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USA Case Definition of Adult (including Occupational) & Child Elevated Blood Lead Levels (EBLL)

This Information was provided by the National Institute for Occupational Safety and Health (NIOSH)
Adult Blood Lead Epidemiology and Surveillance (ABLES) program.

ABLES current case definition for an elevated blood lead level (BLL) is a blood lead concentration ≥ 10 µg/dL. The description below provides more details on the use of this updated case definition and the slide presents it in perspective with other reference blood lead levels.

In 2007 the AOEC published its Medical Management Guidelines for Lead-Exposed Adults (http://www.aoec.org/documents/positions/MMG_FINAL.pdf). In its medical surveillance section, it states that “New employees and those newly assigned to lead work should have a preplacement lead medical examination and BLL test, followed by periodic BLL testing, blood pressure measurement, and health status review. Monthly BLL testing is recommended for the first three months of employment for an initial assessment of the adequacy of exposure control measures. Subsequently, testing frequency can be reduced to every six months as long as BLLs remain below 10 μg/dL (0.48 μmol/L).”In the Pregnancy and Breast Feeding Concerns section “the panel’s recommendation is that the mother’s BLL should be kept below 5 μg/dL (0.24 μmol/L) from the time of conception through pregnancy.” And in the conclusions section “Clinicians are encouraged to advise patients of the risks associated with any elevation of lead level and to advocate strongly for environmental controls that would maintain BLLs below 10 μg/dL (0.48 μmol/L) wherever feasible.”

NIOSH case definition for an elevated blood lead level was updated in 2009:

“ADULT BLOOD LEAD EPIDEMIOLOGY & SURVEILLANCE (ABLES)

Program Description: ABLES is a state-based surveillance program of laboratory-reported adult blood lead levels. In 2009, the ABLES program updated its case definition for an Elevated Blood Lead Level for surveillance purposes as a blood lead concentration ≥ 10 µg/dl.” http://www.cdc.gov/niosh/topics/ABLES/description.html

Also in 2009, CSTE issued a position statement on lead: CSTE List of Nationally Notifiable Conditions. June 2009.

CSTE 2009 Position Statement. Public Health Reporting and National Notification for Elevated Blood Lead Levels http://www.cste.org/ps2009/09-OH-02.pdf

http://www.cste.org/dnn/LinkClick.aspx?fileticket=7CCxM20JUGg%3d&tabid=36&mid=1496

In 2010 CDC included, for the first time, elevated blood lead levels as a Nationally Notifiable Non-Infectious Conditions, using the same BLL (≥ 10 µg/dL) in the case definition.

Nationally Notifiable Non-Infectious Conditions. United States 2010. Elevated Blood Lead Levels:

http://www.cdc.gov/osels/ph_surveillance/nndss/phs/non_infdis2010.htm

http://www.cdc.gov/osels/ph_surveillance/nndss/casedef/lead_current.htm

Also in 2010, DHHS adopted the HP2020 objective OSH-7 “Reduce the proportion of persons who have elevated blood lead concentrations from work exposures Reduce the proportion of persons who have elevated blood lead concentrations from work exposures” (http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicid=30) and the operational definition for HP2020 is presented in http://www.healthindicators.gov/Indicators/Elevated-blood-lead-rates-in-adults_1300/National_0/Profile

To get to this page I suggest the following:

1- In the webpage http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=30 click on OSH-7

2- When this objective expands, click on the link below

3- Which will take you to the HHS Health Indicators Warehouse (http://www.healthindicators.gov/Indicators/Elevatedbloodleadratesinadults_1300/Profile/Data). In this page click on the “Overview” tab that will take you to the operational definition: http://www.healthindicators.gov/Indicators/Elevated-blood-lead-rates-in-adults_1300/National_0/Profile

“Starting in 2009, the ABLES case definition for elevated blood lead levels was changed from 25 µg to 10 µg/dL which is consistent with guidance from the Association of Occupational and Environmental Clinics and the Council of State and Territorial Epidemiologists. CDC has also included in 2010, for the first time, elevated blood lead levels (defined as BLL =>10 µg/dL) in the list of national notifiable conditions. Therefore, this measure uses the updated case definition of 10 µg/dL or greater”

This slide presents the ABLES case definition for an elevated blood level in perspective with other reference levels:

