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Current Trends Adult Blood Lead Epidemiology and Surveillance -- United States, Third Quarter 1994

CDC's National Institute for Occupational Safety and Health (NIOSH) Adult Blood Lead Epidemiology and Surveillance (ABLES) program monitors elevated blood lead levels (BLLs) in adults in the United States. Blood lead data from laboratory reports are transmitted to state-based lead surveillance programs and are compiled by NIOSH for quarterly reporting (1).

The total number of elevated blood lead reports during the first three quarters of 1994 increased 18% over third quarter totals from 1993 Table_1. This increase is consistent with the yearly increase in total reports from 1992 to 1993 (2). However, the number of 1994 third quarter reports of higher BLLs (50-59 ug/dL and greater than or equal to 60 ug/dL) decreased from 1993 to 1994.

Reports of elevated BLLs represent initial reports of newly identified cases or reflect periodic monitoring of known cases or ongoing exposures. The decrease in reports of higher BLLs during 1993-1994 may represent an increase in detection and prevention efforts by industry. Opportunities for prevention include identification of workers with elevated BLLs, reduction of worker exposures, implementation of workplace controls, and/or timely medical removal. The decrease also may have resulted from under- reporting of elevated BLLs.

BLL surveillance allows states to respond rapidly to reports of individual elevated BLLs (or workplace-specific clusters) and to conduct appropriate follow-up and prevention activities. Standardization of BLL reporting by states is progressing and helps to identify the magnitude of the problem and trends among U.S. workers. A year 2000 national health objective is to eliminate exposures that result in workers having blood lead concentrations greater than 25 ug/dL (baseline: 4804 workers with BLLs greater than 25 ug/dL in seven states in 1988) (objective 10.8) (3). Substantial progress is needed to meet this objective. Reported by: JP Lofgren, MD, Alabama Dept of Public Health. C Fowler, MS, Arizona Dept of Health Svcs. FJ Mycroft, PhD, Occupational Health Br, California State Dept of Health Svcs. BC Jung, MPH, Connecticut Dept of Public Health and Addiction Svcs. M Lehnherr, Occupational Disease Registry, Div of Epidemiologic Studies, Illinois Dept of Public Health. R Gergely, Iowa Dept of Public Health. E Keyvan-Larijani, MD, Lead Poisoning Prevention Program, Maryland Dept of the Environment. R Rabin, MSPH, Div of Occupational Hygiene, Massachusetts Dept of Labor and Industries. A Carr, MBA, Bur of Child and Family Svcs, Michigan Dept of Public Health. D Solet, PhD, Div of Public Health Svcs, New Hampshire State Dept of Health and Human Svcs. B Gerwel, MD, Occupational Disease Prevention Project, New Jersey State Dept of Health. R Stone, PhD, New York State Dept of Health. S Randolph, MSN, North Carolina Dept of Environment, Health, and Natural Resources. E Rhoades, MD, Oklahoma 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, Div of Health Hazard Evaluations, South Carolina Dept of Health and Environmental Control. D Perrotta, PhD, Bur of Epidemiology, Texas Dept of Health. D Beaudoin, MD, Bur of Epidemiology, Utah Dept of Health. L Toof, Div of Epidemiology and Health Promotion, Vermont Dept of Health. J Kaufman, MD, Washington State Dept of Labor and Industries. H Anderson, MD, D Higgins, Wisconsin Dept of Health and Social Svcs. Div of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC.


  1. CDC. Surveillance of elevated blood lead levels among adults -- United States, 1992. MMWR 1992;41:285-8.

  2. CDC. Adult blood lead epidemiology and surveillance -- United States, 1992-1994. MMWR 1994;43:483-5.

  3. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives -- full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.

TABLE 1. Reports of elevated blood lead levels (BLLs) among adults -- 22 states, * third quarter 1994
                     Third quarter 1994
Reported BLL      --------------------------   Cumulative reports,   Cumulative reports,
  (ug/dL)         No. reports  No. persons +   third quarter 1994    third quarter 1993 &
25-39               4,637        2,569              13,267                11,261
40-49               1,316          641               4,058                 3,163
50-59                 233          135                 769                   788
 >=60                  86           51                 312                   411

Total               6,272        3,396              18,406                15,623
* Reported by Alabama, Arizona, California, Connecticut, Illinois, Iowa, Maryland,
  Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina,
  Oklahoma, Oregon, Pennsylvania, South Carolina, Texas, Utah, Vermont, Washington, and
+ Individual reports are categorized according to the highest reported BLL for a person
  during the given quarter. Pennsylvania reports only numbers of reports on a quarterly
  basis; quarterly summaries of numbers of persons do not include Pennsylvania data.
& Data for first quarter 1993 reported from 17 states (Alabama, Connecticut, Illinois,
  Iowa, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, Oregon,
  Pennsylvania, South Carolina, Texas, Utah, Vermont, and Wisconsin). Data for second
  and third quarters 1993 also include reports from Arizona, California, and Washington.

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