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Hundreds of people with bullet fragments lodged in their bodies have suffered lead poisoning from the slugs, including several people who have extremely elevated levels of the highly toxic metal in their blood, health authorities reported Thursday.

Researchers from the Centers for Disease Control and Prevention found 457 gunshot-wound victims with elevated levels of lead in their blood when they looked at reports from 41 states between 2003 and 2012. Seventeen people had blood lead levels more than 16 times the limit recommended by the CDC.

Before the survey, fewer than 100 cases of lead toxicity from bullet fragments had been reported in the medical literature. A 2012 study in Colombia called lead poisoning from bullet fragments “an underdiagnosed condition that can be fatal if not recognized.”

More typically, workplace exposure is the culprit when lead is found in adults. There were more than 145,000 cases of lead toxicity overall in the same period, the researchers found.

“Retained bullet fragments are an infrequently reported, but important, cause of lead toxicity,” the team, headed by Debora Weiss, reported in the CDC's Morbidity and Mortality Weekly Report.

That is especially true for 16- to 24-year-olds, who comprised more than 42 percent of those with lead poisoning from bullet fragments. Men accounted for 83.5 percent of the cases. There are about 115,000 gunshot wounds in the United States each year, 70 percent of which are not fatal. Sometimes it is difficult for surgeons to retrieve every fragment, and a decision is made to leave them in the body if they pose no immediate threat.

Public health officials say there is no safe level for lead in the blood, but the National Institute for Occupational Safety and Health considers anything more than 5 micrograms per deciliter of blood as elevated. At more than 10 micrograms, lead can cause hypertension, kidney ailments, cognitive deficits, miscarriages and low-birth weight infants, the report notes. Researchers said they found 17 adults with blood-lead levels over 80 micrograms, including a few with levels over 200 micrograms.

Blood-lead levels in children spiked in Flint, Mich., in 2014 <a href="https://www.washingtonpost.com/news/to-your-health/wp/2016/06/24/blood-lead-levels-spiked-in-kids-after-flint-switched-its-drinking-water-source/?utm_term=.a3caa9f144b3">after the city switched its water source </a>from Lake Huron to the Flint River in a cost-cutting move. Five percent of children younger than 6 years old who were tested during that time had blood-lead levels above 5 micrograms per deciliter.

Lead can also harm wildlife. In 2013, <a href="https://www.washingtonpost.com/national/health-science/with-ban-on-lead-in-hunters-bullets-california-hopes-to-protect-condors/2013/10/20/2e375388-3829-11e3-ae46-e4248e75c8ea_story.html?utm_term=.dcf6d0428d8a">California became the first state to ban lead in hunting ammunition</a> to protect California condors that were consuming the metal in carrion that makes up their diet in the wild.

George Polk Award for medical reporting, 2017

University of Michigan, BA in American culture, 1979

Lenny Bernstein is a former staffer who covered health and medicine. He started as an editor on The Washington Post’s National desk in 2000 and has worked in Metro and Sports.

Lenny Bernstein

The Washington Post

Health Care

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The Washington Post health section provides coverage and analysis of health, healthcare, nutrition and fitness news.