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Adult Blood Lead Epidemiology and Surveillance

April 10, 2024

"ABLES" redirects here. For ABLLS, see Assessment of Basic Language and Learning Skills.

The US National Institute for Occupational Safety and Health funds the Adult Blood Lead Epidemiology and Surveillance (ABLES) program, a state-based surveillance program of laboratory-reported adult blood lead levels. In 2009, the ABLES program updated its case definition for an Elevated Blood Lead Level to a blood lead concentration equal or greater than 10 micrograms per deciliter (10 μg/dL).[1] This chart shows CDC/NIOSH/ABLES Elevated blood lead level case definition in perspective.[2]

The public health objective of the ABLES program is identical to the Occupational Safety and Health objective 7 in Healthy People 2020, which is to reduce the rate of adults (age 16 or older) who have BLLs ≥ 10 μg/dL.[3] The ABLES program aims to accomplish this objective by providing guidance, technical support, and funding to build state capacity to initiate or improve adult blood lead surveillance programs which can accurately measure trends in adult BLLs and which can effectively target interventions to prevent lead exposures.

Impact edit

In the United States, approximately 95% of BLLs ≥25 μg/dL in adults are work related. Lead exposure occurs mainly in the battery manufacturing, lead and zinc ore mining, and painting and paper hanging industries. In 2008, OSHA updated its National Emphasis Program for Lead to reduce occupational exposures by targeting unsafe conditions or high hazard industries. OSHA utilized national ABLES program data to identify those industries where elevated BLLs indicated a need for increased national focus. State ABLES programs also work with OSHA by sharing lead exposure data, which OSHA then uses to initiate investigations and promote prevention interventions.

Over the last 17 years, a 50% decrease in the national prevalence rates of BLL ≥25 μg/dL has been documented using ABLES surveillance data. In 1994 the rate was 14.0 employed adults per 100,000; in 2010 the rate was reduced to 7.0. In 2010, 40 state ABLES programs that provided data reported 31,081 adults with BLLs ≥10 μg/dL. Among these, 8,793 had BLLs ≥25 μg/dL, and 1,388 had BLLs ≥40 μg/dL. Based on data from 37 reporting states, ABLES established the 2010 baseline rate for Healthy People 2020 objective to reduce adult lead exposure. This 2010 baseline rate for BLLs ≥10 μg/dL is 26.4 adults per 100,000 employed adults.

Though rates of BLL ≥25 μg/dL have decreased, the work to prevent elevated BLLs is still far from complete. The ABLES data from 2010 establish that lead exposure remains a national occupational health problem, and that continued efforts to reduce lead exposures are needed. Because BLLs are often not available for many lead-exposed workers (e.g., the workers may not be tested or their tests may not be reported to public health authorities), ABLES data should be considered a low estimate of the true magnitude of elevated adult lead exposures in the United States.[4]

Health effects edit

Elevated blood lead levels (BLLs) in adults can damage the nervous, hematologic, reproductive, renal, cardiovascular, and gastrointestinal systems.

Current research continues to find harmful effects in adults at BLLs previously considered harmless, such as decreased renal function associated with BLLs at 5 micrograms per deciliter (μg/dL) and lower, and increased risk of hypertension and essential tremor at BLLs below 10 μg/dL.[5][6][7]

U.S. Department of Health and Human Services recommends that BLLs among all adults be reduced to <10 μg/dL.[3] OSHA Lead Standards require medical removal from lead exposures only after a construction worker's BLL reaches or exceeds 50 μg/dL or a general industry worker's BLL reaches or exceeds 60 μg/dL.[8][9][10] The geometric mean BLL of all adults in the United States was 1.2 μg/dL in 2009–2010.[11]

Workers with elevated blood lead levels edit

In the U.S. the majority of cases are workplace-related. During 2008–2009, the greatest proportions of adults with elevated BLLs were employed in three main industry sectors:manufacturing, 72.1% in 2008 and 72.3% in 2009; construction, 13.2% in 2008 and 14.4% in 2009; and mining, 6.6% in 2008 and 5.1% in 2009. Industry subsectors with the highest numbers of workers with elevated BLLs were manufacturing of storage batteries, secondary smelting and refining of nonferrous metals, and painting and paper hanging. Industry subsectors with the greatest proportions of adults with BLLs ≥40 μg/dL among adults with BLLs ≥25 μg/dL were painting and paper hanging; bridge, tunnel, and elevated highway construction; copper foundries; special trade contractors; and heavy construction industries.[12]

Program description edit

ABLES state interventions to prevent lead over-exposures include: (1) conducting follow-up interviews with physicians, employers, and workers; (2) investigating work sites; (3) providing technical assistance; (4) providing referrals for consultation and/or enforcement; and (5) developing and disseminating educational materials and outreach programs.

