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RISKS OF LEAD POISONING IN FIREARMS INSTRUCTORS AND THEIR STUDENTS

by Anthony M. Gregory, Copyright 1990 by THE ASLET JOURNAL, March/April 1990 Volume 4 Issue 2

Lead is toxic, and anyone who spends much time on an indoor shooting range is at serious risk of developing lead poisoning. This is particularly true of firearms instructors who devote a lot of thought and attention to making sure that no one gets shot.

Virtually all ranges mandate both ear and eye protection, and yet one almost never sees any precautions being taken against lead poisoning, which indicates that it is not perceived as a serious threat. This is a grave mistake. Even at low levels, lead poisoning can significantly detract from the quality of life, depriving one of energy and vitality for years, and occurs so subtly that it may never be investigated, much less diagnosed. At intermediate levels, lead poisoning produces serious or even devastating symptoms that mimic many other diseases, and explains why it is so easily misdiagnosed. Even at levels one can easily acquire on the shooting range, lead poisoning can, and does, kill.

In the August 19, 1989 issue of the weekly magazine, Science News, there appeared an article summarizing a research project on lead poisoning that was first reported in the American Journal of Public Health. This research documented the significant risk of lead poisoning in indoor range users. The study followed 17 members of a law enforcement trainee class through a three month period of firearms training on a state-owned indoor range. During the peak training period, the trainees spent an hour on the shooting range every four days. This isn't much range time compared to the amount put in by most firearms instructors. Nonetheless, in this class, all but two people developed elevated lead levels, and several developed levels considered to be lead poisoning.

The author of this article is a firearms instructor and an avid shooter, and was aware of the potential of lead poisoning with indoor range use, but like most, he hadn't worried much about it. However, encountering this report caused him to have his blood lead level tested. It turned out that he had serious lead poisoning which explained the reason for a host of unpleasant and debilitating symptoms that had been developing for months, but which his physician had been unable to diagnose. It also motivated the author to do some serious research into lead poisoning, and to write this article.

Most individuals simply do not realize how easy it is to accumulate a toxic dose of lead, nor would they recognize the symptoms of lead poisoning if they had it. Massad Ayoob, a well known firearms expert and author, has stated that he would rather forage for food in a toxic waste dump than to regularly shoot on an indoor shooting range. Nonetheless, it's easy to understand why most people don't take the risk of lead poisoning seriously. Lead is a commonplace material and people are accustomed to it. Lead is used in bullets, batteries, fishing sinkers, old toy soldiers, and for decades it was an additive in gasoline. If told not to handle cyanide or plutonium, everyone takes that warning very seriously, but it's easy to ignore or minimize the toxicity of substances one regularly encounters.

Another problem is that it has only been within the last 10 years or so that much medical attention was paid to lead poisoning. It was thought of as a problem mostly confined to adults working in lead processing industries, or to children chewing on lead based paint. Most physicians knew very little about it, and many had never seen a case (or failed to recognize it if they had).

Make no mistake, LEAD IS EXTREMELY TOXIC. To get some idea of just how toxic, let's take a familiar object, the .38 caliber 158 grain lead semi-wadcutter bullet, and divide it into 1000 parts. Just one of those parts -- 1/1000th of a bullet -- dissolved and circulating in the blood stream, represents enough lead to constitute serious lead poisoning.

What follows is some technical information that will be of use to anyone at risk of developing lead poisoning:

LEVELS OF TOXICITY

The natural, or desirable, level of lead in human beings is zero. A number of metals, notably iron, copper, zinc, magnesium, selenium, and aluminum, are used in various metabolic processes, and are required in small amounts for health and survival. But lead is not used in any way in human metabolism, so there is no tolerable amount.

Lead exposure and lead poisoning are largely problems peculiar to industrialized civilizations. Average levels of lead in the blood of adult Americans runs from about 5 to 10 micrograms of lead per deciliter of blood (5-10 mcg/dl), which is already much higher than "normal". Because lead is absorbed by the bones and stored there quite tenaciously, archaeologists have been able to examine the bones of ancient people in pre-industrialized societies and estimate their lead levels. Ancient people tended to have lead levels around 0 to 2 mcg/dl -- much lower than modern Americans.

