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Adult Lead Exposure: A Guide for Health Care Providers



Details

  • Corporate Authors:
    Iowa. Department of Public Health
  • Description:
    How big of a problem is lead exposure in Iowa? In 2017, Iowa had 1,120 adults whose blood lead level was tested was at or above 5 micrograms per deciliter, the current public health reference value. Common jobs and hobbies with high lead exposure include: Manufacturing storage batteries or metal products; Construction and renovation; Industrial resurfacing or painting; Metal and electronics recycling; Radiator repair; Vehicle body work; Firing guns, casting or reloading ammunition. How does exposure occur? Lead dust or fumes can be inhaled or ingested. Lead is absorbed into the bloodstream and then distributed to all tissues, with the majority of the total body burden depositing in bone. Lead is slowly released from bone back into the blood with a half-life of years to decades. Lead is excreted primarily through the urine with smaller amounts in feces, sweat, hair, and nails. Chronic, low-level exposure impacts health and can worsen existing health issues. What are the health effects? Neurologic: Peripheral neuropathy, Fatigue, Irritability, Impaired concentration, Seizures, Encephalopathy. Reproductive: Miscarriage, Decreased sperm count and abnormal morphology. Hematologic: Anemia. Cardiovascular. Gastrointestinal: Nausea, Dyspepsia, Constipation, Abdominal pain, Gingival lead lines. Renal: Hypertension, Chronic nephropathy with proximal tubular damage. Other: Arthralgia, Myalgia. What is my role as a health care provider? If lead exposure is suspected, the patient's medical evaluation should include: An occupational and environmental history, including past blood lead tests; Possible hobby exposure; Lab testing with a venous blood lead level (BLL). If the BLL is elevated, obtain: Hemoglobin, hematocrit, red blood cell indices, with peripheral smear; BUN and serum creatinine; Routine urinalysis with microscopic examination; Pregnancy or male fertility testing, if requested by employee. All blood lead levels must be reported to the Iowa Department of Public Health, including patient address and name of employer if work-related. All health care providers should be aware of the Occupational Safety and Health Administration (OSHA) General Industry Lead Standard and the Construction Lead Standard. What should I discuss with patients? "Take-Home" Lead Lead can be brought into the home and family vehicle via skin, work clothes and equipment. Preschool children are especially at risk from contact exposure and the adverse developmental effects of lead. Discuss the following preventive measures with patients: Wash hands and face before eating, drinking, or smoking. Eat, drink and smoke only in areas free of lead dust and fumes. Wear a clean, properly fitted PAPR or respirator with HEPA filter in all areas that have lead dust or fumes. Shave to get the best fit. Fit check and medical evaluation are needed. Change into different clothes and shoes at work. Keep street clothes and shoes in a clean place. Shower before going home. Launder clothes separately from other family members' clothes. Screening for children- All children in Iowa should have a blood lead test at 1, 2 and 3 years of age. Consider annual testing through age 5. Concerns for pregnant women Pregnant women, those planning to get pregnant or those breastfeeding should have a blood lead level below 5 ug/dL to protect their health and the baby. Prior exposure should be evaluated. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • Publisher:
    Iowa Department of Public Health
  • Document Type:
    Text
  • Funding:
    Cooperative Agreement
  • Genre:
    Guidance
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Pages in Document:
    1-2
  • NIOSHTIC Number:
    nn:20059049
  • Citation:
    Des Moines, IA: Iowa Department of Public Health, 2019 Apr; :1-2
  • Contact Point Address:
    Iowa Department of Public Health, Lucas State Office Building, 321 E. 12th Street, Des Moines, IA 50319-0075
  • CAS Registry Number:
    Lead (CAS RN 7439-92-1)
  • Federal Fiscal Year:
    2019
  • Performing Organization:
    Iowa State Department of Public Health
  • Peer Reviewed:
    False
  • Start Date:
    20060701
  • Source Full Name:
    Adult lead exposure: a guide for health care providers
  • End Date:
    20210630
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:979556610693b7c875bcd4aea961fafe9af6525a8e587d358ddfe65dd53b85ba5ff4af0e65c94efb344df72610af752d95cc92b6e4d08d820b754ce804fc765b
  • Download URL:
  • File Type:
    Filetype[PDF - 267.82 KB ]
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