Surveillance for occupational lead exposure - United States, 1987

Article Abstract:

California, New Jersey, New York, and Texas have had mechanisms in place since 1981 to monitor exposure to lead in the workplace. These states require that the blood test of any worker which reveals elevated blood-lead levels (BLL) be reported to the state health department (SHD). The SHD then reviews the case to identify possible occupational lead exposure. Case follow-up confirms exposure, provides educational and technical information to workers affected, and requires onsite evaluation of the lead hazard at the workplace. A survey of these SHDs showed that men accounted for 93 percent of the cases reported, and 94 percent of the elevated BLLs were work-related. Of the cases reported in California and Texas, Hispanics represented 44 and 40 percent, respectively, even though they compose only 24 and 25 percent of the states' populations. The high incidence of elevated BLL for Hispanics may indicate a minority health concern that has not been previously investigated. Spanish-language educational material has been developed for minority workers. The Centers for Disease Control note that in 1979 the Occupational Safety and Health Administration (OSHA) set a standard for acceptable and unacceptable levels of occupational exposure to lead. However, this OSHA Lead Standard does not apply to the construction industry, which accounts for the highest proportion of workers with significantly elevated BLL. Since 1987 Wisconsin, Maryland and Colorado have begun similar BLL surveillance systems. In order to eliminate occupationally-related lead poisoning, more states must establish BLL surveillance systems.

Standards, Research, Case studies, Demographic aspects, United States. Occupational Safety and Health Administration, Biological monitoring, Industrial toxicology

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Low-level lead exposure and the IQ of children; a meta-analysis of modern studies

Article Abstract:

Lead in high doses is clearly toxic to the human nervous system. While scientists have suspected that low-level exposure to lead affects the intelligence quotients (IQ) of children, this relationship has been difficult to study for various reasons and has not yet been firmly established. A statistical technique called meta-analysis was used to integrate the results of 12 studies that were conducted independently by different researchers. All 12 studies examined the correlation between lead levels in the blood or teeth and IQ, while attempting to control for factors other than lead that might also influence IQ. The number of children participating in each study ranged from 75 to 724. Results of meta-analysis strongly supported the theory that low-level lead exposure has an adverse effect on IQ in children, since lead level and IQ score were inversely related to a very significant degree. While it cannot be proven that low-level lead exposure causes intellectual deficits, there is much evidence to suggest that the relationship is one of cause and effect. Causation is supported by the following findings. Many studies conducted under different conditions have drawn the same conclusion, and other possible causes of low IQ have been effectively eliminated; in addition, it is logical that lead would depress intelligence, given the physiological effects of this metal on the nervous system. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Children, Developmental disabilities, Intelligence tests, Slow learning children, Slow learners

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The lead-exposed worker

Article Abstract:

The Federal Occupational Safety and Health Administration requires doctors and employers to follow very specific guidelines when treating lead-exposed workers. If a patient's blood lead level exceeds 2.9 micromoles per liter, the worker must be removed from work with full pay and retention of seniority until the level falls below 1.95 micromoles per liter. Doctors play a key role in the implementation of these guidelines, which regulate the frequency of blood lead monitoring, the frequency and extent of other medical monitoring, and removal from work for medical reasons. The regulations on lead are reviewed insofar as they apply to physicians; recommendations are made about managing workers with lead poisoning.

Evaluation, Occupational health and safety, Occupational safety and health, Practice

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