Water......Page 409 5.4.3 Sediment and Soil......Page 411 5.4.5 Other Sources......Page 414 5.5 GENERAL POPULATION AND OCCUPATIONAL EXPOSURE......Page 418 5.6 EXPOSURES OF CHILDREN......Page 426 5.7 POPULATIONS WITH POTENTIALLY HIGH EXPOSURES......Page 435 5.8.1 Identification of Data Needs......Page 436 5.8.2 Ongoing Studies......Page 439 6.1 BIOLOGICAL SAMPLES......Page 443 6.2 ENVIRONMENTAL SAMPLES......Page 451 6.3 ADEQUACY OF THE DATABASE......Page 457 6.3.1 Identification of Data Needs......Page 458 6.3.2 Ongoing Studies......Page 459 7. REGULATIONS AND ADVISORIES......Page 460 8. REFERENCES......Page 484 Case Report......Page 590 Immediately Dangerous to Life or Health (IDLH)......Page 591 Modifying Factor (MF)......Page 592 Pharmacokinetic Model......Page 593 Reportable Quantity (RQ)......Page 594 Uncertainty Factor (UF)......Page 595 Xenobiotic......Page 596 ATSDR MINIMAL RISK LEVELS AND WORKSHEETS......Page 597 MRL WORKSHEETS......Page 599 USER'S GUIDE......Page 600 ACRONYMS, ABBREVIATIONS, AND SYMBOLS......Page 607 Introduction......Page 612 Approach......Page 614 Summary and Discussion......Page 621 References......Page 622