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Adult Blood Lead Epidemiology and Surveillance -- United States, Fourth 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 for 1994 increased 4% over 1993; this increase is attributed to the participation of two additional states (North Carolina and Oklahoma) Table_1. The number of reports in 1994 increased 5% at lower BLLs (25-39 ug/dL and 40-49 ug/dL) and decreased 18% at higher BLLs (50-59 ug/dL and greater than or equal to 60 ug/dL), compared with the number of reports in 1993.

Since 1988, the number of states with legislation requiring laboratories and physicians to report elevated BLLs in adults to state health departments has increased from four to 32. As of this report, 22 of these 32 states contribute to quarterly national reporting; 10 others are developing their capacity to report. Aggregation of state-specific data began in 1992 with 12 states providing quarterly data (4).

ABLES data have improved understanding of the magnitude of this public health problem; identified workplace-specific clusters of overexposures to lead; and resulted in follow-up investigations leading to either remedial activities by employers (5), identification of new sources of exposures (6-8), or enforcement actions by the Oc-cupational Safety and Health Administration (9). Reported by: JP Lofgren, MD, Alabama Dept of Public Health. C Fowler, MS, Arizona Dept of Health Svcs. S Payne, MA, Occupational Lead Poisoning Prevention Program, California 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. L Thistle-Elliott, MEd, 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. V Ingram-Stewart, MPH, 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, fourth quarter, 1993. MMWR 1994;43:246-7.

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

  4. CDC. Elevated blood lead levels in adults -- United States, second quarter, 1992. MMWR 1992;41:715-6.

  5. CDC. Control of excessive lead exposure in radiator repair workers. MMWR 1991;40:139-41.

  6. CDC. Lead intoxication associated with chewing plastic wire coating -- Ohio. MMWR 1993; 42:465-7.

  7. CDC. Lead poisoning among sandblasting workers -- Galveston, Texas, March 1994. MMWR 1995;44:44-5.

  8. CDC. Controlling lead toxicity in bridge workers -- Connecticut, 1991-1994. MMWR 1995;44: 76-9.

  9. CDC. Lead poisoning among battery reclamation workers -- Alabama, 1991. MMWR 1992; 41:301-4.

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) in adults -- 22 states, * fourth quarter 1994
                                             Cumulative  reports,     Cumulative reports,
                   Fourth quarter 1994       fourth quarter 1994 @    fourth quarter 1993 + &
Reported BLL    --------------------------   --------------------------------------------------------
  (ug/dL)       No. reports  No. persons @      No.       (%)           No.       (%)
25-39             4,975         2,332         19,399    ( 72)        18,529    ( 72)
40-49             1,393           684          5,806    ( 22)         5,398    ( 21)
50-59               309           168          1,140    (  4)         1,311    (  5)
 >=60               114            58            459    (  2)           633    (  2)

Total             6,791         3,242         26,804    (100)        25,871    (100)
* 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 Wisconsin.
@ The cumulative number of reports for 1993 and 1994 have been revised in this report from the
  number previously reported (2,3). Additional reports for a specific quarter often are received by
  states after the quarterly reporting deadlines. These reports are included in the year-end
  cumulative totals to reflect updated quarterly reporting.
& 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 through fourth quarters 1993
  also include reports from Arizona, California, and Washington.
@ Individual reports are categorized according to the highest reported BLL for a person during the
  given quarter. Pennsylvania reports only numbers of reports.   Summaries of numbers of persons do
  not include Pennsylvania data.

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