The first detrimental effects of lead are seen as an increase in blood pressure, starting at a blood lead level of about 7 mcg/dl. Blood pressure continues to rise as the lead level increases, indicating that lead is slightly toxic at almost any level. And even though serious problems do not usually arise until the lead reaches a higher level, establishing the "toxic" level of lead is obviously an arbitrary exercise.

The first level OSHA considered "elevated" in adults and used by most medical labs is 40 mcg/dl. At this level, most people will show hematologic (blood chemistry) changes, and adults will exhibit low level symptoms. OSHA requires continuous medical monitoring of employees who have tested at this level. The level of 60 mcg/dl is considered to be nominal lead poisoning, and OSHA requires removal from the source of exposure. At this level, almost everyone will exhibit symptoms of lead poisoning, while some will exhibit severe symptoms. At a level of about 75 mcg/dl, or if symptoms are severe, many physicians will want to intervene with a procedure called "chelation therapy". This involves intravenously infusing the chemical EDTA, or orally administering D-penicillamine, both of which bind to lead in the blood stream and allow it to be quickly excreted. Because these procedures are expensive, time consuming, and can have their own dangerous side effects, they are usually reserved for very serious problems.

Children are much more sensitive to lead, and the Center for Disease Control considers a level of 25 mcg/dl to be toxic in children (they are considering lowering this to 20 mcg/dl -- half the adult level). This sensitivity to lead is very significant to anyone who has small children and also spends a lot of time on the shooting range, and will be further addressed later in this article.

SYMPTOMS OF LEAD POISONING

The following is a partial list of common symptoms of lead poisoning, and symptoms that appear in any individual will vary. Furthermore, a lead level that produces only moderate problems in one individual may prove lethal to another:

  1. Loss of memory, and difficulty in concentration. This is frequently the first symptom seen.
  2. Fatigue. This can become profound and incapacitating.
  3. Irritability and aggressiveness.
  4. Loss of sexual interest. Impotence.
  5. Insomnia. (Which greatly complicates the fatigue.)
  6. Depression.
  7. Headaches.
  8. Neurological symptoms, such as hand twitching.
  9. Encephalopathy. This is the medical term for major brain dysfunction (actually, all of the above are symptoms of central nervous system problems). This can manifest itself as loss of function or paralysis in a limb, confusion, disorientation, loss of coordination, or the symptoms of several forms of insanity. (Lead poisoning probably contributed to the insanity of several of the Roman Ceasars, and contributed to the fall of the empire. The Roman upper classes boiled their wine in lead-lined pots. This sweetened the wine, and made it resistant to souring by yeast. Bones recovered from graves of Roman nobility have shown phenomenal lead contents.)
  10. Elevated blood pressure.
  11. Digestive difficulties and abdominal pains.
  12. Weight loss.
  13. Joint pains, particularly in the joints of the long bones, like the wrists.
  14. Anemia.
  15. In women, menstrual irregularity and decreased fertility. (Again, lead poisoning may have been responsible for the documented dramatic decrease in fertility among the Roman nobility and upper classes.)
  16. Kidney damage and/or liver damage.
  17. Sore or bleeding gums around the margin of the gum and tooth.
  18. In children, retarded intellectual development, behavioral problems, as well as most of the other problems listed above.
As one can see, the difficulty in recognizing or diagnosing lead poisoning is that the most common symptoms are also the symptoms of acute stress or clinical depression. Victims of lead poisoning often feel like they are having a nervous breakdown, and they frequently attribute this to stress from their job. They feel as though their job is killing them. Few jobs are more stressful than police work and this makes it very easy for an officer to ignore the symptoms of lead poisoning until things are quite advanced. Few jobs demand more sharpness, attention, judgement, or a cooler head than police work, yet lead poisoning directly diminishes these very qualities. A moment of bad judgement can get an officer killed, or ruin his career.

ROUTES OF EXPOSURE

Lead poisoning can come from a number of sources. The more common ones are, lead in paint, in the glaze on dishes, in old lead lined water pipes, water tanks, and water coolers, in plumbing lead-solder joints, in dust contaminated from years of burning leaded gasoline, in industrial settings, in moonshine whiskey distilled in lead soldered auto radiators, and from the shooting range or the handling of ammunition. The last two are obviously the concern of this article, but it is important to remember that if you are exposed to lead from several sources it can add up quickly.

