CSTE Leads Effort to Improve Blood Lead Reporting

/PRNewswire / -- Citing evidence that even a very low level of blood lead is a significant health risk at any age, the Council of State and Territorial Epidemiologists (CSTE) is recommending a change in the case definition of elevated blood lead levels in adults. In a vote at the CSTE annual conference in Buffalo, NY, State Epidemiologists approved a proposal to consider blood levels of 10 ug/dl or more in adults as "elevated" -- the same standard as currently exists for children.

Studies show that blood lead levels as low as 10 ug/dl contribute to an elevation in blood pressure and attendant health risks, including stroke. Low blood levels also are associated with an increase in mortality from heart disease, decreased kidney function and changes in cognition.

"Having this additional data will allow researchers, epidemiologists and the public to know more about the burden of lead poisoning across the age spectrum," CSTE President Mel Kohn, M.D., M.D.H. said. "While we often think of lead poisoning as a health concern in children and pregnant women, we need to address how lead poisoning is affecting adults, from exposure in the workplace and from hobbies such as target shooting."

The risk of lead poisoning is especially pronounced among workers in certain industries, including lead refining and smelting; construction work involving paint removal; manufacture of bronze and brass products such as plumbing fixtures; demolition and maintenance of outdoor metal structures such as bridges and water towers; and battery manufacturing and recycling.

Many occupational exposures are not identified because not all employers do the required occupational testing. Compounding the problem is the fact that only a fraction of known occupational cases are included in national health statistics, which currently only include counts of individuals with blood lead levels 25 ug/dl and greater.

Some states are already obtaining reports from laboratories of individuals with blood lead levels lower than 25 ug/dl and share this information with the Centers for Disease Control and Prevention/National Institute of Occupational Safety and Health Adult Blood Lead and Epidemiology (ABLES) Program. ABLES received reports of 12,935 adults with blood lead levels from 10-24 ug/dl who were tested in 2007 in 21 states, compared to reports of 5,419 adults with blood lead levels of 25 ug/dl and above in these same states. These reports are likely minimum estimates of the true magnitude of the problem.

"The current ABLES data for adults with blood lead levels of less than 25 ug/dl reflects only sporadic reporting," Dr. Kohn said. "The result is a significant underestimation of the health impact of elevated blood lead levels in the population of the United States that will be greatly alleviated by the new recommended reporting practices. With more complete reporting, we will have a clearer picture of the true scope of the problem to guide our efforts to prevent lead poisoning. This will reduce the toll of lead exposure on the health of Americans of all ages."

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