Adult Lead Exposure: Time for Change

Abstract

We have assembled this mini-monograph on adult lead exposure to provide guidance to clinicians and public health professionals, to summarize recent thinking on lead biomarkers and their relevance to epidemiologic research, and to review two key lead-related outcomes, namely, cardiovascular and cognitive. The lead standards of the U.S. Occupational Safety and Health Administration are woefully out of date given the growing evidence of the health effects of lead at levels of exposure previously thought to be safe, particularly newly recognized persistent or progressive effects of cumulative dose. The growing body of scientific evidence suggests that occupational standards should limit recent dose to prevent the acute effects of lead and separately limit cumulative dose to prevent the chronic effects of lead. We hope this mini-monograph will motivate renewed discussion of ways to protect lead-exposed adults in the United States and around the world.

Lead Exposure in Female Workers Who are Pregnant or of Childbearing Age

“…New findings of lead-related adverse reproductive outcomes have led to recommendations for women who are pregnant or of childbearing age to avoid occupational lead exposure, even at blood lead concentrations <10 µ g/dl 16,65) . A growing body of scientific evidence suggests that occupational exposure to 'safe' lead levels may not prevent toxicity, both in the acute setting and from cumulative doses 69) . In addition, there is no evidence of a threshold below which lead has no adverse health effects 70) .…”

Uncertainties in the Relationship between Tibia Lead and Cumulative Blood Lead Index

“…This compares to 5–10 μg/dL for 40 working years associated with Schwartz and Hu’s (2007) recommended CBLI of 200–400 μg-years/dL.…”

Evaluation of lead and isocyanate exposure in a maintenance facility with small arms repair and vehicle painting shops.

“…The PEL, REL, and TLV may prevent overt symptoms of lead poisoning, but do not protect workers from lead's contributions to conditions such as hypertension, renal dysfunction, reproductive, and cognitive effects [Brown-Williams et al 2009;Holland and Cawthorn 2016;Institute of Medicine 2012;Schwartz and Hu 2007;Schwartz and Stewart 2007]. Generally, acute lead poisoning with symptoms has been documented in persons having BLLs above 70 µg/dL.…”