Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC.
National Capital Poison Center, Washington, DC.
Am J Ind Med. 2020 Aug;63(8):733-737. doi: 10.1002/ajim.23119. Epub 2020 May 11.
The use and maintenance of firearms is a common and often preventable source of adult lead exposure that is often poorly understood by medical professionals. This case describes an elevated blood lead level (BLL) in an adult man due to the exposure sources of ammunition reloading and indoor target shooting in the basement of his home and details the challenges involved in the diagnosis and management of such cases. The elevated BLL was reduced through strict attention to personal hygiene during the reloading process and while shooting, improved ventilation and cleaning of the basement, and avoidance of vacuuming and use of dry cleaning techniques. Medical providers may be unfamiliar with the risks of indoor residential shooting and how to ameliorate them; this knowledge deficit may result in delays in diagnosis as well as an inability to successfully mitigate the risks for exposure. Time-sensitive diagnosis and treatment, comprehensive risk assessments, and reduction of exposure sources are important facets in the care of adult patients who are exposed to lead through recreational activities. Health care professionals should be aware of the potential dangers of ammunition reloading and indoor shooting, be familiar with ways to reduce lead exposure during these activities, and understand the resources that are available for the management of lead-exposed patients.
枪支的使用和维护是成人接触铅的常见且通常可预防的来源，但医学专业人员对此往往了解甚少。本案例描述了一名成年男子因在家中地下室进行弹药装填和室内射击而导致血铅水平升高，并详细介绍了此类病例的诊断和管理所面临的挑战。通过在装填过程中和射击时严格注意个人卫生、改善地下室通风和清洁度、避免吸尘以及使用干洗技术，该男子的血铅水平得到了降低。医疗服务提供者可能不熟悉室内住宅射击的风险以及如何减轻这些风险；这种知识上的欠缺可能导致诊断延迟，以及无法成功降低接触风险。及时诊断和治疗、全面的风险评估以及减少接触源，是治疗因娱乐活动而接触铅的成年患者的重要方面。医疗保健专业人员应意识到弹药装填和室内射击的潜在危险，熟悉在这些活动中减少铅暴露的方法，并了解管理接触铅患者的可用资源。
