Case series of chronic occupational lead exposure in shooting ranges

Introduction: Despite existing occupational lead exposure prevention regulations, Lithuanian shooting range workers still complain of chronic lead poisoning related symptoms. This indicates a poor understanding of occupational safety when working in lead-polluted environments. Case presentation: 20 men, whose age ranged from 32 to 57 (mean 41.8 +/- 10 years), were consulted at the Toxicology Centre at the Republican Vilnius university hospital in Vilnius, Lithuania in the 2016-2019 year period. All of the patients were working as shooting instructors, with their work experience varying from 2 to 30 years. Clinical examination showed blood lead levels ranging from 5.64 mu g/dL to 45.8 mu g/dL (norm for occupational exposure - <40 mu g/dL). Main symptoms were fatigue (12 patients out of 20), dizziness (5/20), arthralgia (5/20). Other symptoms included impaired memory (3/20), nausea (3/20), sleep disorders (3/20), metallic or sweet taste (3/20), dermatological disorders (3/20), coxarthrosis (2/20), balance disorders (2/20), paresthesia (2/20), abdominal pain (2/20) and others. 4 patients were asymptomatic. Discussion: Shooting range employees are highly vulnerable to daily lead exposure. Even low constant elevated blood lead concentrations can have significant toxic effects over time.