View Full Version : Long term lead shot vs steel shot in tissue?
September 11, 2009, 11:16 PM
I have a question on the long term affects of steel shot vs lead shot in soft tissue.
This first came up when I was discussing with people the merits of steel shot vs lead shot for waterfowl. The general consensus was that steel shot results in more wounded birds than lead shot. That got the gears in my head turning.
There are plenty of people who have lead bullets or lead shot in their bodies and unless it gets lodged in a bad spot it generally gets left where it is if it doesn't have to be removed. The lead and even copper, in bullet jackets, is relatively inert and doesn't seriously react or corrode.
My question is what happens with steel shot in living tissue, be it animal or human? I've seen steel shot for rust rather badly, that could be a serious breeding ground for infection in soft tissue and cause other medical problems. I ask about the affects on humans mainly because there will probably be more long term info on the subject than on waterfowl.
I tried using search, but came up empty. Any information on this subject?
September 11, 2009, 11:30 PM
Steel shot may need air to rust and inside the body it may not get enough air to rust. Just a guess.
September 12, 2009, 07:53 AM
When the steel shot is left in the body (being as small as it is) the body forms a wall of tissue around it, basically rendering it inert. At least that is what the doctor told me, when I asked him to explain it in layman's terms.
He said in a worst case scenario, I might have a little more iron in my blood, n=but it is not worth the time/risk to remove it. (Secondary infection because of the surgery, nerve damage, etc..)
September 12, 2009, 08:22 AM
Physiologically speaking steel shot is better than lead.
The iron in the steel will rust, but will absorb into the body fluids, given enough time. The iron can be used for maintaining hemeglobin and myoglobin.
Lead has no phsyiological use. It is depositied in the bone (mostly) and is toxic. Despite what the lab values are, there is no minimum "safe" level of lead.
Greg LeMond, the Tour De France Champion, now physician, spoke at a Sports Medicine conference a few years ago about his attempt at returning to cycling after his bird hunting accident. He still had multiple pellets of bird shot in his body. He never could get back to form, and looking back on it, even though his lead levels were "acceptable" he was suffering effects of lead poisoning. Which kept him from reclaiming his world class physique.
September 15, 2009, 01:39 PM
The Food and Drug Administration, Center for Devices and Radiologic Health, are the folks that have the research data for metals (and plastics, and cotton) being left in living human tissue. Every medical device gets a safety & efficacy review, from the ball & pin replacement joints to the steel plates in the skull, to breast implants, down to braces, fillings, and even toothbrushes and items of a personal nature (http://www.accessdata.fda.gov/cdrh_docs/pdf4/k040164.pdf).
In a quick search, I didn't see anything about bullets left in. But if you are interested, you can email or call, and theoretically somebody will get back to you.
You can also go to Toxnet, and read abstracts of research papers, like this one (http://toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~OWw1DP:6), or this one (http://toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~sCnY5Z:3).
September 15, 2009, 04:58 PM
I can think of one time where having steel shot in your body would be worse than having lead, MRI. The pain would be terrible. Steel will rust in your body even surrounded by scar tissue because steel just needs Oxygen to rust and your blood contains Oxygen.
My dad still has quite a few peices of lead in him and it does cause problems, now that he is older he is having blood count problems and requires shots to increase the iron and platelette levels in his blood, the doctor says it is from the lead pieces still in him.
September 15, 2009, 05:58 PM
Lead from bullets can be dissolved by synovial fluid in the body. This means that if the lead shot, bullet or fragment thereof is anywhere in a joint or an intervertebral disc, then plumbism can occur (lead poisoning). The effects may only be evident years later.
Any steel projectile is a ferrous hazard for MRI. Lead and steel shotgun pellets can usually be identified on X-ray because the steel ones are less prone to deformation and fragmentation. The likelihood is that a guy with multiple steel shotgun pellets in his body, will be refused an MRI on safety grounds.
If it is one or two steel pellets or a single unknown bullet or fragment thereof in a non-critical area, the radiographers might try advancing the patient slowly into the bore of the MRI scanner and asking the patient if there are any unusual sensations such as pulling in that area. It might well be that a guy with an embedded steel pellet in the thigh may still be able to have his brain MRI if there is no untoward motion of that foreign body.
I doubt that rusting pellets are an issue. If ferrous foreign bodies were prone to causing rust-related injuries to patients we would have found this out a long time ago with common workshop and vehicle-related injuries.
In terms of infection, you have the same chance of being infected by a steel or a lead projectile. Projectiles are not rendered sterile after firing, and bacteria have been successfully cultured from the surfaces of fired bullets. Generally the surgeons won't go for a retrieval of a projectile at the time of surgery unless they happen to find it during their work. Only if the projectile poses a mechanical hazard they may make it a priority to retrieve, eg if it is in a joint or has occluded a vessel. If it can't be proved that the projectile is not lead and the projectile has access to synovial fluid, they will probably go for a retrieval to prevent plumbism. This should be the action taken even if the bullet appears to have a smooth outline (appears to have an intact jacket) because you cannot tell if the base is exposed lead, and indeed the X-rays cannot be used to prove that the jacket is intact all the way around the surface of the bullet.
Bullets with lead cores constitute ferrous hazards if there is mild steel in the jacket. Radiologically, torn jacket fragments cannot be identified / excluded as being ferrous on the X-ray image. A piece of jacketing left in the wound must be assumed to be a ferrous hazard (even if no core is found, or a lead core is found in the clothing).
Lastly, all jacket fragments are sharps hazards, and care must be taken during surgery not to rummage in the patient's insides carelessly if jacketing is known to be in the area.
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