ABLES case definition for an elevated blood level in perspective with other reference levels

Thank you,

Walter A. Alarcon, MD MSc

Adult Blood Lead Epidemiology and Surveillance (ABLES) Program Project Officer

Surveillance Branch / Division of Surveillance, Hazard Evaluations and Field Studies

National Institute for Occupational Safety and Health

Centers for Disease Control and Prevention

4676 Columbia Parkway, R-17

Cincinnati, OH, 45226

Phone: 513-841-4451

Fax: 513-841-4489

NIOSH is a Federal agency responsible for conducting research and making recommendations for the prevention of work-related illnesses and injuries:

http://www.cdc.gov/niosh/about.html

NIOSH Safety and Health Topic: Adult Blood Lead Epidemiology and Surveillance (ABLES)

http://www.cdc.gov/niosh/topics/ABLES/ables.html

Additional Links

California. Workplace hazard alert. New Health Dangers from Lead. http://www.cdph.ca.gov/programs/olppp/Documents/LeadHazAlert.pdf

Health Effects of Low-level Lead Evaluation

NTP Monograph on Health Effects of Low-level Lead (June 2012)

http://ntp.niehs.nih.gov/?objectid=4F04B8EA-B187-9EF2-9F9413C68E76458E

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The LEAD Group Inc. Fact Sheet Index

NSW Lead Reference Centre and NSW Government Publications On this site PDF

  1. About the Global Lead Advice and Support Service (GLASS)

  2. Main Sources of Lead

  3. How Would You Know If You or Your Child Was lead poisoned?

  4. Lead aware housekeeping

  5. Ceiling dust & lead poisoning

  6. Is your yard lead safe?
    你的院子是铅安全的吗

  7. Health Impacts of lead poisoning

  8. Rotary Questionnaire

  9. Lead poisoned Pets and Your Family

  10. Childhood Lead Poisoning Risk Factor Questionnaire

  11. Is Your Child Safe From Lead? - What Can You Do About Lead?

  12. Lead in Drinking Water in Australia

  13. Have We Really Resolved The Lead Issue?

  14. The Importance of the Availability of "Spot Tests" for Lead in Paint

  15. Pregnant or Planning a Pregnancy

  16. Breastfeeding and Lead

  17. Lead in breast milk

  18. Beware The Lead In Lead Lighting

  19. Renting and Lead

  20. What to do if you have too much lead in your tank water PDF

  21. Lead Contamination in Stormwater PDF

  22. Contamination At Shooting Ranges PDF

  23. Banned: Leaded Wick Candles

  24. Lead, Ageing and Death
    铅,衰老和死亡

  25. Metal miniatures: How to minimise the risks of lead poisoning and contamination

  26. 7 Point Plan for the MANAGEMENT OF LEAD by Australian parents and carers

  27. Countries where Leaded Petrol is Possibly Still Sold for Road Use, As at 17th June 2011

  28. Lead Poisoning And The Brain - Cognitive Deficits And Mental Illness

  29. Facts and Firsts of Lead

  30. Lead mining royalties by state and territory

  31. Lead Mining Stewardship - Grey Lead and the Role of The LEAD Group

  32. Preventative Strategies of The LEAD Group

  33. What do Doctors need to do about Lead?

  34. A Naturopath's Experience Of Lead & People With Diagnosed Mental Illness

  35. Case File: Helping Manage Australian Lead in Petrol - How GLASS Works

  36. Glass Web & Service-Users, Experts & Volunteers, by Country; Countries with Leaded Petrol for Road Use & Worst Pollution

  37. Lead in ceiling dust

  38. Lead paint & ceiling dust management - how to do it lead-safely

  39. Esperance parliamentary inquiry follow-up factsheet: Where to from Here??
    埃斯佩兰斯议会调查后续情况说明书:从这里去哪里??

  40. Broken Hill lead miners factsheet 1893 with Note 20081015

  41. Helping a Doctor Help 35,000 Lead-Poisoned People Around the Lead Smelter at La Oroya in Peru
    Ayuda a un doctor que ayuda 35,000 personas envenenadas por plomo alrededor de la fundidora de plomo en la Oroya-Peru
    案例档案:帮助一个医生救助在秘鲁的拉奥罗亚的铅冶炼厂周围的35000铅中毒的人民全球铅咨询和支持的服务机构是怎末工作的

