Bullets left in place can poison shooting survivors

Bullets left in place can poison shooting survivors

ST. LOUIS – Blacks here face a proportionately higher threat of being shot than do members of other ethnic groups – and because of that, blacks also face a greater threat of lead poisoning.

Old city homes were found to have lead paint. Same for city schools: First the paint, then the drinking water tested positive for it. Now, the threat of lead poisoning is growing along with the high number of gunshot victims who survive shootings, but have bullets retained in their bodies. And ridding bodies of the harmful metal is a lot more complicated than preventing lead poisoning through the lead abatement programs instituted by the city and school district. 

Leaving non-life-threatening bullets lodged in victims is routine for several reasons, according to Dr. Laurie Punch, a Barnes-Jewish trauma surgeon and associate professor at Washington University. One: The health care powers that be don’t see revenue in the long-term care of removing lead-based bullets. Second: Most victims of gun violence are poor black males without insurance. 

“That’s why the energy and effort is not being poured into the process,” Punch said. 

“I’m not trying to act like there isn’t top-of-line trauma care when they come to the hospital. What I’m talking about is recovery once they’re out of the hospital – that’s the place where I see the gap,” Punch said. 

That’s a gap that she wants to close. One thing that would help, she said, is if doctors would check the blood lead level of gunshot victims, especially those who express concern about the long-term effects of retained bullets. 

“I think we should be doing more to address the concerns that people have, because for all we know, they know something that the science hasn’t figured out yet,” she said. 

What science has figured out is that is that lead intoxication (plumbism) from retained bullets, which has rarely been reported, may be fatal if unrecognized. That’s according to a 1982 study by the Departments of Neurology and Surgery, University of Texas Health Science Center at Dallas and the Department of Geology, University of Texas at Dallas. 

Lead-based bullets retained in the body cause blood lead levels to rise. They can cause unexplained anemia, abdominal colic, nephropathy, or neurological deterioration, the study reported, confirming well-documented outcomes. 

A more recent study by the Centers for Disease Control and Prevention found that hypertension, kidney dysfunction, memory loss, depression and fatigue can also occur. Those study results were published in a Morbidity and Mortality Weekly Report in 2017, using data from 2003-2012. 

That study, part of the CDC’s Adult Blood Lead Epidemiology and Surveillance program, revealed hat 457 shooting survivors tested positive for elevated blood levels.

It’s alarming because, as the report points out, gunshot wounds cause an estimated 115,000 injuries in the U.S. each year. That’s about 70 percent of the total number of gunshot injuries; only about 30 percent are fatal. 

Last year in St. Louis, 418 people were shot, according to the St. Louis Metropolitan Police Department. That count does not include those shot by police officers. 

Punch believes there needs to be more data, more comprehensive studies, more care. She is taking it upon herself to dive in. 

“I’d really like to start by sitting down with people who have already been shot and talk to them about where they are in terms of what they need and where the holes are in their recovery,” she said.

“This is part of a much bigger picture for me. What are we doing to truly treat and help people recover after they’ve been hurt?”

In the next few weeks, Punch and her team at their community center – The “T” (Community Health Education Center) at 5874 Delmar Boulevard – will invite gunshot victims to begin study and treatment.

“The seed for tomorrow’s violence is planted in unhealed, present trauma. People get hurt, they experience trauma emotionally, financially, physically, and that unhealed trauma plants the seed that is tomorrow’s violence,” she said. “And if we want to see violence change, we have to be putting more energy into people who are experiencing trauma, before it becomes violent.” 

For more information about Punch’s work to counter gun violence and trauma, visit www.STBSTL.com