NORA Manufacturing Sector Strategic Goals
9278509 - Adult Blood Lead Epidemiology and Surveillance & Research Program (ABLES)
Principal Investigator (PI)
Primary Goal Addressed
Secondary Goal Addressed
Attributed to Manufacturing
The Adult Blood Lead Epidemiology and Surveillance (ABLES) program aims to assist the states to reduce to zero the rate of adults who have blood lead levels of 25 mcg/dL or greater (Objective 20.7 in Healthy People 2010). ABLES identifies cases among adults in 40 states. Cases identified through ABLES surveillance are used to target high risk industries for intervention and are frequently referred to State or Federal OSHA programs for consultation or enforcement. The most crucial ABLES activity is building state capacity to initiate or improve adult blood lead surveillance programs which can accurately measure trends in adult blood lead levels and which can effectively intervene to prevent lead over-exposures. ABLES is a surveillance tool, providing data to the construction, manufacturing, mining, and wholesale and retail trade NORA sectors.
The purpose of the Adult Blood Lead Epidemiology and Surveillance (ABLES) program is to assist the states to reduce to zero the rate of adults who have blood lead levels of 25 mcg/dL or greater (Objective 20.7 in Healthy People 2010). ABLES is the national data source used to track this objective. ABLES is a state-based surveillance system for identifying and preventing elevated blood lead levels among U.S. adults. ABLES data provide the public health community with essential information for setting priorities for research and intervention.
ABLES-related activities accomplished in 2006-7 include: (1) To keep the issue of adult lead exposures before the public, the ABLES report for 2003 - 2004 and a paper on lead exposure among females of childbearing age were published in the MMWR. (2) To make the ABLES data more useful to outside researchers, they were posted at: http://www.cdc.gov/niosh/topics/ABLES/ables.html under "Blood Lead Level Data - Reported from 2002 through 2004." (3) To make the ABLES data more useful to OSHA for targeting lead inspections, an MOU to share the ABLES data with OSHA was completed. (4) To help lower lead exposures among construction workers, a "Model Intervention to Lower Exposures in Lead Paint Removal" was approved for NORA 2007 - 2009 funding. In 2007, 40 state ABLES programs collected blood lead level data from local health departments, private health care providers and, from public and private reporting laboratories.
State ABLES programs are encouraged to: (1) Collect, analyze and report their data, (2) Conduct follow-ups with physicians, workers and employers, (3) Target on-site inspections of work sites, (4) Provide referrals to cooperating agencies, (5) Identify new exposures and failures in prevention and, (6) target educational and other interventions. State educational materials and other reports on lead will continue to be disseminated via the ABLES topic website and via the ABLES listserv. The ABLES program will continue its collaboration within CDC; and with the CSTE; the Center to Protect Workers' Rights; OSHA; and 40 State health departments. Over the next 3-5 years ABLES plans include: adding additional states; improving data standardization; updating elevated blood lead level case definition; publishing data and posting them on the ABLES topic website in a timely manner; and encourage research collaborations to better describe effective intervention programs, health risks and under-reporting. The most crucial ABLES activity to help attain the Healthy People 2010 adult lead objective is building state capacity to initiate or improve adult blood lead surveillance programs which can accurately measure trends in adult blood lead levels and which can effectively intervene to prevent lead over-exposures.
The project goal of the ABLES program is to assist the States to reduce the rate to zero for adults who have blood lead levels of 25 mcg/dL or greater (Objective 20-7 in Healthy People 2010). ABLES data are the source for tracking this objective. The national prevalence rate for adults with blood lead levels of 25 mcg/dL or greater as reported by the ABLES states has declined from 14/100,000 employed in 1994 to 7.6/100,000 employed in 2006. There was a 5% decline from 2004 to 2005, but a 3% increase was recorded from 2005 to 2006. Current projections to 2010 indicate that a rate of zero will not be achieved. The projected rate for 2010 is 5.6/100,000. The baseline year was 1998 which had a rate of 12.1/100,000. If a rate of 5.6/100,000 is reported in 2010, this would be a decline from baseline of 54%. ABLES data are also used to track GPRA targets for NIOSH. These GPRA targets use FY 03 data as the baseline and expect three percent reductions in FY 04, FY 05, and FY 06. This target was not achieved from 2005 to 2006, but based on projections from ABLES data from 1994 through 2006, these overall GPRA targets are likely to be achieved. During the last year, the ABLES website was accessed 5,957 times (23,544 views). ABLES information is used worldwide, as a total of 109 foreign countries accessed the ABLES website during last year.
There is a need for a national surveillance system for occupational surveillance for lead in order to assist the states to reduce to zero the rate of adults who have blood lead levels of 25 mcg/dL or greater. This is Objective 20.7 in Healthy People 2010 and ABLES is the national data source used to track this objective. ABLES data are also used to track GPRA targets for NIOSH. NIOSH provides the only federal funding support for occupational surveillance for lead. The public health community, based on recent research on lead exposure, is strongly recommending lowering the elevated blood lead level surveillance case definition to 10 mcg/dL.
ABLES addresses the following NIOSH NORA sectors intermediate objectives:
• Manufacturing sector. The majority of adults with elevated blood lead levels reported to the ABLES program (72.7% or 4,773 cases in 2006) come from the manufacturing sector.
• Strategic Goal 8 - Reduce the incidence of injuries, illnesses, and fatalities within specific sub-sectors and small businesses within the manufacturing sector.
• Construction sector accounts for 12.2% (797 adults in 2006) of elevated blood lead levels reported to the ABLES program. However underreporting of cases in this sector is large.
• Research to Practice Goal 11.4.4. Increase communication with other construction safety and health researchers to integrate research findings into training programs.
• High priority 2009 goal. Intermediate Goal 14.1 Partner with surveillance researchers and federal and state surveillance programs to support, enhance, and expand collection of traditional surveillance information relevant for the construction sector
• Mining sector accounts for 9.6% (630 adults in 2006) of elevated blood lead levels reported to the ABLES program.
• Intermediate Goal 7.4 - Develop a more rigorous program to assess the effectiveness of NIOSH-developed interventions.
• Intermediate Goal 7.6 - Reduce injuries and illnesses caused by chemical hazards found in mining by conducting epidemiological studies that track disease and illness.
• Services accounts for 3% (199 adults in 2006) of elevated blood lead levels reported to the ABLES program. Underreporting of cases in this sector may also be large.
• Intermediate Goal 17.1 - Evaluate illnesses, injuries, and fatalities that may be due to working conditions and identify opportunities for interventions in the services sector
• Cancer, Reproductive, and Cardiovascular Diseases. Recent research on lead exposure establishes the potential for hypertension, effects on renal function, cognitive dysfunction and adverse female reproductive outcome in adults with whole blood lead concentrations less than 40 mcg/dL.
• Goal 3.1.4. - Improve surveillance methods to identify potential workplace risk factors, for example, through the development of automated NAICS codes for standard birth records (e.g., birth certificates).
• Strategic Goal 5: Reduce the incidence and mortality of other chronic diseases, including (but not limited to), work-related neurologic (cerebrovascular) and renal disease.
• Surveillance. This project meets most of the intermediate goals for surveillance. Two examples are provided:
• Intermediate goal 2.1 - Enhance and expand the development of State-based public health surveillance systems through State-based surveillance.
• Intermediate goal 3.2 - Continue and enhance existing surveillance activities to track priority injuries, illnesses, hazards, and risk factors.