LEAD Action News
LEAD Action News Volume 13 Number 1, November 2012, ISSN 1324-6011
Incorporating Lead Aware Times ( ISSN 1440-4966) and Lead Advisory Service News (ISSN 1440-0561)
The Journal of The LEAD (Lead Education and Abatement Design) Group Inc.
Editor-in-Chief: Zac Gethin-Damon

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Case Study re: lead poisoned artist

By Zac Gethin-Damon, from case notes made by Elizabeth O’Brien, and emails from the artist. Artworks photos all provided by Claire Lewis.

Claire_LewisAn artists experience demonstrates the need for education of artists in lead awareness and the importance of the support of the medical system if people are going to be properly notified when they are lead poisoned and given the right advice re what action to take. Fortunately, in this case not only was a lead blood test taken but The LEAD Group was contacted. This meant firstly that it could be ensured that there was no ongoing lead exposure to the artist, and secondly that she was given advice as per how to minimise her lead absorption, but there should have been proper medical procedures in place which meant that The LEAD Group’s involvement was not required to achieve these outcomes.

Claire Lewis, a 76 year old artist and Gwandalan resident, had a worrying experience in 2010 when, after taking a blood lead test following the advice of a fellow artist, she was told by her GP that she had an elevated blood lead level. She was not surprised by the fact that she had an elevated blood lead level: “When my doctor told me I had elevated blood lead level I was not surprised because as a china painter I had heard of others with this condition who had kidney problems.”

“When my doctor told me I had elevated blood lead level I was not surprised because as a china painter I had heard of others with this condition who had kidney problems.”

Claire was surprised however, when a second lead blood test came back with a higher number. Claire was confused that her blood lead level had risen from 88 to 97, and didn’t know what 88 or 97 meant, she had a number but no unit. She was aware that she had been exposed to lead as a working artist throughout her lifetime, having worked for a greeting card firm where she painted all day with lead based paints, and having done lead lighting work, but for the last while she had worn a mask and hadn’t been using lead lighting glass. Did her raising blood lead level mean she was still being exposed to lead? And if that wasn’t the case than how was it that her blood lead level was going up? Claire had many questions without many answers, answers which her ongoing medical problems called for.

Ongoing Medical Problems

Claire_Lewis1Claire had been feeling unwell for some time. When she would do art society exhibitions all day she could hardly walk when she got home. She had a pain in the stomach and a pain mastoid bone which would later be identified as arthritis. Regarding her elevated blood level, Claire’s GP, with little experience in lead poisoning, suggested that Claire contact the Poisons information Service. It was Poisons who referred her to The LEAD Group.

Elizabeth O’Brien at The LEAD Group told Claire her blood lead level was too high and that all of her medical problems could be symptoms of lead poisoning. She made it clear that lead comes from unusual exposures as well as common, and that she was on her own – “Doctors aren’t educated, and the health department are not there to help you.”

“Doctors aren’t educated, and the Health Department are not there to help you.”

Elizabeth was also able to give a possible answer to Claire’s question of her increasing blood lead level. She told Claire that even in an adult who is not being exposed to an increasing amount of lead, blood lead levels can rise because stored lead is leaching out of the bones into the blood stream during the demineralisation of bones which occurs with ageing. Leaving nothing to chance, she encouraged Claire to have her studio lead tested to ensure she was no longer being exposed to lead, and to ensure she was making her art in a lead safe way.

Unanswered Questions

The crucial question remained however, what was the unit of Claire’s result? Without a unit it was unclear whether her past blood lead results were either 88 and 97 µg/dL: an extremely high amount, OR 0.88 µmol/L and 0.99 µmol/L micromoles per litre: a level around 1/5 as high, approximately 20µg/dL.

The goal for all Australians is to be below 10 µg/dL, and 15 µg/dL was the ‘notifiable’ level for people in NSW, up until January 2012 when the notifiable level was reduced to 10 µg/dL,. Claire’s result therefore, whether it was 97 µmol/L. micromoles/L or 20 µg/dL was a notifiable level, so had the NSW Health Department been notified?

