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Adult Blood Lead Epidemiology and Surveillance -- United States, First Quarter, 1993

The Adult Blood Lead Epidemiology and Surveillance (ABLES) program of CDC's National Institute for Occupational Safety and Health (NIOSH) monitors elevated blood lead levels (BLLs) in adults through laboratory reports received by state-based surveillance programs and summarizes these results quarterly in MMWR (Table 1). The goals of ABLES are to 1) describe the magnitude of occupational lead poisoning, 2) monitor trends in the incidence and prevalence of this condition, 3) identify new or unrecognized sources of lead exposure, 4) focus public health attention on this ongoing problem, and 5) effectively target worksites for intervention to reduce excessive lead exposure.

Reported by: B Harrell, MPA, Div of Epidemiology; CH Woernle, MD, State Epidemiologist, Alabama Dept of Public Health. J McCammon, MS, Epidemiology Div, Colorado Dept of Health. CJ Dupuy, BJ Jung, MPH, Connecticut State Dept of Health Svcs. M Lehnherr, Occupational Disease Registry; H Howe, PhD, Div of Epidemiologic Studies, Illinois Dept of Public Health. S Jones, R Gergely, Iowa Dept of Public Health. E Coe, MPH, E Keyvan, MD, Health Registries Div, Maryland Dept of the Environment. R Rabin, MSPH, Div of Occupational Hygiene, Massachusetts Dept of Labor and Industries. P Dunbar, MPH, Alethia Carr, Bur of Child and Family Svcs, Michigan Dept of Public Health. D Solet, PhD, Karen Royce, Occupational Health Program, Bur of Risk Assessment, Div of Public Health Svcs, New Hampshire State Dept of Health and Human Svcs. B Gerwel, MD, Occupational Disease Prevention Program, New Jersey Dept of Health. R Stone, PhD, New York 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, A Gardiner, Div of Health Hazard Evaluations, South Carolina Dept of Health and Environmental Control. T Willis, DM Perrotta, PhD, Environmental Epidemiologist, Texas Dept of Health. D Beaudoin, MD, Bur of Epidemiology, Utah Dept of Health. L Paulozzi, MD, L Toof, Bur of Chronic Disease Epidemiology, Vermont Dept of Health. L Hanrahan, MS, Div of Health, Wisconsin Dept of Health and Social Svcs. Div of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC.

Editorial Note

Editorial Note: State-based ABLES programs recognize that parents' exposure to lead at the workplace can be a source of "take-home" exposure (e.g., contaminated clothing, automobiles, and other items brought home from the worksite) for their children (1). During case follow-up of lead-poisoned workers, states participating in the ABLES program gather information on the children and/or other at-risk family members living in the household; when appropriate, children are referred for blood lead monitoring.

Conversely, cases of lead poisoning in children detected through community lead screening efforts may provide important information regarding parental occupational exposure to lead. For example, in 1991, the first year of the Alabama lead surveillance program, follow-up reports for 46 children aged 6 months-16 years with BLLs greater than 15 ug/dL revealed that 11 (24%) had a potential parental occupational source for their lead exposure (C. Woernle, Alabama Department of Public Health, personal communication, 1993). Similarly, follow-up investigation of two siblings (aged 3 and 7 years) in Colorado with BLLs of 38 and 36 ug/dL, respectively, found that the children received day care at their parents' radiator repair shop. In addition, the parents regularly wore lead-contaminated clothing home (J. McCammon, Colorado Department of Health, personal communication, 1993). The father's BLL was 52 ug/dL, and the mother's, 20 ug/dL; a co-worker at the shop had a level of 79 ug/dL. The overall magnitude of take-home lead exposure and the frequency at which children are exposed to lead through parental contact with lead at work or at home remain unknown.

Compliance with current Occupational Safety and Health Administration (OSHA) standards mandates the removal of lead-contaminated protective clothing and shoes before leaving the workplace, which should substantially reduce or eliminate these take-home exposures (2). Furthermore, a new interim final OSHA standard on "Lead Exposure in Construction" (effective June 3, 1993) extends regulatory coverage to workers in the construction trades, providing health and safety provisions similar to those required under the OSHA lead standard for general industry (3).


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

  2. Office of the Federal Register. Code of federal regulations: occupational safety and health standards. Subpart Z: toxic and hazardous substances -- lead. Washington, DC: Office of the Federal Register, National Archives and Records Administration, 1985. (29 CFR section 1910.1025).

3. US Department of Labor, Occupational Safety and Health Administration. Lead exposure in construction: interim final rule. Federal Register 1993;58:26590-649. (29 CFR section 1926).

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