ABLES states are required to have a mandatory state requirement that laboratories report blood lead level results to the state health department or designee.[13] The lowest blood lead level to be reported varies from state to state.

Lead may be taken home from the workplace on clothes or in cars potentially exposing spouses and children. Children who come in contact with lead-exposed workers should be targeted for blood lead screening.

State ABLES programs edit

ABLES' success is based on its longstanding strategic partnerships with state ABLES programs, federal agencies, and worker affiliated organizations.

The NIOSH ABLES program partners with 40 funded states and one state that participates with no ABLES funding: Alabama, Alaska, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Maine, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Washington, Wisconsin, and Wyoming.

ABLES began in 1987 with four states and has continued to grow to include forty-one states in 2010.[13]

See also edit

References edit

  1. ^ "NIOSH Adult Blood Lead Epidemiology & Surveillance (ABLES) - About ABLES". CDC. Cincinnati, OH: US Department of Health and Human Services, CDC, National Institute for Occupational Safety and Health. 2013.
  2. ^ "Elevated blood lead level case definition in perspective" (PDF). CDC/NIOSH/ABLES. February 8, 2012.
  3. ^ a b . U.S. Department of Health and Human Services. Washington, DC. 2013. Archived from the original on October 12, 2013. Retrieved July 20, 2013.{{cite web}}: CS1 maint: unfit URL (link)
  4. ^ Data into Action: NIOSH Blood Lead Surveillance Program Contributes to a Decline in National Prevalence Rates. DHHS (NIOSH) Publication No. 2012-164. 2012. doi:10.26616/NIOSHPUB2012164.
  5. ^ Health Effects of Low-Level Lead (NTP Monograph). Research Triangle Park, NC: U.S. Department of Health and Human Services, National Toxicology Program (NTP). June 2012.
  6. ^ (PDF). Association of Occupational and Environmental Clinics. Washington, DC. April 24, 2007. Archived from the original (PDF) on October 21, 2022. Retrieved July 30, 2013.
  7. ^ Kosnett, MJ; Wedeen, RP; Rothenberg, SJ; et al. (2007). "Recommendations for medical management of adult lead exposure". Environ Health Perspect. 115 (3): 463–71. doi:10.1289/ehp.9784. PMC 1849937. PMID 17431500.
  8. ^ "Lead Standards: General Industry (29 CFR 1910.1025) and Construction Industry (29 CFR 1926.62)". U.S. Department of Labor, Occupational Safety and Health Administration (OSHA). Washington, DC. 1978.
  9. ^ Final standard; occupational exposure to lead. U.S. Department of Labor, Occupational Safety and Health Administration. Federal Register 1978; 43:52952–3014 (29 CFR § 1910.1025).
  10. ^ Lead exposure in construction—interim rule. U.S. Department of Labor, Occupational Safety and Health Administration. Federal Register 1993;58:26590–26649 (29 CFR § 1926.62).
  11. ^ Fourth National Report on Human Exposure to Environmental Chemicals (PDF). Atlanta, GA: US Department of Health and Human Services, CDC. September 2012.
  12. ^ Centers for Disease Control Prevention (CDC) (July 1, 2011). "Adult Blood Lead Epidemiology and Surveillance --- United States, 2008--2009". Morbidity and Mortality Weekly Report. 60 (25). CDC: 841–845. PMID 21716198.
  13. ^ a b "NIOSH Adult Blood Lead Epidemiology & Surveillance (ABLES) program: State-based Programs". Cincinnati, OH: US Department of Health and Human Services, CDC, National Institute for Occupational Safety and Health. 2013.

Further reading edit

  • Klotz, Katrin; Göen, Thomas (2017). "Chapter 6. Human Biomonitoring of Lead Exposure". In Astrid, S.; Helmut, S.; Sigel, R. K. O. (eds.). Lead: Its Effects on Environment and Health. Metal Ions in Life Sciences. Vol. 17. de Gruyter. pp. 99–122. doi:10.1515/9783110434330-006. PMID 28731299.