  42. Fact sheet for Australian toy importers and traders

  43. Iron Nutrition & Lead Toxicity PDF
    Informe de Acciones – Hierro y Plomo en la Nutrición PDF
    情况说明书铁的营养和铅的毒性 PDF

  44. Sanitarium-Are You getting Enough Iron PDF

  45. Do-It-Yourself-Lead-Safe-Test-Kits-flyer

  46. Blood lead testing: who to test, when, and how to respond to the result

  47. Dangers of a blood lead level above 2 µg/dL and below 10 µg/dL to both adults and children PDF
    血铅水平高于
    2微克/分升和低于10微克/分升对予成人和儿童的危险。
    PDF

  48. Lead Exposure & Alzheimer’s Disease: Is There A Link?

  49. In CHINA - Blood lead testing: who to test, when, and how to respond to the result
    在中国血铅测试:谁应该去检查,什么时候,如何对待不同的测试结果

  50. Why you should have your ceiling dust removed before you take advantage of the Australian government's Energy Efficient Homes Package: Insulation Program

  51. Alperstein et al Lead Alert - A Guide For Health Professionals 1994 PDF

  52. Ceiling Dust WorkCover Guide Lee Schreiber Final Nov 1999 PDF

  53. What can I do about climate change AND lead?

  54. The Need for Expert Clinical Assessments in Diagnosis Of Heavy Metal Poisoning

  55. Why you should have your ceiling dust removed before you have insulation installed

  56. Thirty Thought-Starters on Ceiling Void Dust in Homes

  57. Pectin: Panacea for both lead poisoning and lead contamination

  58. Nutrients that reduce lead poisoning June 2010 PDF

  59. Lead poisoning and menopause PDF

  60. Fact sheet For Schoolkids From Professor Knowlead About Lead PDF

  61. Prevention of Exposure to Lead at Work in Indonesia

  62. Mencegah kontak dengan timbal di tempat kerja di Indonesia

  63. How to Protect Your Family from Lead in Indonesia

  64. Bagaimana melindungi keluargamu dari timbal di Indonesia

  65. Cigarette Smoking & Lead Toxicity
     صحيفة معلومات: التدخين والتسمم بالرصاص

  66. Medical Evaluation Questionnaire For Occupational Lead Exposure

  67. Dangers of a blood lead level above 2 µg/dL and below 10 µg/dL to children

  68. Dangers of a blood lead level above 2 µg/dL and below 10 µg/dL to adults

  69. Biosolids used as fertilizer in China and other countries
    在中国和其他国家生物固体作肥料

  70. What are the lead poisoning risks of a lead pellet, bullet or shot lodged in the body?

  71. Alcohol’s link to higher lead and iron levels

  72. USA Case Definition of Adult (including Occupational) & Child Elevated Blood Lead Levels (EBLL)

  73. Low Level Lead Exposure Harms Children - A Renewed Call for Primary Prevention

  74. Occupational Health & Safety Fact Sheet Dangers of lead for roofers

  75. Let’s Make Leaded Petrol History - Let’s Make Leaded Gasoline History

  76. Lead, Your Health & the Environment. Available in Arabic, Chinese, English, Korean, Macedonian, Spanish, Turkish and Vietnamese  PDF

  77. Lead Safe Housekeeping PDF

  78. Old Lead Paint PDF

  79. Working safely with lead PDF

  80. A Renovator's Guide To The Dangers Of Lead (Brochure 30 pages) PDF

  81. A Guide For Health Care Professionals (Brochure 34 pages) PDF

  82. A Guide To Keeping Your Family Safe From Lead (Brochure 20 pages) PDF

  83. Lead Hazard Management In Children's Services (Brochure 15 pages) PDF

  84. A Guide To Dealing With Soil That Might Be Lead-Contaminated

  85. Exposure Assessment: Lead Neurotoxicity - Is the Center for Disease Control's goal to reduce lead below 10 µg/dl blood in all children younger than 72 months by 2010, good enough?

About Us | bell system lead poisoning | Contact Us | Council LEAD Project | egroups | Library - Fact Sheets | Home Page | Media Releases
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Last Updated 29 May 2014
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