Definition

Prevalence of adults, aged >=16 years old with a blood lead level >=25 ug/dL, per total number of adults employed in a non-agricultural occupation.

Numerator

The number of adult cases, aged >=16 years old, with a blood lead level >=25 ug/dL.

Denominator

Total number of adults employed in non-agricultural occupations, aged >=16 years old.

Why Is This Important?

All persons are exposed to lead in the environment, a significant source of lead exposure for some adults may be their workplace environment. The current occupational health protection standards require medical intervention and occupational exposure control for non-agriculturally related cases of repeated blood lead concentration repeatedly exceeding 50 ug/dL or exceeding 60 ug/dL (Code of Federal Regulations 29:1910.1025). However, adverse health effects in adults with elevated blood lead levels less than the national health protection standards have been noted. Also, adults that are being exposed to lead at the workplace may bring home the leaded dust on their clothes, shoes, etc. and possibly expose other family members if precautionary measures are not taken. Lead-contaminated water, soil, and paint have been recognized as potential sources of children's lead exposure. Dust from deteriorating lead-based paint is considered to be the largest contributor to the lead problem. Until the 1950s, many homes were painted inside and out with leaded paints. Lead began to fall from favor in the 1950s, but was still commonly used until it was banned from use in homes after 1977. Because of the long term use of lead-based paints, many homes in the United States contain surfaces with paint, which is now peeling, chalking, flaking, or wearing away. The dust or paint chips contain high levels of lead that easily find ways into the mouths of young children. A particular problem has emerged due to the large number of homes with lead-based paints which are now undergoing renovation/remodeling. Often the dust created by this work has high lead levels which are readily absorbed by children's developing bodies and those persons performing the renovation/remodeling, if safe work practices are not followed.

Healthy People Objective EH-20.3:

Reduce exposure to lead in the population, as measured by blood and urine concentrations of the substance or its metabolites
U.S. target: 2.94 ug/dL

Other Objectives

{{style color:#003366 Healthy People 2020 Objective EH-22:}} Increase the number of States, Territories, Tribes, and the District of Columbia that monitor diseases or conditions that can be caused by exposure to environmental hazards {{style color:#003366 EH-22.1 Lead Poisoning}}[[br]] '''U.S. Target''': 56 States, Territories, and the District of Columbia [[br]] '''Utah Target''': Utah is currently one of the states monitoring lead poisoning

What Is Being Done?

In order to study the epidemiology of occupational lead poisoning in Utah, the Utah Department of Health Environmental Epidemiology Program (EEP), applied for and received a three-year grant from the National Institute of Occupational Safety and Health (NIOSH) to establish and develop the Adult Blood Lead Epidemiology and Surveillance (ABLES) project in 1992. The purpose of that project was 1) to develop surveillance tools to collect information on the epidemiology of adult lead poisoning, 2) management of occupational lead poisoning, and 3) to develop and provide information and educational materials to persons at risk and lead industries. Federal funding for the project ended in 1995 and later funded in 2002 to the present. The EEP continues to maintain the program as a laboratory-based surveillance system for occupational lead exposure in Utah adults. The ABLES project is maintained within the Environmental Epidemiology Program. Utah Administrative Code R386-703 (Injury Reporting Rule) establishes an injury surveillance and reporting system for major injuries occurring in Utah. Lead poisoning was added to the list of reportable injuries in 1990. Initially, under that rule, lead poisoning injuries were defined to include lead poisoning of all persons with whole blood lead concentrations >= 30 mcg/dL. In December 1991, the reportable level was lowered to >= 15 mcg/dL, and on January 1, 1997, the reportable level was lowered to >= 10 mcg/dL. The EEP receives reports of all blood lead test results, which include the case name, age or birth date, sex, test date, BLL, and name of physician or agency. The EEP collaborates with clinical laboratories to report all blood lead tests conducted on Utah residents, either on a weekly or monthly basis. Surveillance data is maintained in the Utah Blood Lead Registry (UBLR), housed in the EEP. The analysis of the data helps in determining trends, prevalence of EBLL adults, screening rates among specific high-risk occupations and areas identified high risk such as certain hobbies, including: target shooting/reloading, ceramics/pottery, stained glass, painting, and refinishing furniture.

Available Services

The Utah Department of Health Environmental Epidemiology Program is available to answer questions about lead poisoning and provide educational material to the public. Contact your local health department or physician for a blood lead test. If you have any questions please call the Utah Department of Health, Blood Lead Program and ask for Mark Jones at (801) 538-6191.

Risk Factors

Adults identified with an EBLL experienced the following behaviors: not changing clothes before leaving work, not showering at end of work shift, eating snacks on the job, using tobacco products at work area, and not washing hands before eating. Symptoms experienced included: joint or muscle pain, nausea, extreme fatigue, constipation, and headache. High-risk industries identified in 2006 by SIC codes are: 1795 (Wrecking and Demolition Work), 1799 (Special Trade Contractors, NEC), 2819 (Industrial Inorganic Chemicals, NEC), 3679 (Electronic Components), 3312 (Blast Furnaces and Steel Mills), 3482 (Small Arms Ammunition), 3728 (Aircraft Equipment, NEC), 3484 (Small Arms), 1793 (Glass & Glazing Work), 7539 (Automotive Repair Shops, NEC), 1021 (Copper Ores), and 3949 (Sporting & Athletic Goods, NEC).

Data Notes

Prevalence is calculated as (number of cases with an elevated blood lead level per number of adult individuals employed in non-agricultural jobs) x 100,000. Prevalence for 1997 was re-calculated based on final population data. 1998 employment data is estimated from the growth rate during the previous year.

References and community resources

Utah Department of Health/Environmental Epidemiology Program[[br]] [http://health.utah.gov/epi/enviroepi/] Utah Department of Environmental Quality (Lead-Based Paint Program)[[br]][https://deq.utah.gov/air-quality/lead-based-paint-program] National Institute for Occupational Safety and Health[[br]] [http://www.cdc.gov/niosh/topics/lead] Industrial Commission of Utah (Utah OSHA)[[br]] [http://www.osha.gov] Centers for Disease Control and Prevention [[br]] [http://www.cdc.gov/nceh/lead] Office of Healthy Homes and Lead Hazard Control (HUD)[[br]] [https://www.hud.gov/program_offices/healthy_homes/healthyhomes/lead] Environmental Protection Agency (EPA)[[br]] [http://www.epa.gov/lead]