External links edit

  • National Institute for Occupational Safety and Health - ABLES Page
  • International Chemical Safety Cards (ICSCs)
  • NIOSH Pocket Guide to Chemical Hazards
  • Occupational Health Guidelines for Chemical Hazards

April 10, 2024
adult, blood, lead, epidemiology, surveillance, ables, redirects, here, ablls, assessment, basic, language, learning, skills, national, institute, occupational, safety, health, funds, ables, program, state, based, surveillance, program, laboratory, reported, a. ABLES redirects here For ABLLS see Assessment of Basic Language and Learning Skills The US National Institute for Occupational Safety and Health funds the Adult Blood Lead Epidemiology and Surveillance ABLES program a state based surveillance program of laboratory reported adult blood lead levels In 2009 the ABLES program updated its case definition for an Elevated Blood Lead Level to a blood lead concentration equal or greater than 10 micrograms per deciliter 10 mg dL 1 This chart shows CDC NIOSH ABLES Elevated blood lead level case definition in perspective 2 The public health objective of the ABLES program is identical to the Occupational Safety and Health objective 7 in Healthy People 2020 which is to reduce the rate of adults age 16 or older who have BLLs 10 mg dL 3 The ABLES program aims to accomplish this objective by providing guidance technical support and funding to build state capacity to initiate or improve adult blood lead surveillance programs which can accurately measure trends in adult BLLs and which can effectively target interventions to prevent lead exposures Contents 1 Impact 2 Health effects 3 Workers with elevated blood lead levels 4 Program description 5 State ABLES programs 6 See also 7 References 8 Further reading 9 External linksImpact editIn the United States approximately 95 of BLLs 25 mg dL in adults are work related Lead exposure occurs mainly in the battery manufacturing lead and zinc ore mining and painting and paper hanging industries In 2008 OSHA updated its National Emphasis Program for Lead to reduce occupational exposures by targeting unsafe conditions or high hazard industries OSHA utilized national ABLES program data to identify those industries where elevated BLLs indicated a need for increased national focus State ABLES programs also work with OSHA by sharing lead exposure data which OSHA then uses to initiate investigations and promote prevention interventions Over the last 17 years a 50 decrease in the national prevalence rates of BLL 25 mg dL has been documented using ABLES surveillance data In 1994 the rate was 14 0 employed adults per 100 000 in 2010 the rate was reduced to 7 0 In 2010 40 state ABLES programs that provided data reported 31 081 adults with BLLs 10 mg dL Among these 8 793 had BLLs 25 mg dL and 1 388 had BLLs 40 mg dL Based on data from 37 reporting states ABLES established the 2010 baseline rate for Healthy People 2020 objective to reduce adult lead exposure This 2010 baseline rate for BLLs 10 mg dL is 26 4 adults per 100 000 employed adults Though rates of BLL 25 mg dL have decreased the work to prevent elevated BLLs is still far from complete The ABLES data from 2010 establish that lead exposure remains a national occupational health problem and that continued efforts to reduce lead exposures are needed Because BLLs are often not available for many lead exposed workers e g the workers may not be tested or their tests may not be reported to public health authorities ABLES data should be considered a low estimate of the true magnitude of elevated adult lead exposures in the United States 4 Health effects editElevated blood lead levels BLLs in adults can damage the nervous hematologic reproductive renal cardiovascular and gastrointestinal systems Current research continues to find harmful effects in adults at BLLs previously considered harmless such as decreased renal function associated with BLLs at 5 micrograms per deciliter mg dL and lower and increased risk of hypertension and essential tremor at BLLs below 10 mg dL 5 6 7 U S Department of Health and Human Services recommends that BLLs among all adults be reduced to lt 10 mg dL 3 OSHA Lead Standards require medical removal from lead exposures only after a construction worker s BLL reaches or exceeds 50 mg dL or a general industry worker s BLL reaches or exceeds 60 mg dL 8 9 10 The geometric mean BLL of all adults in the United States was 1 2 mg dL in 2009 2010 11 Workers with elevated blood lead levels editIn the U S the majority of cases are workplace related During 2008 2009 the greatest proportions of adults with elevated BLLs were employed in three main industry sectors manufacturing 72 1 in 2008 and 72 3 in 2009 construction 13 2 in 2008 and 14 4 in 2009 and mining 6 6 in 2008 and 5 1 in 2009 Industry subsectors with the highest numbers of workers with elevated BLLs were manufacturing of storage batteries secondary smelting and refining of nonferrous metals and painting and paper hanging Industry subsectors with the greatest proportions of adults with