Claire_Lewis2The only way to answer the remaining questions: to clarify the unit of Claire’s blood lead level and if her case had been referred to Health Dept, was to get in contact with her doctor. Under Elizabeth’s advice, Claire rang the doctor’s office for the figures but the woman who answered didn’t understand the question and gave her wrong figures. The search for the doctor was on.

The Doctor Finally Contacted

After a week of left and unreturned messages Elizabeth was finally told that fortunately Claire’s results were in µmol/L, the highest of her results being 0.97 µmol/L (20µg/dL). Elizabeth was also told that as the result was over 0.72 it was notified to the NSW Health Department.

Under Elizabeth’s advice, Claire arranged to see a toxicologist at The Mater Hospital. It was the toxologist’s opinion that the lead level was causing the high blood pressure, gout and arthritis, well known possible side effects of lead poisoning. As Dr. Ronald Hoffman states in a factsheet on his website about arthritis: “Lead poisoning in adults can produce arthritic symptoms, and ‘saturnine gout’ was common among ancient Romans who deliberately leaded their wine” (Dr. Ronald Hoffman, 2006). In another of the factsheets on Dr. Hoffman’s website, Gout: An overview, “decreased excretion of uric acid as seen in chronic renal disease, lead-induced nephropathy (kidney damage), [and] diabetic ketoacidosis.” (Hoffman Center Staff, 2006), are given as possible causes of gout.

Claire was never contacted or given any assistance by The NSW Health Department or WorkCover, the two institutions which are supposedly those which deal with lead poisoning issues such as Claire’s.

A Need to Educate

Claire’s case demonstrates the lack of lead education of two groups: artists who work with lead and the Australian medical system. The lack of education amongst artists who work with lead is clear, if Claire had been properly educated as an artist working with lead than she would have been able to make her art in a lead safe way and hence her blood lead level would never have been elevated.

The second group, that of the Australian medical system, represents a much larger body of people as it includes any lead poisoned person in Australia who deals with the medical system concerning their lead poisoning. The education issues within the Australian medial system that this case raises therefore are all the more worrying. The confusion surrounding both Claire’s blood lead level and the implications of her lead poisoning could easily be avoided through the establishment of nationwide procedures designed to respond in the case of an elevated blood lead level which, most importantly, are taught to and followed by medical practitioners nationwide. Misinformation to patients on the part of medical practitioners stemming from lack of education regarding lead poisoning is a problem that we tackle all the time at The LEAD Group Inc., an issue this case illustrates.

Lessons Learned

Claire, with new knowledge concerning lead safety and in light of her health concerns has chosen to now no longer make leadlights. She also gave away lead and glass altogether. When grounding on porcelain wears a mask so to not breathe in particles of the porcelain paint, some of which is still 77% lead. She has cleaned up her work area to get rid of all lead residue. She has not had her blood lead level tested again, and feels well.

As can be seen from this recount of the events, Claire was very fortunate in this case as she was put into contact with Elizabeth O’Brien at The Lead Group who were able to make sure that not only was Claire not continuing to be exposed to lead, but that she knew what steps to take to minimise her lead absorption into blood.

Claire_Lewis3The point that I hope to make through this piece is that Elizabeth O’Brien’s involvement should have not been required, and Claire was lucky that she was referred to The LEAD Group. Had Claire never been put in contact with The LEAD Group it is very possible that she would continue being exposed to the lead in her home and would have wasted much more time with a medical system which didn’t properly respond to her lead poisoning. (see Claire Lewis’s design for Toukley Art Gallery exterior mural to the left)

To read more on arthritis and gout see the links to Dr. Ronald Hoffman’s Website below in the references:

Hoffman Center Staff (circa 2006), Gout: an overview, at Dr Hoffman Website: http://www.drhoffman.com/page.cfm/546, accessed 29/10/12

Dr. Ronald Hoffman (circa 2006), Arthritis: not for seniors only at Dr Hoffman Website: http://www.drhoffman.com/page.cfm/112, accessed 29/10/12

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Last Updated 29 November 2012
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