Lead Poisoning in Divers

Problem: Lead absorption form diving weights and environment
Risks: Absorption in sports divers from weight, minimal; absorption via the hands to mouth in divemasters, instructors and gear handlers, possible; absorption in abandoned lead mines, probable without protective gear.

Risk management: Wash weights with fresh water after dives; wash hands after handling; keep weights separate from other gear.

We had a query several years ago about the hazards of diving in a flooded abandoned lead mine. It also appears that there are hazards from the absorption of lead through the skin as well as through the usual lung and GI tract avenues. Just how great this is has never been determined by studies. Lead is changed to forms in water (salts, chlorides and acetates) that are best absorbed by increased temperature, acidity of the water and presumably by the surface area of the metal. Lead shot in bags would offer significantly greater surface area and pools are generally kept fairly warm but the chlorination process alkalinates the water which is then filtered. The whole process most likely turns out to be a wash. There are urine studies that might be done (delta-aminolaevulinic acid concentration) that might make for an interesting study.

Lead, as a solution of lead acetate or nitrate, was applied to the skin of mice. In less than 24 hours there were large increases in lead in skin, muscle, pancreas, spleen, kidney, liver, caecum, bone, heart and brain, but not in blood. For i.v.-injected lead there were increases in blood lead and in all organs except muscle. Previous research found that inorganic lead can also be absorbed through the skin of humans. The results show the importance of taking into account the possibility of skin absorption of lead in occupational exposure, especially since blood lead, the prime index of lead status, is not an indicator of skin absorption.

Possible oral lead intake via contaminated facial skin.
Karita K, Shinozaki T, Tomita K, Yano E.
Sci Total Environ. 1997 Jun 20;199(1-2):125-31.

Thirty-six workers exposed to low or moderate levels of lead at low temperature refining processes were surveyed to examine the route of lead intake. Blood lead level (BPb), delta-aminolevulinic acid in urine, lead in facial skin wipes (Face-Pb) and lead in fingernails (Nail-Pb) were measured and their personal hygienic behavior was surveyed by a questionnaire. BPb showed a significant correlation with Face-Pb and Nail-Pb (r = 0.730 and r = 0.590, respectively). Multiple regression analysis extracted the factors of smoking at the workplace, face-Pb and nail-Pb as significantly related to BPb level. Electron-microscopic observation revealed that the majority of dust particles collected from worker’s faces were larger than respirable size. Lead ingestion from contaminated face skin and fingers may contribute to elevations in the BPb level among workers.

Selected biomarkers for evaluating occupational exposure to lead among workers from the “Miasteczko Slaskie” zincworks in Tarnowskie Gory
Kwapulinski J, Komosinska K, Wiechula D, Krasnicka A, Orczyk H.
Med Pr. 1995;46(2):141-7. Polish.

A dose-response relationship between exposure to lead and delta-aminolaevulinic acid concentration in urine (ALA-U), and between blood lead (Pb-B) and zinc protoporphyrin IX (ZPP-B) concentrations in blood were examined in 90 male workers exposed to lead. Concentrations of ZPP-B correlated closely with blood lead levels. Concentrations of ALA-U ranged from 1.6 to 19.4 mg/l. These data suggest that ALA-U is a useful indicator of early effects of exposure to lead on heam biosynthesis. Lead concentrations in air at different work posts were analysed. The results obtained were compared with the levels of standard values of lead concentrations in air and with blood lead levels at those work posts.

I have seen nothing about this in the medical literature and would suppose that it has not become a problem, otherwise there would have been more of an uproar. However, the ingestion of lead dust is the greatest source of exposure to lead in children and this should be kept in mind when dealing with the bagged leaded weights. No studies or reports could be found related to diving weights.

It would be a reasonable precaution to wash these bags with fresh water and store separately from your other gear. Handwashing would also be advisable due to the possible transfer of the lead salts to the mouth. Whether or not the degree of exposure in adults would lead to plumbism (lead poisoning) is not known.

AUTHOR

Ernest S. Campbell, M.D., FACS

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