International Journal of Environmental Research and Public Health Review Lead Toxicity and Pollution in Poland Angelika Edyta Charkiewicz 1,* and Jeffrey R. Backstrand 2 1 Department of Public Health, Faculty of Health Sciences, Medical University of Bialystok, 15-295 Bialystok, Poland 2 School of Public Affairs and Administration, Center for Collaboration and the Urban Child, Rutgers University, Newark, NJ 07102, USA; [email protected] * Correspondence: [email protected]; Tel.: +48-856865051 Received: 15 May 2020; Accepted: 11 June 2020; Published: 18 June 2020 Abstract: Background: Human exposure to lead can occur in a variety of ways, all of which involve exposure to potentially toxic elements as environmental pollutants. Lead enters the body via ingestion and inhalation from sources such as soil, food, lead dust and lead in products of everyday use and in the workplace. The aim of this review is to describe the toxic effects of lead on the human body from conception to adulthood, and to review the situation regarding lead toxicity in Poland. Results: Pb is very dangerous when it is absorbed and accumulates in the main organs of the body, where it can cause a range of symptoms that vary from person to person, the time of exposure and dose. Lead in adults can cause an increase in blood pressure, slow nerve conduction, fatigue, mood swings, drowsiness, impaired concentration, fertility disorders, decreased sex drive, headaches, constipation and, in severe cases, encephalopathy or death. Conclusions: Exposure to lead in Poland remains an important public health problem. This review will cover the range of lead exposures, from mild to heavy. Public health interventions and policies also are needed to reduce occupational and environmental exposure to this element. Keywords: lead absorption; lead poisoning; lead’s effects; lead exposure 1. Introduction Lead (Pb) is a potentially toxic element that, when absorbed by the body, accumulates in blood and bones, as well as in organs such as the liver, kidneys, brain and skin. Its negative health effects can be both acute and chronic, because the human body poorly excretes Pb. In humans, lead has been shown to affect the function of the reproductive, hepatic, endocrine, immune and gastrointestinal systems [1]. There is limited evidence of a carcinogenic effect of lead and its inorganic compounds on humans [2]. Human exposure to lead can occur in a variety of ways, all of which involve environmental pollution. Lead enters the body via ingestion or inhalation from sources such as soil, food, lead dust and contact with lead in products of everyday use and in the workplace (Figure1). In the work environment, the main route of absorption of Pb and its compounds is through the respiratory system, although lead is also absorbed via the digestive system (atsdr.cdc.gov) [3–7]. Lead has had many different industrial applications in the past, and is currently used for a range of purposes. Currently, Pb is used in battery plates and equipment for the production of sulfuric acid, cable covers, soldering materials, shields in atomic reactors, aprons and containers for radioactive materials, in the paint and ceramics, and chemical and construction industries, and in the production of bearings and printing fonts, and aviation gasoline, etc. Until recently, lead-based house paint and tetraethyl lead in gasoline were major sources of environmental lead [2–4]. Toxic exposure to lead in Poland remains an important public health problem. Constantly expanding knowledge in the field of pollution by Int. J. Environ. Res. Public Health 2020, 17, 4385; doi:10.3390/ijerph17124385 www.mdpi.com/journal/ijerph Int. J. Environ. Res. Public Health 2020, 17, 4385 2 of 14 Int. J. Environ. Res. Public Health 2020, 17, 4385 2 of 16 toxicbecause elements, they are including broadly lead,harmful is particularly to health and important, even human because life. theyIn the are case broadly of Pb, harmful it is necessary to health to anddetermine even human the levels life. Inof theexposure case of as Pb, well it is as necessary absorption, to determine as the effects the levels of Pb of poisoning exposure asare well often as absorption,visible only asafter the a e fffewects years. of Pb poisoning are often visible only after a few years. TheThe aimaim of of this this review review is to is describe to describe the toxic the etoffectsxic ofeffects lead onof thelead human on the body human from conceptionbody from toconception adulthood. to The adulthood. second main The aim second is to describe main aim sources is andto describe levels of leadsources contamination and levels in of Poland, lead wherecontamination exposure in to Poland, environmental where exposure lead varies to environmental by region. lead varies by region. FigureFigure 1.1. Exposure to lead pollution andand possiblepossible healthhealth eeffectsffects inin humanshumans (Adopted(Adopted from:from: [[2]).2]). 