Lead from ammunition harmful to public health

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    All ingestion of lead, regardless of the amount, is harmful to health. It is therefore paradoxical that the use of lead-based ammunition is still allowed.

    Illustration: Journal of the Norwegian Medical Association
    Illustration: Journal of the Norwegian Medical Association

    Lead exposure is ranked as the worst chemical threat to humanity (1). The presence of lead in the environment is now 1000 times higher than the natural background levels before we started extracting and using lead (2). There is no 'safe' level of lead digestion or blood lead concentration. Acute lead poisoning can be fatal, but chronic, low-level lead exposure is also associated with health problems, such as reduced cognitive development, ADHD and autism in children, as well as increased risk of aggression, substance use and criminal behaviour, cancer and cardiovascular disease in adults (2–5).

    Lead concentrations from 0.06 to 0.17 µmol/L (12–36 µg/L) have been associated with reduced IQ in children, as well as increased systolic blood pressure and chronic kidney damage in adults (3). Children absorb lead much more efficiently than adults. Lead is absorbed orally, via inhalation or through intact skin, and most of it is stored in the bones. Lead is gradually released from bone tissue with a half-life of 10–30 years. In blood, the half-life is 4–5 weeks (3).

    Blood concentrations in the Norwegian population

    Blood concentrations in the Norwegian population

    Skogheim et al. (6) reported a 75th percentile for blood lead levels in whole blood of 0.06 µmol/L (12 µg/L) in 1034 Norwegian children. This means that approximately 25 % of the children had a lead concentration associated with a reduction in IQ. A total of 13 % of pregnant women in the Norwegian Mother and Child Cohort Study (MoBa) had a blood lead concentration associated with neurotoxic effects on the fetus (7). A multi-centre study of blood donors in Norway found that 18 % had lead concentrations that could be harmful in blood transfusions to infants (8).

    Lead-based ammunition constitutes the largest unregulated source of lead in the environment in Norway

    Lead exposure from ammunition

    Lead exposure from ammunition

    Lead-based ammunition constitutes the largest unregulated source of lead in the environment in Norway (9). Both those using the ammunition and the surrounding environment are exposed, as lead dust settles on clothes and equipment. A study from the United States showed a correlation between lead exposure in children and the number of guns in their household (10). In Norway, there are more than 1.3 million registered civilian firearms (11), and nearly 500,000 Norwegians have one or more guns in their home.

    Shooting and handling ammunition increases blood lead concentrations. Laidlaw et al. (12) reviewed 36 published articles with data on blood lead concentrations in shooters, and found that several had very high levels. Lead levels were associated with lead in aerosols when firing shots, the number of shots fired and the calibre of the weapon. We are aware of one study on blood lead concentrations in biathletes (13), which showed that the median blood lead concentration was more than twice as high in biathletes as in a comparable group of cross-country skiers.

    Shooting is one of the most popular recreational sports in Norway, and lead-based ammunition is primarily used. On standard shooting ranges, the bullets are caught by a mound of earth or sand located behind the targets. In biathlon, metal targets, known as self-indicating targets, are mostly used. Upon impact with the metal, the bullet is pulverised, and lead fragments and dust fall to the ground. This lead will eventually disperse into the environment, thereby exposing all users of the facility. The primer in most types of ammunition is lead-based, and the gunpowder gas released upon firing also contains lead.

    Norway has approximately 3000 active or decommissioned shooting ranges (14, 15). All are heavily contaminated with lead from ammunition and pose a health risk to humans, animals and the environment (14, 16, 17). In some cases, the concentration of lead is so high that the soil is classified as hazardous waste, i.e. > 2500 mg Pb/kg of dry matter (17–19). Thousands of tonnes of lead are present at active and decommissioned shooting ranges (14). In the summer of 2024, a cattle herd was exposed to lead at a biathlon range, where piles of pure lead were found under the targets (20). Three calves were found dead, while two others showed signs of acute lead poisoning. The sick calves had blood lead concentrations of 4.79 and 6.07 µmol/L (993 and 1257 µg/L), respectively. One calf died and the other was euthanised.

    Bullets with lead cores are also commonly used for hunting large game such as moose and deer (21). The bullets fragment upon impact, depositing lead in the animal (22). Fragments larger than 0.1–0.2 mm are visible on X-rays and can be found at least 45 cm from the wound channel. Synchrotron X-ray can detect fragments smaller than 0.01 mm. These fragments are the size of a red blood cell and can circulate in the bloodstream to all parts of the body in animals that survive for some time after being shot. There can also be up to 50 million lead nanoparticles per gram of muscle tissue located near the wound channel. Nanoparticles can pass through intact cell membranes, including the blood-brain barrier (23).

    Consuming meat from wild game shot with lead-based ammunition is associated with increased blood lead concentration, both in children and adults

    Meat from wild game shot with lead-based ammunition can therefore contain significant amounts of lead. Two studies found that the average lead content in minced moose meat sold in Norwegian supermarkets was 18 and 56 times higher, respectively, than the maximum permitted limit for lead in livestock meat, which is 0.1 mg/kg (23). However, this legislation does not apply to wild game meat. Several studies have shown that consuming meat from wild game shot with lead-based ammunition is associated with increased blood lead concentration, both in children and adults (23, 24).

    When hunting with shotguns, cartridges containing 200–500 round pellets of lead or other metals are used. Although lead shot is now banned for most types of hunting in Norway (25), enforcement is practically non-existent and compliance is unknown. Lead shot breaks into fragments and deposits lead around the wound channel. If ingested with food, lead shot can become lodged in the appendix and release lead over time. This is commonly observed in people who regularly eat meat from wild fowl killed using lead shot (23).

    Lead from ammunition poses a threat to health in both humans and animals

    Diagnostics

    Diagnostics

    All exposure to lead is harmful to health, but clinical signs of low-dose lead exposure can be nonspecific or absent. Absorbed lead is stored in bone tissue, and the concentration in the blood therefore only reflects current or recent exposure (26). Consequently, any suspicion or information regarding potential lead exposure should trigger efforts to identify the source and reduce further exposure.

    Light at the end of the tunnel?

    Light at the end of the tunnel?

    It is well-documented that lead from ammunition poses a threat to health in both humans and animals (27). However, there are lead-free alternatives for most types of weapons. Based on a risk assessment by the European Chemicals Agency (28), the EU is currently considering potential restrictions or a ban on the use of lead-based ammunition. A decision is expected in 2025.

    It is not possible to have a zero-tolerance approach to lead exposure, but one source can easily be eliminated. We therefore hope that the EU will ban lead-based ammunition. Furthermore, lead and lead dust at and around shooting ranges must be controlled to prevent exposure to humans and animals in the area.

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