Recommendations for medical management of adult lead exposure

Details

• Personal Author:
  Hipkins KL ; Hu H ; Kosnett MJ ; Materna BL ; Rothenberg SJ ; Schwartz BS ; Wedeen RP ; Woolf A
• Description:
  Research conducted in recent years has increased public health concern about the toxicity of lead at low dose and has supported a reappraisal of the levels of lead exposure that may be safely tolerated in the workplace. In this article, which appears as part of a mini-monograph on adult lead exposure, we summarize a body of published literature that establishes the potential for hypertension, effects on renal function, cognitive dysfunction, and adverse female reproductive outcome in adults with whole-blood lead concentrations < 40 microg/dL. Based on this literature, and our collective experience in evaluating lead-exposed adults, we recommend that individuals be removed from occupational lead exposure if a single blood lead concentration exceeds 30 microg/dL or if two successive blood lead concentrations measured over a 4-week interval are > or = 20 microg/dL. Removal of individuals from lead exposure should be considered to avoid long-term risk to health if exposure control measures over an extended period do not decrease blood lead concentrations to < 10 microg/dL or if selected medical conditions exist that would increase the risk of continued exposure. Recommended medical surveillance for all lead-exposed workers should include quarterly blood lead measurements for individuals with blood lead concentrations between 10 and 19 microg/dL, and semiannual blood lead measurements when sustained blood lead concentrations are < 10 microg/dL. It is advisable for pregnant women to avoid occupational or avocational lead exposure that would result in blood lead concentrations > 5 microg/dL. Chelation may have an adjunctive role in the medical management of highly exposed adults with symptomatic lead intoxication but is not recommended for asymptomatic individuals with low blood lead concentrations. [Description provided by NIOSH]
• Subjects:
  Blood Cardiovascular Diseases Cardiovascular System Environmental Monitoring Hematologic Tests Lead Lead Poisoning Men Occupational Health Pregnancy Safety Urogenital Diseases Urogenital System Women

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• Keywords:
  Author Keywords: Adult Lead Exposure Blood-samples Blood Lead Chelation Exposure-assessment Exposure-levels Exposure-limits Humans Hypertension Lactation Lead-absorption Lead-poisoning Medical Management Medical Surveillance Reproductive-effects Reproductive-hazards

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• ISSN:
  0091-6765
• Document Type:
  Text
• Funding:
  Grant ; Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  California ; Colorado ; Maryland ; Massachusetts ; Michigan ; New Jersey ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 8 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  463-471
• Volume:
  115
• Issue:
  3
• NIOSHTIC Number:
  nn:20037683
• Citation:
  Environ Health Perspect 2007 Mar; 115(3):463-471
• Contact Point Address:
  M. Kosnett, 1630 Welton St., Ste. 300, Denver, CO 80202 USA
• Email:
  Michael.Kosnett@uchsc.edu
• CAS Registry Number:
  Lead (CAS RN 7439-92-1)
• Federal Fiscal Year:
  2007
• Performing Organization:
  Johns Hopkins University
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Environmental Health Perspectives
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9ea1edd99551730297c7d0da1913092090ae617c6418d5efc09efcfd5244f67c3644dd28f8661f803de3a507dce85d7e26497587c815669f74364a712846d236
• Download URL:
  https://stacks.cdc.gov/view/cdc/191679/cdc_191679_DS1.pdf
• File Type:
  [PDF - 508.47 KB ]