2. Lead Absorption 2. Lead Absorption 2.1. Lead Absorption, Excretion and Storage in Body 2.1. Lead Absorption, Excretion and Storage in Body 2.1.1. Ingestion 2.1.1. Ingestion The ingestion of lead occurs by the consumption of lead-contaminated food and water, and from lead-containingThe ingestion substances of lead whichoccurs areby inhaledthe consumption and subsequently of lead-contaminated absorbed (Figure food1). and Tetraethyl water, andand tetramethylfrom lead-containing lead are absorbed substances by the which digestive are system inhaled and and transported subsequently to the blood,absorbed from where(Figure they 1). areTetraethyl distributed and totetramethyl various tissues lead are within absorbed an hour by [ 4the,8]. digestive system and transported to the blood, fromDiet where and they nutritional are distributed status are to importantvarious tissues factors within that can an influencehour [4,8]. lead absorption. A diet rich in zinc, copper,Diet and iron nutritional or calcium status can reduceare important the absorption factors ofthat lead can by influence the digestive lead system.absorption. Diets A rich diet in rich fat orin proteinzinc, copper, can improve iron or overallcalcium vitamin can reduce D status, the absorption which can of increase lead by lead the uptake.digestive Phosphorus system. Diets in food rich canin fat cause or protein the conversion can improve of lead over toall highly-soluble vitamin D status, phosphates, which can which increase can belead absorbed uptake. toPhosphorus a limited extent.in foodIntake can cause of vitamin the conversion C with Pb of may lead increase to highly-soluble lead absorption. phosphates, Lead iswhich also capablecan be absorbed of displacing to a essentiallimited extent. microelements Intake of from vitamin metalloenzymes. C with Pb may It can increase also impede lead absorption. the biosynthesis Lead of isheme also capable and cause of disturbancesdisplacing essential in microelement microelements (Fe, Cu, from Zn Semetalloenzymes. and Ca) metabolism It can [2 ,also9–11 ].impede Calcium the and biosynthesis phosphorus of administeredheme and cause in a disturbances single dose reduce in microelement Pb absorption (Fe, from Cu, Zn the Se gastrointestinal and Ca) metabolism tract by [2,9–11]. 1.3 and 1.2 Calcium times, albeitand phosphorus less than when administered these nutrients in a aresingle given dose jointly redu (whichce Pb absorption can result in from a 6-fold the reduction).gastrointestinal Zinc tract also playsby 1.3 a and protective 1.2 times, role, albeit reducing less than ALAD when inhibition these nutrients by Pb. Leadare given displaces jointly zinc (which readily can inresult one ofin a the 6- alloenzymesfold reduction). of the Zinc protein. also plays The relationshipa protective role between, reducingδ-aminolevulinic ALAD inhibition acid dehydratase by Pb. Lead genotypedisplaces andzinc sensitivityreadily in toone lead of atthe di ffalloenzymeserent blood leadof the concentrations protein. The is,relationship at present, unclear.between Pbδ-aminolevulinic also causes an acid dehydratase genotype and sensitivity to lead at different blood lead concentrations is, at Int.Int. J. Environ. Res. Res. Public Public Health Health 20202020,, 1717,, 4385 4385 33 ofof 1416 present, unclear. Pb also causes an increase in zinc protoporphyrin by a mechanism that is not fully increaseunderstood in zinc [2,10]. protoporphyrin Pb absorption by in a mechanismpeople with that iron is deficiency not fully understood may be 2–3 [2 ,10times]. Pb higher absorption than in peoplepeople withwithout iron iron deficiency deficit [9,12,13]. may be 2–3 times higher than in people without iron deficit [9,12,13]. 2.1.2. Lead in the Human Body Following absorption, Pb concentrations in the blood equilibrate approximately 3 months afterafter exposure (atsdr.cdc.gov).(atsdr.cdc.gov). Most Most lead lead is is stored stored in in the the liver, liver, and and to toa lesser a lesser degree, degree, in the in thekidneys; kidneys; the theremaining remaining lead lead is dispersed is dispersed throughout throughout the the body body (cerebral (cerebral cortex, cortex, spinal spinal cord, cord, ovary, ovary, pancreas, spleen, prostate,prostate, adrenals,adrenals, brain,brain, fatfat tissue,tissue, testes,testes, heartheart andand skeletalskeletal muscles)muscles) [[14].14]. InIn adults,adults, Pb Pb is is found found in bones,in bones, and concentrationsand concentrations increase increase with age with by upage to by ten up times, to ten especially times, inespecially the tibias. in Afterthe tibias. lead exposure, After lead its eliminationexposure, its comprises elimination two phases:comprises the firsttwo (eliminationphases: the fromfirst blood(elimination and soft from tissues) blood takes and about soft tissues) 20–30 days; takes the about second, 20–30 the days; slow eliminationthe second, phase the slow of lead elimination from the blood,phase involvesof lead from excretion the blood, from theinvolves bones. excretion The biological from half-lifethe bones. of lead The in biologic trabecularal half-life bone is estimatedof lead in totrabecular be one year, bone and is estimated in cortical to bone be one from year, 10–20 and years in cortical [15].