BLLs 40 mg dL among adults with BLLs 25 mg dL were painting and paper hanging bridge tunnel and elevated highway construction copper foundries special trade contractors and heavy construction industries 12 Program description editABLES state interventions to prevent lead over exposures include 1 conducting follow up interviews with physicians employers and workers 2 investigating work sites 3 providing technical assistance 4 providing referrals for consultation and or enforcement and 5 developing and disseminating educational materials and outreach programs ABLES states are required to have a mandatory state requirement that laboratories report blood lead level results to the state health department or designee 13 The lowest blood lead level to be reported varies from state to state Lead may be taken home from the workplace on clothes or in cars potentially exposing spouses and children Children who come in contact with lead exposed workers should be targeted for blood lead screening State ABLES programs editABLES success is based on its longstanding strategic partnerships with state ABLES programs federal agencies and worker affiliated organizations The NIOSH ABLES program partners with 40 funded states and one state that participates with no ABLES funding Alabama Alaska Arizona California Colorado Connecticut Florida Georgia Hawaii Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Maine Missouri Montana Nebraska New Hampshire New Jersey New Mexico New York North Carolina Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina Tennessee Texas Utah Vermont Washington Wisconsin and Wyoming ABLES began in 1987 with four states and has continued to grow to include forty one states in 2010 13 See also editLead poisoning Lead safe work practices Lead based paint in the United StatesReferences edit NIOSH Adult Blood Lead Epidemiology amp Surveillance ABLES About ABLES CDC Cincinnati OH US Department of Health and Human Services CDC National Institute for Occupational Safety and Health 2013 Elevated blood lead level case definition in perspective PDF CDC NIOSH ABLES February 8 2012 a b Healthy People 2020 Occupational Safety and Health objective 7 U S Department of Health and Human Services Washington DC 2013 Archived from the original on October 12 2013 Retrieved July 20 2013 a href Template Cite web html title Template Cite web cite web a CS1 maint unfit URL link Data into Action NIOSH Blood Lead Surveillance Program Contributes to a Decline in National Prevalence Rates DHHS NIOSH Publication No 2012 164 2012 doi 10 26616 NIOSHPUB2012164 Health Effects of Low Level Lead NTP Monograph Research Triangle Park NC U S Department of Health and Human Services National Toxicology Program NTP June 2012 Medical Management Guidelines for Lead Exposed Adults PDF Association of Occupational and Environmental Clinics Washington DC April 24 2007 Archived from the original PDF on October 21 2022 Retrieved July 30 2013 Kosnett MJ Wedeen RP Rothenberg SJ et al 2007 Recommendations for medical management of adult lead exposure Environ Health Perspect 115 3 463 71 doi 10 1289 ehp 9784 PMC 1849937 PMID 17431500 Lead Standards General Industry 29 CFR 1910 1025 and Construction Industry 29 CFR 1926 62 U S Department of Labor Occupational Safety and Health Administration OSHA Washington DC 1978 Final standard occupational exposure to lead U S Department of Labor Occupational Safety and Health Administration Federal Register 1978 43 52952 3014 29 CFR 1910 1025 Lead exposure in construction interim rule U S Department of Labor Occupational Safety and Health Administration Federal Register 1993 58 26590 26649 29 CFR 1926 62 Fourth National Report on Human Exposure to Environmental Chemicals PDF Atlanta GA US Department of Health and Human Services CDC September 2012 Centers for Disease Control Prevention CDC July 1 2011 Adult Blood Lead Epidemiology and Surveillance United States 2008 2009 Morbidity and Mortality Weekly Report 60 25 CDC 841 845 PMID 21716198 a b NIOSH Adult Blood Lead Epidemiology amp Surveillance ABLES program State based Programs Cincinnati OH US Department of Health and Human Services CDC National Institute for Occupational Safety and Health 2013 Further reading editKlotz Katrin Goen Thomas 2017 Chapter 6 Human Biomonitoring of Lead Exposure In Astrid S Helmut S Sigel R K O eds Lead Its Effects on Environment and Health Metal Ions in Life Sciences Vol 17 de Gruyter pp 99 122 doi 10 1515 9783110434330 006 PMID 28731299 External links editNational Institute for Occupational Safety and Health ABLES Page Center to Protect Workers Rights CPWR Council of State and Territorial Epidemiologists CSTE OSHA Safety and Health Topics Heavy Metals Lead International Chemical Safety Cards ICSCs NIOSH Pocket Guide to Chemical Hazards Occupational Health Guidelines for Chemical Hazards Retrieved from https en wikipedia org w index php title Adult Blood Lead Epidemiology and Surveillance amp oldid 1206873282, wikipedia, wiki, book, books, library,

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