Lead levels and retained bullet fragments from firearm injury

Lead levels and retained bullet fragments from firearm injury

Study Title: Lead Toxicity and Retained Bullet Fragments: A Longitudinal Pilot Study of Lead Levels after Firearm Injury

PI: Randi N. Smith, Emory University School of Medicine and Rollins School of Public Health; Co-Is: Ziad Kazzi, Emory University School of Medicine, Department of Emergency Medicine and Georgia Poison Center & Christine Castater, Trauma/Clinical Care Fellow; Community collaborators: Aric Johnson, Grady Memorial Hospital & Jeffery Gates, community member

Overexposure to lead remains a major health problem for children and adults around the world.  Lead affects various organ systems, leading to adverse neurologic (brain and nervous system), cardiovascular (heart and blood vessels), hematologic (blood) and developmental effects.  In the US, elevated blood lead levels have been found in individuals with occupational (e.g. battery manufacturing, mining and painting industries) and environmental exposures (e.g. lead-based paint and contaminated drinking water).  Retained bullet fragments (RBFs) after firearm injury are another potential source of lead exposure with limited research. Given there is no standard medical guideline regarding removal of RBFs, individuals with RBFs may be exposed to lead for long periods of time.  Hence, this study plans to evaluate the blood levels of lead and other heavy metals in individuals with and without RBFs after firearm injury.  Data generated from this study about lead exposure from RBFs has the potential to impact clinical management guidelines and procedures for handling RBFs.

How this study contributes to the exposome: The results from this study will provide important insights about a long-term source of lead exposure that many individuals experience during their lifetime. 

Dr. Randi Smith is an Assistant Professor of Surgery in the Emory School of Medicine Department of Surgery with a joint appointment in the School of Public Health in the Department of Behavioral, Social, and Health Education Sciences.  She serves as a trauma surgeon, emergency/elective general surgeon and surgical critical care intensivist at Grady Memorial Hospital.  Her research interests includes violence/injury prevention, clinical outcomes and evaluation of the social and environmental determinants that impact health.