Adult Blood Lead Epidemiology and Surveillance --
United States, First Quarter, 1993
The Adult Blood Lead Epidemiology and Surveillance (ABLES)
program of CDC's National Institute for Occupational Safety and
Health (NIOSH) monitors elevated blood lead levels (BLLs) in adults
through laboratory reports received by state-based surveillance
programs and summarizes these results quarterly in MMWR (Table 1).
The goals of ABLES are to 1) describe the magnitude of occupational
lead poisoning, 2) monitor trends in the incidence and prevalence
of this condition, 3) identify new or unrecognized sources of lead
exposure, 4) focus public health attention on this ongoing problem,
and 5) effectively target worksites for intervention to reduce
excessive lead exposure.
Reported by: B Harrell, MPA, Div of Epidemiology; CH Woernle, MD,
State Epidemiologist, Alabama Dept of Public Health. J McCammon,
MS, Epidemiology Div, Colorado Dept of Health. CJ Dupuy, BJ Jung,
MPH, Connecticut State Dept of Health Svcs. M Lehnherr,
Occupational Disease Registry; H Howe, PhD, Div of Epidemiologic
Studies, Illinois Dept of Public Health. S Jones, R Gergely, Iowa
Dept of Public Health. E Coe, MPH, E Keyvan, MD, Health Registries
Div, Maryland Dept of the Environment. R Rabin, MSPH, Div of
Occupational Hygiene, Massachusetts Dept of Labor and Industries.
P Dunbar, MPH, Alethia Carr, Bur of Child and Family Svcs, Michigan
Dept of Public Health. D Solet, PhD, Karen Royce, Occupational
Health Program, Bur of Risk Assessment, Div of Public Health Svcs,
New Hampshire State Dept of Health and Human Svcs. B Gerwel, MD,
Occupational Disease Prevention Program, New Jersey Dept of Health.
R Stone, PhD, New York State Dept of Health. M Barnett, MS, State
Health Div, Oregon Dept of Human Resources. J Gostin, MS,
Occupational Health Program, Div of Environmental Health,
Pennsylvania Dept of Health. R Marino, MD, A Gardiner, Div of
Health Hazard Evaluations, South Carolina Dept of Health and
Environmental Control. T Willis, DM Perrotta, PhD, Environmental
Epidemiologist, Texas Dept of Health. D Beaudoin, MD, Bur of
Epidemiology, Utah Dept of Health. L Paulozzi, MD, L Toof, Bur of
Chronic Disease Epidemiology, Vermont Dept of Health. L Hanrahan,
MS, Div of Health, Wisconsin Dept of Health and Social Svcs. Div of
Surveillance, Hazard Evaluations, and Field Studies, National
Institute for Occupational Safety and Health, CDC.
Editorial Note
Editorial Note: State-based ABLES programs recognize that parents'
exposure to lead at the workplace can be a source of "take-home"
exposure (e.g., contaminated clothing, automobiles, and other items
brought home from the worksite) for their children (1). During case
follow-up of lead-poisoned workers, states participating in the
ABLES program gather information on the children and/or other
at-risk family members living in the household; when appropriate,
children are referred for blood lead monitoring.
Conversely, cases of lead poisoning in children detected
through community lead screening efforts may provide important
information regarding parental occupational exposure to lead. For
example, in 1991, the first year of the Alabama lead surveillance
program, follow-up reports for 46 children aged 6 months-16 years
with BLLs greater than 15 ug/dL revealed that 11 (24%) had a
potential parental occupational source for their lead exposure (C.
Woernle, Alabama Department of Public Health, personal
communication, 1993). Similarly, follow-up investigation of two
siblings (aged 3 and 7 years) in Colorado with BLLs of 38 and 36
ug/dL, respectively, found that the children received day care at
their parents' radiator repair shop. In addition, the parents
regularly wore lead-contaminated clothing home (J. McCammon,
Colorado Department of Health, personal communication, 1993). The
father's BLL was 52 ug/dL, and the mother's, 20 ug/dL; a co-worker
at the shop had a level of 79 ug/dL. The overall magnitude of
take-home lead exposure and the frequency at which children are
exposed to lead through parental contact with lead at work or at
home remain unknown.
Compliance with current Occupational Safety and Health
Administration (OSHA) standards mandates the removal of
lead-contaminated protective clothing and shoes before leaving the
workplace, which should substantially reduce or eliminate these
take-home exposures (2). Furthermore, a new interim final OSHA
standard on "Lead Exposure in Construction" (effective June 3,
1993) extends regulatory coverage to workers in the construction
trades, providing health and safety provisions similar to those
required under the OSHA lead standard for general industry (3).
References
CDC. Lead poisoning among battery reclamation workers --
Alabama,
1991. MMWR 1992; 41:301-4.
Office of the Federal Register. Code of federal regulations:
occupational safety and health standards. Subpart Z: toxic and
hazardous substances -- lead. Washington, DC: Office of the Federal
Register, National Archives and Records Administration, 1985. (29
CFR section 1910.1025).
3. US Department of Labor, Occupational Safety and Health
Administration. Lead exposure in construction: interim final rule.
Federal Register 1993;58:26590-649. (29 CFR section 1926).
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