What Is a Normal Blood Lead Level?

Details

• Corporate Authors:
  Michigan State University. College of Human Medicine
• Description:
  With the decrease in exposure to lead to the general public after its ban from residential paint in 1978, lead solder in tin cans for food in 1995, and gasoline in 1996 except for fuel in aircraft, racing cars, farm equipment, and marine engines, the average level of lead in the general population has decreased. In 2021, the Centers for Disease Control and Prevention (CDC) updated the Blood Lead Reference Value (BLRV) for children, decreasing it from 5 to 3.5 µg/dL. This reduction was based on the 97.5% percentile level in the general population measured in the 2015-2016 and 2017-2018 National Health and Nutrition Examination Survey cycles (NHANES) (Ruckart PZ, Jones RL, Courtney JG et al. Update of the blood lead reference value - United States, 2021. MMWR 2021 Oct 29; 70(43): 1509-1512). In recognition that there is no safe level of lead and accordingly no "normal" level, CDC no longer uses the term "elevated blood lead level" and, instead, uses "at or above the BLRV". Subsequently, CDC calculated that the 97.5% percentile level in adults was the same as that for children. Though commonly thought of as a problem unique to toddlers from the ingestion of paint chips, lead toxicity is also an important health issue in adults. One of the responses to the Flint Water Lead contamination was that in 2018 Michigan OSHA required that workers be removed from exposure to lead with blood leads ≥30 µg/dL, or three consecutive tests or all tests within the last six months > 20 µg/dL, or a detected medical condition which places the worker at an increased health risk from lead exposure. The worker cannot return to lead exposure until their blood lead is < 15 µg/dL. The new MIOSHA standard also eliminated the requirement to perform blood testing for zinc protoporphyrin (ZPP), a hemoglobin precursor increased after exposure to lead. These Michigan standards are in contrast to the rest of the country where the respective numbers are 60, 50 and 40 µg/dL. Each year in Michigan, approx. 16,000 individuals ≥16 years old are tested for lead exposure. The appropriate test is a venous blood sample for lead. Since all guidelines on treatment and management in adults are based on blood lead levels, a urine test for lead is not useful. See Table 1 for management guidelines for different blood lead levels. Treatment decisions should not be based on urine leads, particularly those done after administration of a chelating agent. There are 14 laboratories that analyze blood lead samples for blood drawn for lead in Michigan patients. At the date of this newsletter, eight have lowered their reference range for adult blood lead levels to 3.5 µg/dL, the other six continue to use a reference range of 5 µg/dL. All use a reference range of 3.5 µg/dL for children. [Description provided by NIOSH]
• Subjects:
  Environmental Pollution Occupational Exposure Occupational Health Safety
• Keywords:
  Blood Lead Levels Drinking Water Environmental Contamination Occupational Exposure Surveillance
• Publisher:
  Michigan State University-College of Human Medicine
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Newsletter
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-4
• Volume:
  33
• Issue:
  4
• NIOSHTIC Number:
  nn:20066668
• Citation:
  Project S.E.N.S.O.R. News 2022 Oct; 33(4):1-4
• Contact Point Address:
  MSU-CHM, West Fee Hall, 909 Fee Road, Room 117, East Lansing, MI 48824-1316
• CAS Registry Number:
  Lead (CAS RN 7439-92-1)
• Federal Fiscal Year:
  2023
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Project S.E.N.S.O.R. News
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1a2d375513279b2ffc0a8bb4886d6174ff502978583e0cd792d8248cae67a25773cf2fc3d4b9063e764095065541ffe0ce4b1428655c0aa8982ed61ede4856de
• Download URL:
  https://stacks.cdc.gov/view/cdc/230950/cdc_230950_DS1.pdf
• File Type:
  [PDF - 333.33 KB ]