Lead can enter the body by breathing it in as a dust or vapor, by ingesting it, and to a lesser extend, by absorption through the skin. On the shooting range it tends to enter via all three routes. Every time you discharge a handgun a spray of lead erupts into the air around you. If you are shooting cast lead bullets, part of this lead is in the form of microscopic particles sheared from the bullet as it passes down the barrel. Down range, the bullet impacting on the armor plate emits a spray of fine lead particles. More importantly, the chemical commonly used in primers is lead styphnate, and detonating the primer discharges a cloud of molecular lead compounds. So the air on a shooting range -- even an extremely well ventilated range -- tends to contain a lot of lead, both as dust, and as gas. It settles in large amounts on the floor, and on other horizontal surfaces as well. Even if the range passes OSHA standards for airborne lead contamination (which many don't), you will still often find yourself standing in a cloud of lead filled gun smoke as the air currents eddy around you. All the while you are breathing in lead, about 30-50% of which will dissolve from your lungs into your bloodstream. If you have any doubts about this, just blow your nose when you leave the range after a lengthy shooting session. That black stuff in the mucous is the residue of gun smoke, and it contains a lot of lead.

The powder residue you get all over your hands also contains a lot of lead. Left on your hands, some of this can actually be absorbed directly through your skin. More importantly, if you eat with this residue still on your hands, you will contaminate your food with a significant amount of lead. You can also contaminate your food with residue from around your mouth, particularly if you have a mustache. Your breathing concentrates lead around your nose and upper lip, and a mustache will act as a filter to trap the particles and gases. Your sandwich or pizza will then carry those particles into your mouth. This is particularly important to realize, because although only about 10% of ingested elemental lead is absorbed, nearly 100% of ingested lead salts -- formed when you ignite the primer -- are absorbed. So ingestion is a very efficient way to absorb certain forms of lead.

Handling fired brass can result in the same problem. The powder residue on fired brass also contains a lot of chemical and particulate lead. The author knows of one individual who didn't spend much time on the range, but who regularly sorted brass while munching snacks, and gave himself serious lead poisoning in the process.

If you have small children, it is also important to realize that you can carry lead residue home and contaminate your living quarters and car. You will get the dust on your shoes, on your clothes, on your shooting gear, and in your hair. It will then be tracked into and settle on the floor of your home. Children, of course, live on the floor and put everything into their mouths. And as we noted before, they are extremely susceptible to lead poisoning. In the course of the research for this article, the author was told by a local health official of a case where the children of one particular family were found to have elevated blood levels of lead, and the family car was so badly contaminated (from the family's clothing) that it simply had to be gotten rid of.

DIAGNOSIS

Initial testing for lead poisoning is extremely straightforward. A blood sample is drawn and sent to the laboratory where the lead level is measured. A level above 40 mcg/dl is considered outside the normal range, and above 60 mcg/dl is considered lead poisoning. However, remember that 40 mcg/dl is not a magic number. Elevated levels below that will still have an effect, so the lower the better. The author personally would like to see his lead level remain well below 20 mcg/dl.

If the level is elevated or indicates lead poisoning, the physician may want to do some other tests since blood lead tests are not notoriously accurate. One follow up test is the zinc protoporphyrin test which determines whether the exposure to lead took place over a long period of time, or all at once. An elevated zinc level indicates that the exposure was chronic. This has important implications for how long it will take to recover, which will be addressed in the treatment and prevention section.

As noted above, one problem with diagnosing lead poisoning is that it mimics too many other disorders, particularly stress and psychological disorders. This actually makes victims reluctant to seek medical aid, since no one wants to admit to falling apart psychologically, or to being unable to cope with the stress of their job. Furthermore, it's just rare enough that physicians fail to test for it. If you suspect the possibility of lead poisoning, ask for a blood lead test.

TREATMENT AND PREVENTION

It's a lot easier to prevent lead poisoning than to treat it. But in most cases, the treatment consists of simply removing oneself from the source of exposure, and allowing the body to slowly eliminate the lead by excreting it in the urine.

