RESUMO
PROBLEM/CONDITION: Elevated blood lead levels (BLLs) in adults can damage the cardiovascular, central nervous, reproductive, hematologic, and renal systems. The majority of cases are workplace-related. U.S. Department of Health and Human Services recommends that BLLs among all adults be reduced to < 25 microg/dL. The highest BLL acceptable by standards of the U.S. Occupational Safety and Health Administration is 40 microg/dL. The mean BLL of adults in the United States is < 3 microg/dL. REPORTING PERIOD: This report covers cases of adults (aged > or = 16 years) with BLLs > or = 25 microg/dL, as reported by 25 states during 1998-2001. DESCRIPTION OF SYSTEM: Since 1987, CDC has sponsored the state-based Adult Blood Lead Epidemiology and Surveillance (ABLES) program to track cases of elevated BLLs and provide intervention consultation and other assistance. Overall ABLES program data were last published in 1999 for the years 1994-1997. This report provides an update with data from 25 states reporting for > or = 2 years during 1998-2001. During that period, the ABLES program funded surveillance in 21 states - Alabama, Arizona, Connecticut, Iowa, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Washington, Wisconsin, and Wyoming. Four additional states - California, Nebraska, New Hampshire, and Utah contributed data without CDC funding. RESULTS: During 1998-2001, the overall program's annual mean state prevalence rate for adults with BLLs > or = 25 microg/dL was 13.4/100,000 employed adults. This compares with 15.2/100,000 for 1994-1997. Yearly rates were 13.8 (1998), 12.9 (1999), 14.3 (2000), and 12.5 (2001). For adults with BLLs > or = 40 microg/dL, the overall program's annual mean state prevalence rare during 1998-2001 was 2.9/ 100,000 employed adults. This compares with 3.9/100,000 for 1994-1997. Yearly rates were 3.3 (1998), 2.5 (1999), 2.9 (2000), and 2.8 (2001). INTERPRETATION: Although certain limitations exist, the overall ABLES data indicate a declining trend in elevated BLLs among employed adults. PUBLIC HEALTH ACTIONS: ABLES-funded states increased from 21 to 35 in 2002, and more detailed reporting requirements were put into effect. These, and other improvements, will enable the ABLES program to work more effectively toward its 2010 target of eliminating all cases of BLLs > or = 25 microg/dL in adults caused by workplace exposures.
Assuntos
Intoxicação por Chumbo/epidemiologia , Adulto , Exposição Ambiental , Humanos , Chumbo/sangue , Intoxicação por Chumbo/diagnóstico , Vigilância da População , Estados Unidos/epidemiologiaRESUMO
In 2003, a chemical handling and use survey was mailed to New Jersey employers identified as currently using lead in their industrial processes. This survey was used to ascertain characteristics about lead use, handling, and protection of employees during manufacturing operations. The survey included a diverse group of current lead users with a total lead use range from less than 1 pound to more than 63 million pounds of lead per year. The survey allowed for a comprehensive characterization of hazards and protective measures associated with this metal, still commonly used in many products and industrial processes. Forty-five surveys were returned by companies that are listed in the New Jersey Adult Blood Lead Registry, which is part of the New Jersey Adult Blood Lead Epidemiology and Surveillance (ABLES) program. This program records and investigates cases of adults with greater than 25 mu g/dL of lead in their blood; most cases are related to occupational exposures. This survey found that greater than 25% of these surveyed companies with significant potential for lead exposure did not employ commonly used and basic industrial hygiene practices. In addition, the survey found that 24% of these companies had not conducted air sampling within the last 3 years. Air sampling is the primary trigger for compliance with the Occupational Safety and Health Administration (OSHA) general industry lead standard. Only 17% of the companies have ever been cited for a violation of the OSHA lead standard, and only 46% of these companies have ever had an OSHA inspection. State-based surveillance can be a useful tool for OSHA enforcement activities. Elevated blood lead values in adults should be considered as a trigger for required compliance with an OSHA general industry lead standard.