Adult blood lead epidemiology and surveillance.
Chowdhury NH; Fowler C; Mycroft FJ; Jung BC; Lehnherr M; Gergely R; Keyvan-Larijani E; Rabin R; Carr A; Solet D; Gerwel B; Stone R; Randolph S; Rhoades E; Barnett M; Gostin J; Marino R; Perrotta D; Beaudoin D; Toof L; Kaufman J; Higgins D
MMWR 1994 Oct; 43(40):741-742
CDC's National Institute for Occupational Safety and Health Adult Blood Lead Epidemiology and Surveillance program (ABLES) monitors elevated blood lead levels (BLLs) among adults in the United States (1). Twenty-two states currently report surveillance results to ABLES. Beginning in 1993, ABLES began detecting both new cases and persons with multiple reports over time. In this report, ABLES provides data for the first quarter of 1994 and compares annual data for 1993 and 1992. During January 1-March 31, 1994, the number of reports of elevated BLLs increased over those reported for the same period in both 1992 and 1993 in all reporting categories; this increase is consistent with the increase from 1992 to 1993 in total annual BLL reports. The number of reports of adults with elevated BLLs reflects monitoring practices by employers. Variation in national quarterly reporting totals, especially first-quarter totals, may result from 1) changes in the number of participating states; 2) timing of receipt of laboratory BLL reports by state-based surveillance programs; and 3) interstate differences in worker BLL testing by lead-using industries. The reported number of adults with elevated BLLs increased from 8886 in 1992 to 11,240 in 1993; this increase resulted in part from a net gain of two reporting states (three additions and one deletion) to ABLES in 1993. A total of 6584 new case reports * accounted for 59% of the total cases (11,240) reported during 1993. Fifty-two percent of persons reported in 1992 were reported again to the system during 1993. Reasons for repeat reports of elevated BLLs include 1) recurring exposure resulting from lack of existing control measures and inapropriate worker-protection practices; 2) routine tracking of elevated employee BLLs below the medical removal limits; and 3) increased employer monitoring during medical removal. Increased testing of workers in construction trades -- as new workplace medical-monitoring programs are established to comply with new Occupational Safety and Health Administration regulations (3) -- also may partially explain increases in reports of elevated BLLs. These data suggest that work-related lead exposure is an ongoing occupational health problem in the United States. By expanding the number of participating states, reducing variability in reporting, and distinguishing between new and recurring elevated BLLs in adults, ABLES can enhance surveillance for this preventable condition.
Blood-samples; Blood-tests; Surveillance-programs; Epidemiology; Analytical-processes; Lead-absorption; Lead-compounds; Lead-poisoning; Occupational-exposure; Occupational-hazards; Work-environment; Worker-health; Medical-examinations
Morbidity and Mortality Weekly Report
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