Usually, the level drops quickly at first as the kidneys remove lead from the blood. However, lead is stored in the bones, liver, kidneys, and other internal organs, and is only slowly surrendered back to the blood. This means that the blood level can remain elevated for quite some time, and can vary considerably from day to day. It is the blood level, not the level stored in the tissues, that results in lead poisoning. People have been known to have acute episodes resulting from lead being released from their own tissues. (For instance, women who have been chronically exposed to lead, and who develop post-menopausal osteoporosis -- where the bones quickly lose a lot of mass -- are at risk of being poisoned by the lead being released from their own bones.) The longer one has been exposed to lead, the longer it will take to recover since the tissue level of lead is much higher and endures longer. Consequently, it can take weeks, months, or even years for one's blood lead level to return to normal.

In extreme cases, as noted above, chelation therapy is employed. This rapidly lowers the blood level of lead, and causes some lead to be leached from the bones and tissues. But it may still take a long time for the blood lead level to come down to normal.

Obviously, the sensible thing to prevent lead poisoning in the first place is to take the proper precautions. Exclusive use of jacketed bullets can prevent much of the lead contamination on shooting ranges (this was the original reason why the Nyclad round was developed), but this is more expensive than using cast-lead reloads, and may be impossible to enforce on many ranges. Furthermore, this still leaves the lead from the primer, and the down range impact spray. Federal Cartridge is developing a lead free primer, but it is not available yet. So one should assume that most indoor ranges are contaminated with significant amounts of lead, and will continue to be for quite some time. This leaves personal precautions as the only other course of action.

Not shooting on an indoor range is the best solution, but that simply isn't an option for most instructors and their students. If you must shoot on an indoor range, use the proper respirator. All safety and equipment supply houses sell two-stage respirator masks rated for metallic particles and vapors, and they aren't that expensive. If you find that wearing a full respirator makes it impossible to talk and to be heard on the range, at least use one of the disposable paper masks rated for fine dust and paint overspray. This will not catch the lead gases, but it will filter out some of the lead dust which is better than nothing. If wearing a mask on the range makes you feel "silly", or inadequately macho, remember that this was the attitude towards hearing protection just 10-15 years ago. At that time only wimps wore hearing protectors, and .38 cases stuffed in the ears were commonplace. As a result we have officers today going around and saying "huh?" and "what?" a lot. Hearing, once lost, is lost forever, So is a career, or life itself.

When you leave the range, blow your nose, and wash your face and hands immediately with cold soapy water. The cold water closes the pores of your skin, and prevents the washing of lead particles into the pores. Thoroughly cleanse the facial area around your mouth, particularly if you have a mustache or beard. And for obvious reasons, blow your nose before you wash your face.

Try to wear an outer garment, like a jumpsuit or coverall, that you can either have washed after each range session, or leave in your locker. This will prevent carrying the lead dust on your clothing into your car and home. Likewise, have a pair of shoes to change into after you get off the range. If you do go home wearing the same outer clothes you wore on the range, change them immediately, and put them in the washer. Washing one's hair before bedtime is also a good idea. Your hair can hold a lot of dust, and you will transfer it to your pillow every night. Again, these precautions are particularly important if you have young children at home. And finally, have your blood lead level checked every six months to make sure the precautions you are observing are adequate.

All of this may sound like a pain, but following these precautions will greatly reduce the likelihood of lead poisoning, and the author can vouch for the fact that lead poisoning is a REAL pain. It ruins the lives of many people each year who never find out what's wrong with them, and we know for certain that it kills some people. It's a danger that anyone who spends much time on a shooting range needs to understand and respect.

This article is respectfully dedicated to the memory of ASLET member Sergeant Thomas Kelly, who died on Sept. 17, 1989. Sergeant Kelly died of acute respiratory failure after being exposed daily for two weeks to lead and associated gases on the firing range. It is the author's sincere hope that the information presented herein will contribute to preventing further such tragic losses.

NOTE: For anyone wanting further or more detailed information, a complete research bibliography for this article is available. Send a stamped, self-addressed envelope to Anthony M. Gregory, Tactical Training Associates, 8709 Castle Park Drive, Indianapolis IN 46256

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