Adult Blood Lead Epidemiology and Surveillance

The National Institute for Occupational Safety and Health funds the Adult Blood Lead Epidemiology and Surveillance (ABLES)program, a state-based surveillance program of laboratory-reported adult blood lead levels. The goal of ABLES is to reduce the rate of adults(age 16 or older) who have blood lead levels of 25 micrograms per deciliter (mcg/dL) or greater (objective 20.7 in Healthy People 2010). The ABLES program objective is to build state capacity to initiate or improve adult blood lead surveillance programs which can accurately measure trends in adult blood lead levels and which can effectively intervene to prevent lead over-exposures.

Health Effects
Elevated blood lead levels (BLL's) in adults can damage the nervous, hematologic, reproductive, renal, cardiovascular, and gastrointestinal systems. The majority of cases are workplace-related. During 2003--2004, the industry sectors with the highest annual average numbers of resident adults with elevated BLLs were manufacturing, 4,622 (69%); construction, 1,252 (19%); and mining, 488 (7%). The specific industries with the highest numbers were manufacture of storage batteries, 2,499; painting, paperhanging, and decorating, 626; and mining of lead ores, 482. U.S. Department of Health and Human Services recommends that BLLs among all adults be reduced to <25 µg/dL. The highest BLL acceptable by standards of the U.S. Occupational Safety and Health Administration is 40 µg/dL. The geometric mean BLL of all adults in the United States is <3 µg/dL.

Program Description
ABLES state interventions to prevent lead over-exposures include: (1) conducting follow-up interviews with physicians, employers, and workers; (2) investigating work sites; (3) providing technical assistance; (4) providing referrals for consultation and/or enforcement; and (5) developing and disseminating educational materials and outreach programs.

ABLES states are required to have a mandatory state requirement that laboratories report blood lead level results to the state health department or designee. The lowest blood lead level to be reported varies from state to state.

Lead may be taken home from the workplace on clothes or in cars potentially exposing spouses and children. Children who come in contact with lead-exposed workers should be targeted for blood lead screening.

ABLES States
The ABLES program collects data from 40 funded states: Alabama, Alaska, Arizona, California, Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Maine, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Washington, Wisconsin, and Wyoming.