Objectives-To test a simple procedure for preparing samples for measurement of lead in blood plasma (P-Pb) and whole blood (B-Pb) by inductively coupled plasma mass spectrometry (ICP-MS), to measure P-Pb and B-Pb in lead workers and controls, and to evaluate any differences in the relation between B-Pb and PPb between people. Methods-P-Pb and B-Pb were measured by ICP-MS in 43 male lead smelter workers and seven controls without occupational exposure to lead. For analysis, plasma and whole blood were diluted 1 in 4 and 1 in 9, respectively, with a diluted ammonia solution containing Triton-X 100 and EDTA. The samples were handled under routine laboratory conditions, without clean room facilities. Results-P-Pb was measured with good precision (CV = 5%) even at concentrations present in the controls. Freeze storage of the samples had no effect on the results. The detection limit was 0*015 gye.The P-Pb was 0 15 (range 0.1-0.3) ug/l in controls and 1-2 (0.3-3.6) ug/l in lead workers, although the corresponding BPbs were 40 (24-59) ugll and 281 ug/l (1,ug Pb/l = 4'8 nmolIl). B-Pb was closely associated with P-Pb (r = 0.90).The association was evidently non-linear; the ratio B-Pb/P-Pb decreased with increasing P-Pb. Conclusions-By means of ICP-MS and a simple dilution procedure, P-Pb may be measured accurately and with good precision down to concentrations present in controls. Contamination of blood at sampling and analysis is no major problem. With increasing P-Pb, the percentage of lead in plasma increases. In studies of lead toxicity, P-Pb should be considered as a complement to current indicators of lead exposure and risk. (Occup Environ Med 1996;53:736-740)