Association between acute lead exposure from indoor firing ranges and iron metabolism

Background: Iron deficiency and lead poisoning are common and are often associated. This associated has been suggested previously, mainly by retrospective cross-sectional studies. Objective: To assess the impact of short-term lead exposure at indoor firing ranges, and its relationship to iron, ferritin, lead, zinc protoporphyrin, and hemoglobin concentrations in young adults Methods: We conducted a clinical study in 30 young healthy soldiers serving in the Israel Defense Forces. Blood samples were drawn for lead, zinc protoporphyrin, iron, hemoglobin and ferritin prior to and after a 6 week period of intensive target practice in indoor firing ranges. Results: After a 6 week period of exposure to lead dust, a mean blood lead level increase (P<0.0001) and a mean Iron (P<0.0005) and mean ferritin (P<0.0625) decrease occurred simultaneously. We found a trend for inverse correlation between pre-exposure low ferritin levels and post-exposure high blood lead levels. Conclusion: The decrease in iron and ferritin levels after short-term lead exposure can be attributed to composition between iron and lead absorption via divalent metal transport-1, suggesting that lead poisoning can cause iron depletion and that iron depletion can aggravate lead poisoning. This synergistic effect should come readily to every physician's mind when treating patients with a potential risk for each problem separately.