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Gunshot Fragments Can Lead to Lead Poisoning

Lead poisoning is a major concern in America. Lead-based products such as paint, gasoline, and cans have been removed for the most part. Lead-based bullets are still in use because they break into pieces on impact, causing greater soft tissue damage. Anyone with bullet fragments still in the body is at risk for lead poisoning, a condition called plumbism.

In this study, doctors report on adults with bullet or bullet fragments in the intervertebral disc space. This is the space between the bones of the spine. Doctors found 238 patients with gunshot wounds to the spine at their hospital in Miami between 1969 and 1993. Only 12 of these patients still had a bullet fragment in their spines.

The researchers examined these 12 patients. They took X-rays and ran blood tests. There were no signs of lead poisoning from any of these tests for 11 patients. Only one patient had symptoms of plumbism. She reported fatigue and constipation. Both these symptoms went away when the bullet fragment was removed.

The authors say that with increasing urban violence, the number of gunshot wounds to the spine is also going up. They conclude that patients with gunshot fragments in the spine should be followed carefully on a long-term basis. Any signs of lead poisoning is a signal that the fragment should be taken out. The fragment could also move into the spinal canal, putting the spinal cord and spinal nerves at risk of injury.

References: Gaetano J. Scuderi, MD, et al. Long-Term Clinical Manifestations of Retained Bullet Fragments within the Intervertebral Disk Space. In Journal of Spinal Disorders. April 2004. Vol. 17. No. 2. Pp. 108-111.

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