1 Lindboe M.

Henrichsen E.N.

Høgåsen H.R.

Bernhoft A. Lead concentration in meat from lead-killed moose and predicted human exposure using Monte Carlo simulation. 2 Knott J.

Gilbert J.

Green R.E.

Hoccom D.G. Comparison of the lethality of lead and copper bullets in deer control operations to reduce incidental lead poisoning; field trials in England and Scotland. 3 Chase L.

Rabe M.J. Reducing lead on the landscape: anticipating hunter behavior in absence of a free nonlead ammunition program. Figure Examples of 0.30-caliber, 165-grain lead and lead-free rifle projectiles and illustrations of projectile cross-section. A typical solid-copper projectile (A) is longer than a copper-jacketed lead projectile (B) for the same caliber because of the greater density of lead than copper. Both projectiles are designed to expand on impact; however, the lead projectile typically disintegrates into hundreds of fragments while the copper projectile retains nearly all of its mass. These lead fragments are the source of lead ingested when eating wild game. Nearly all lead hunting projectiles have a copper jacket to reduce lead fouling of the firearm barrel, which occurs with pure lead projectiles. People generally reject the idea of injecting toxic substances into food, except when it involves hunting wild game. Perhaps surprising to nonhunters, up to 95% of hunters use lead projectiles,despite nonlead projectiles offering a suitable alternative ( Figure ).The use of nonlead projectiles eliminates lead exposure experienced through eating wild game. Hunters are not averse to using lead-free projectiles: when hunters were given free copper projectiles, 77% used these nontoxic projectiles.Physicians are in a unique position to explain the risks of lead exposure to hunting patients and their families and also explain the option of using nonlead projectiles.

4 Hunt W.G.

Watson R.T.

Oaks J.L.

et al. Lead bullet fragments in venison from rifle-killed deer: potential for human dietary exposure. 5 Paulsen P.

Bauer F.

Sager M.

Schuhmann-Irschik I. Model studies for the release of metals from embedded rifle bullet fragments during simulated meat storage and food ingestion. 6 Tsuji L.J.

Wainman B.C.

Martin I.D.

et al. Lead shot contribution to blood lead of First Nations people: the use of lead isotopes to identify the source of exposure. , 7 Iqbal S.

Blumenthal W.

Kennedy C.

et al. Hunting with lead: association between blood lead levels and wild game consumption. 8 Tsuji L.J.

Wainman B.C.

Jayasinghe R.K.

VanSpronsen E.P.

Liberda E.N. Determining tissue-lead levels in large game mammals harvested with lead bullets: human health concerns. 9 Knott J.

Gilbert J.

Hoccom D.G.

Green R.E. Implications for wildlife and humans of dietary exposure to lead from fragments of lead rifle bullets in deer shot in the UK. 9 Knott J.

Gilbert J.

Hoccom D.G.

Green R.E. Implications for wildlife and humans of dietary exposure to lead from fragments of lead rifle bullets in deer shot in the UK. 10 Pain D.J.

Cromie R.L.

Newth J.

et al. Potential hazard to human health from exposure to fragments of lead bullets and shot in the tissues of game animals. 1 Lindboe M.

Henrichsen E.N.

Høgåsen H.R.

Bernhoft A. Lead concentration in meat from lead-killed moose and predicted human exposure using Monte Carlo simulation. 11 Finkelstein M.E.

Doak D.F.

George D.

et al. Lead poisoning and the deceptive recovery of the critically endangered California condor. Eighty percent of ground meat packages of wild-harvested deer contain leadand this lead is bioavailable.Eating meat harvested with lead projectiles increases serum lead levels,and while it has been suggested that the tissue from around the wound channel can be discarded to reduce lead exposure,there are an average of 356 metal fragments in a deer carcass after being shot with a lead projectile from a rifle.This is an impossible number of fragments to pick out by hand, especially because some of these fragments are microscopic.Regularly eating game birds harvested with lead shot may exceed World Health Organization lead intake limits,and regular consumption of large game shot with lead bullets using a rifle is likely to exceed World Health Organization lead intake limits.It is important to keep in mind that the California condor nearly went extinct largely from lead poisoning as a result of scavenging lead-shot carrion.Medically, it is clear that eating wild game harvested with lead projectiles increases lead serum levels.

12 Canfield R.L.

Henderson Jr., C.R.

Cory-Slechta D.A.

Cox C.

Jusko T.A.

Lanphear B.P. Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. 13 Fachehoun R.C.

Levesque B.

Dumas P.

St-Louis A.

Dube M.

Ayotte P. Lead exposure through consumption of big game meat in Quebec, Canada: risk assessment and perception. 14 Monahan M.

Boelaert K.

Jolly K.

Chan S.

Barton P.

Roberts T.E. Costs and benefits of iodine supplementation for pregnant women in a mildly to moderately iodine-deficient population: a modelling analysis. As lead is one of the few substances that does not have a safe level of exposure, it is important to prevent all lead exposure. Lead has negative consequences for nearly every major physiologic system, with the central nervous system being the system classically impacted. Very low levels of lead exposure result in neurologic impairments,and as many as 7.7% of children that eat wild game harvested with lead bullets will experience a reduction of one IQ point.That magnitude of a reduction in IQ translates into a decreased lifetime earnings value of between £1319 (2042 USD) and £11,967 (18,528 USD).

2 Knott J.

Gilbert J.

Green R.E.

Hoccom D.G. Comparison of the lethality of lead and copper bullets in deer control operations to reduce incidental lead poisoning; field trials in England and Scotland. 15 California State Legislature

Hunting: Nonlead Ammunition. Assembly Bill 711; Chapter 742. Particularly because there are readily available suitable projectile alternatives to lead, such as copper,limiting the use of lead projectiles for hunting is reasonable, and California has moved to ban all lead projectiles for hunting by 2019.Physicians need to be proactive in sharing with their patients the risks of potential lead exposure through eating wild game. Often when I explain to hunters the risks associated with lead exposure, especially when considering their children, their response is, “I have been hunting for years and I am fine.” My response to them is, “but just imagine how smart you could have been.”