The epidemiology of adult blood lead (7439921) levels (BLLs) in the United States from October 1, 1996 to December 31, 1996 was reported. The elevated BLLs reported by laboratories were monitored in 25 states by the NIOSH Adult Blood Lead Epidemiology and Surveillance (ABLES) program. A total of 6,215 cases of BLLs exceeding 25 micrograms per deciliter (microg/dL) were reported. This total was 11% lower than the 7,014 elevated cases reported in the fourth quarter of 1995. The total number of cases of BLLs greater than 25microg/dL was 8% lower in all four quarters of 1996 than in all four quarters of 1995. For BLLs ranging from 40 to 49microg/dL, about 18% less cases were reported in 1996 than in 1995. For BLLs varying from 50 to 59microg/dL, about 16% less cases were reported in 1996 than in 1995. According to the New York State Department of Health, a total of 64 cases of severe lead poisoning, of which 66% were occupationally related, were reported during the 1982 to 1993 period. Of the work related severe lead poisonings, 52% and 43% occurred among manufacturing and construction workers, respectively. Although only one severe lead poisoning case was reported in 1994 and no severe lead poisoning cases were reported in 1995, seven severe lead poisoning cases, of which 57% were occupationally related, were reported in 1996. All four occupationally related cases reported in 1996 occurred among residential painters. The authors conclude that while the incidence of elevated BLLs is apparently decreasing, this report serves to document the continuing hazards associated with occupational lead exposure. The ABLES program improves surveillance by increasing the number of participating states, decreasing variability in reporting, deciphering between new and recurring elevated BLLs, and identifying new sources of lead.