Occupational exposure to heavy metals affecting various organ systems, poses a significant health risk to workers. Consequently, its precise estimation is of clinical concern and warrants the need for an analytical method with reliable precision and accuracy. Current study aimed to develop an analytical method using inductively coupled plasma mass spectrometry (ICPMS) to detect trace to elevated levels of potentially toxic elements in human blood. The sample preparation optimized using a two-step ramp temperature microwave acid digestion program. The toxic elements quantified using ICPMS operating in kinetic energy dispersion (KED) mode, adjusting data acquisition parameters and instrumental settings. The analytical method was validated using standard performance parameters. Each validation parameter aligned with the acceptable criteria outlined in standard guidelines. The method achieved optimal linearity (r2 > 0.99), recovery (85.60–112.00%), precision (1.35–7.03%), capable of detecting the lowest concentration of 0.32, 0.28, 0.28, and 0.19 µg/L, and quantifying trace levels of 1.01, 0.88, 0.90, and 0.62 µg/L for arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb), respectively. Post-validation, the method was applied to estimate heavy metals in blood samples from 250 Pb smelting plant workers, revealing potential health implications of occupational exposure. The cohort analysis revealed demographic and employment factors were associated with elevated blood lead levels (BLL), leading to symptoms and health risks. Clinical analysis indicated 33.6% participants experienced hypertension, and 20 were anemic at BLL above 300 µg/L. It emphasizes the importance of continuous monitoring, interventions, and improved occupational hygiene to protect the well-being of workers.