1. ADULT LEAD EXPOSURE Richard Rabin Lead Registry Coordinator Massachusetts Division of Occupational Safety

2. Health Effects Cancer Cataracts High blood pressure Decreased life span Decreased cognition Peripheral arterial disease (PAD)

3. Sources - Occupational Construction Bridge painting House and commercial painting Deleading Demolition

4. Sources - Occupational Manufacturing Foundries Smelters Batteries Glass Plastics

5. Sources - Occupational Services/repair Autobody, paint refinishing Auto radiator repair Recycling – batteries, scrap metal, computers

6. OSHA Lead Standards General Industry (1978) Construction (1993)

7. OSHA Lead Standards Maximum allowable air lead level –.05 mg/m³ (50 mcg/m³) Protective measures Ventilation Respirators Personal protective clothing Separate eating area Showers, changing area Medical monitoring Medical exams Blood lead testing Medical removal, paid if blood lead => 50 mcg/dl

8. Sources - Non- occupational Firing ranges; “reloading” (at home) Home renovation and painting Remedies Litargirio Greta Ayurvedic medicines Herbs prepared in lead-soldered pots

9. Take-home Exposure Sources lead dust on body, clothes, shoes taken home contamination of home, car

10. Take-home Exposure Meta-analysis of 10 reports (NIOSH, 1999) Children of lead-exposed workers vs. US population Mean BLL: ~ 2.5 times higher Percent => 10 mcg/dl: 52% vs. 8.9% Percent => 20 mcg/dl: 21% vs. 1.1%

11. Take-home Exposure Construction workers study (NIOSH and NJ Health Dept., 1997) * most workers brought work clothes home; * employers with no shower facilities * dust lead levels higher in workers’ homes and cars than in controls’ * workers’ children’s BLL (26% => 10 mcg/dl) vs. controls’ BLL (5%)

12. Adult Lead Registries NIOSH Funding (~35 states) Coordination, data analysis Health People 2010 goal: elimination of BLLs => 25 mcg/dl

13. Adult Lead Registries Purposes Identify industries with over-exposures Identify individual companies Education for workers, management, physicians Publicize findings

14. Adult Lead Registries Basic elements Labs required to report (similar to childhood programs) Blood lead level (MA: => 15 mcg/dl) Patient information Physician information

15. Adult Lead Registries Follow-up Contact health care provider (HCP) Information on patient Educate HCP Contact patient/worker Interview Educate Workplace Industrial hygiene investigation Referral to OSHA- funded consultation Referral to OSHA Special projects – training, educational material

16. Adult Lead Registries Data analysis and dissemination Limitations Many workers/adults not tested Most registries do not receive reports of all tests (low levels)

17. House Painting High lead exposures Power sanding (up to a few mg/m³) Scraping Heat gun

18. House Painting Poor control of dust Sanding – no vacuum attachment Scraping – no misting Tracking dust from one area to another Dry sweeping Non-HEPA v acuuming

19. Data from 1996 – 2001 report (BLL => 40 mcg/dl) House and commercial painting (excl. bridge) – 94 (33% of occupational cases) Deleading - approx. 65 (23%) Workers with young children (< 6 years old) – approx. 25% Hispanic ethn. – 9.5% (4.7% in working pop.)

20. Data from 1996 – 2001 report (BLL => 40 mcg/dl) Compliance with OSHA lead standard Medical monitoring program House painters - 21% Deleaders – approx. 90% Training on lead hazards House painters – 29% Deleaders – approx. 90%

21. Data from 1996 – 2001 report (BLL => 40 mcg/dl) Non-occupational cases Home renovation & painting – 3% Target shooting – 3%