Current Trends
Adult Blood Lead Epidemiology and Surveillance -- United States,
Third Quarter 1994
CDC's National Institute for Occupational Safety and Health
(NIOSH) Adult Blood Lead Epidemiology and Surveillance (ABLES)
program monitors elevated blood lead levels (BLLs) in adults in the
United States. Blood lead data from laboratory reports are
transmitted to state-based lead surveillance programs and are
compiled by NIOSH for quarterly reporting (1).
The total number of elevated blood lead reports during the
first three quarters of 1994 increased 18% over third quarter
totals from 1993 Table_1. This increase is consistent with the
yearly increase in total reports from 1992 to 1993 (2). However,
the number of 1994 third quarter reports of higher BLLs (50-59
ug/dL and greater than or equal to 60 ug/dL) decreased from 1993 to
1994.
Reports of elevated BLLs represent initial reports of newly
identified cases or reflect periodic monitoring of known cases or
ongoing exposures. The decrease in reports of higher BLLs during
1993-1994 may represent an increase in detection and prevention
efforts by industry. Opportunities for prevention include
identification of workers with elevated BLLs, reduction of worker
exposures, implementation of workplace controls, and/or timely
medical removal. The decrease also may have resulted from under-
reporting of elevated BLLs.
BLL surveillance allows states to respond rapidly to reports
of individual elevated BLLs (or workplace-specific clusters) and to
conduct appropriate follow-up and prevention activities.
Standardization of BLL reporting by states is progressing and helps
to identify the magnitude of the problem and trends among U.S.
workers. A year 2000 national health objective is to eliminate
exposures that result in workers having blood lead concentrations
greater than 25 ug/dL (baseline: 4804 workers with BLLs greater
than 25 ug/dL in seven states in 1988) (objective 10.8) (3).
Substantial progress is needed to meet this objective.
Reported by: JP Lofgren, MD, Alabama Dept of Public Health. C
Fowler, MS, Arizona Dept of Health Svcs. FJ Mycroft, PhD,
Occupational Health Br, California State Dept of Health Svcs. BC
Jung, MPH, Connecticut Dept of Public Health and Addiction Svcs. M
Lehnherr, Occupational Disease Registry, Div of Epidemiologic
Studies, Illinois Dept of Public Health. R Gergely, Iowa Dept of
Public Health. E Keyvan-Larijani, MD, Lead Poisoning Prevention
Program, Maryland Dept of the Environment. R Rabin, MSPH, Div of
Occupational Hygiene, Massachusetts Dept of Labor and Industries.
A Carr, MBA, Bur of Child and Family Svcs, Michigan Dept of Public
Health. D Solet, PhD, Div of Public Health Svcs, New Hampshire
State Dept of Health and Human Svcs. B Gerwel, MD, Occupational
Disease Prevention Project, New Jersey State Dept of Health. R
Stone, PhD, New York State Dept of Health. S Randolph, MSN, North
Carolina Dept of Environment, Health, and Natural Resources. E
Rhoades, MD, Oklahoma 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, Div of Health Hazard
Evaluations, South Carolina Dept of Health and Environmental
Control. D Perrotta, PhD, Bur of Epidemiology, Texas Dept of
Health. D Beaudoin, MD, Bur of Epidemiology, Utah Dept of Health.
L Toof, Div of Epidemiology and Health Promotion, Vermont Dept of
Health. J Kaufman, MD, Washington State Dept of Labor and
Industries. H Anderson, MD, D Higgins, Wisconsin Dept of Health and
Social Svcs. Div of Surveillance, Hazard Evaluations, and Field
Studies, National Institute for Occupational Safety and Health,
CDC.
References
CDC. Surveillance of elevated blood lead levels among adults --
United States, 1992. MMWR 1992;41:285-8.
CDC. Adult blood lead epidemiology and surveillance -- United
States, 1992-1994. MMWR 1994;43:483-5.
Public Health Service. Healthy people 2000: national health
promotion and disease prevention objectives -- full report, with
commentary. Washington, DC: US Department of Health and Human
Services, Public Health Service, 1991; DHHS publication no.
(PHS)91-50212.
Table_1 Note:
To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.
TABLE 1. Reports of elevated blood lead levels (BLLs) among adults -- 22 states, * third quarter 1994
======================================================================================================
Third quarter 1994
Reported BLL -------------------------- Cumulative reports, Cumulative reports,
(ug/dL) No. reports No. persons + third quarter 1994 third quarter 1993 &
------------------------------------------------------------------------------------------------------
25-39 4,637 2,569 13,267 11,261
40-49 1,316 641 4,058 3,163
50-59 233 135 769 788
>=60 86 51 312 411
Total 6,272 3,396 18,406 15,623
------------------------------------------------------------------------------------------------------
* Reported by Alabama, Arizona, California, Connecticut, Illinois, Iowa, Maryland,
Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina,
Oklahoma, Oregon, Pennsylvania, South Carolina, Texas, Utah, Vermont, Washington, and
Wisconsin.
+ Individual reports are categorized according to the highest reported BLL for a person
during the given quarter. Pennsylvania reports only numbers of reports on a quarterly
basis; quarterly summaries of numbers of persons do not include Pennsylvania data.
& Data for first quarter 1993 reported from 17 states (Alabama, Connecticut, Illinois,
Iowa, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, Oregon,
Pennsylvania, South Carolina, Texas, Utah, Vermont, and Wisconsin). Data for second
and third quarters 1993 also include reports from Arizona, California, and Washington.
======================================================================================================
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