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How does lead poisoning contribute to anemia?

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A periodic table element box for lead (Pb) shows atomic number 82, atomic weight 207.2, electron configuration, and labels for symbol, name, crystal structure, and physical state, with a legend for color and symbol meanings. — lead Properties of lead.

Lead poisoning contributes to anemia primarily by interfering with the body's ability to produce red blood cells. This process involves the inhibition of the enzyme delta-aminolevulinate dehydratase (ALAD), which plays a critical role in heme biosynthesis—the pathway responsible for creating the oxygen-carrying component of blood.1

When lead enters the body, it binds to and inhibits the activity of the ALAD enzyme. Because this enzyme is essential for the formation of red blood cells, its disruption hinders the body's normal hematological function, often resulting in the development of anemia as a symptom of chronic lead exposure.1