As each case may well represent hundreds of others, then workers who are exposed to lead would appear to be a huge potential market for pathology and other medical services, occupational health and hygiene assessment and training services, HEPA filter air conditioning, vacuuming and respirator technologies etc.

Lead poisoned workers also highlight the desperate need for in-service training for doctors in lead poisoning case management.

The LEADLINE Project is receiving more inquiries for information and referrals for the training of workers in lead safety.

Two members of The LEAD Group’s Technical Advisory Board, recognising the pressing need for immediate training in the workplace, have already established a training course in lead assessment and paint management in conjunction with Macquarie University’s Centre for Open Education.

Lead poisoning represents a serious threat to many industrial sectors. Not practicing adequate lead safe practices can mean expensive law suits, poisoned workers, increased insurance costs. Not addressing the problem of lead poisoning can increase the burden on insurance companies, the legal system and even expose the Government to litigation (as has happened in the USA).

The growing lead management industry and the rising awareness amongst occupational health and safety officers can save thousands of dollars for Australian industry. The USA already has an established lead abatement industry.

Case A worked with a firm which specialised in paint removal from houses in Brisbane. When he became ill, he "had no support from the medical profession" - he was "told he was imagining things". His blood lead was tested only because Workplace Health and Safety demanded that a blood lead test be done. His blood lead level was 5.2 µmol/L (110 µg/dL), which required chemical chelation. Two years on, he is still experiencing symptoms of dry retching, nausea and confusion.

Case B was a doctor, a G.P., who rang in a state of considerable concern because he had a patient who was "collapsing". His patient worked in a cadmium factory and had a blood lead level of 1.17 µmol/L (24 µg/dL). LEADLINE referred the G.P to a leading toxicologist who serves on The LEAD Group’s Technical Advisory Board.

Case C was a full war-service pensioner with prostate cancer. During the Second World War he was an artificer - "a gun mechanic" in the Artillery. The base on which he served was near the sea, and to prevent rust deterioration he was required to constantly coat all armaments and other metal equipment with red lead paint. In 1950 he and his wife underwent

tests at the Sterility Clinic at Royal North Shore Hospital, which showed that he had a sperm motility count of zero. He had surgery for his cancer in 1992, but he has had a recurrence since.

He felt he had been "battling a number of doctors over a period of time for information", and that the information he got from LEADLINE "was significantly helpful - it made it possible for me to ask more intelligent questions to get the information I needed".

LEADLINE also referred this inquirer to a professor from Macquarie University who was able to arrange for him to have a bone lead scan (a relatively recent innovation in medical assessment of lead in Australia and only rarely available in Sydney), which showed that he still had a bone lead level "in the top end of normal limits". Given that the half-life of lead is 15 years, this result would seem to indicate that the original exposure 40 years ago could have been significantly high.

Case D is the Hygiene, Health and Safety Adviser for a major Australian lead mine and smelter. He was seeking information to assist him in preparing an induction program for use with new workers in the company. The program is to make workers fully aware of the dangers related to working with lead, without creating a panic or strike situation. Such programs are the best insurance that companies can have against future claims that workers were not informed of the risks.

He described the information he received from LEADLINE as "invaluable to him professionally -he has used it constantly to back up his induction program, to understand the whole lead issue and to answer workers’ questions."

Case E was the wife of a 52 year old Telecom linesman who has been forced into early retirement for the last 8 years after 30 years working with Telecom. His blood lead level was tested 5 years ago, 3 years after leaving work, when he was not given the actual figure but told it was "slightly over what it should be". This means it could have been slightly over the NHMRC "level of concern" for the general population which at that time was 25 µg/dL; or slightly over the accepted level for lead workers, which was 70 µg/dL. Presuming that the process of demineralisation of the bone which occurs with old age was not contributing significantly to his blood lead at the age of 47, it is fairly safe to assume that his blood lead level 3 years earlier, when his ill health forced him to stop work, was excessive.

He was 15 when he started working with Telecom, and worked "in confined spaces, down manholes, there were no washing facilities, he came home in his overalls and nursed the children. All the doctors he was sent to by Telecom were the Telecom ones and they said there was nothing wrong with him. He got compensation of $100 a week for a little while after he left work - Telecom accepted responsibility only for "stress". They stopped it after a few months because they said if he wasn’t working then he shouldn’t be having stress. Most of the men who worked with him are dead - a lot committed suicide. "Those who are left don’t want to do anything about compensation".

Case F was the solicitor for a female petrol bowser operator (part-time) from Western Australia who accepted a $220,000 out-of-court settlement for her ill health due to exposure to leaded petrol.

Case G is a firearms instructor for the Security industry. He contacted LEADLINE after watching a TV home improvement program on lead paint. When he had his blood lead tested and found he had a blood lead level of 1.68 µmol/L (35 µg/dL) his doctor "was helpful, but I don’t think she knows that much about it herself". The senior police sergeant in charge of the Firearms Registry in his area had suggested that he be tested when the instructor started getting "very short-tempered". The Firearms Registry supervises all security firearms instructors in Victoria. The senior sergeant had been lead-poisoned himself (4.1 µmol/L - over 80 µg/dL) and needed chelation, and so was aware of the symptoms. The Victorian Police Department’s Central Firearms Registry has prepared a 5 page information leaflet for instructors on the dangers of lead poisoning.

The instructor had previously worked only on outdoor ranges. The day after running his first 3 hour course at an indoor range, he felt "generally off-colour. The range isn’t well-ventilated". After 12 of these sessions, "I have violent mood swings -my wife says it’s like bad PMT. I realise it at the time but I can’t stop myself. Any increase of pressure on me is hard to handle. When I go out into the sun, if I get a lot of UV, I know I’m going to get a lead dump. I get hot flushes - it feels like I’m spontaneously combusting from inside - my entire body heats up and breaks out into a sweat. [See article following "Lead Poisoning: the Summer Disease".] I have short term memory loss and I get a hot metallic taste in my mouth after work." He also suffers joint pain for which he is being treated with anti-inflammatories. His marriage has been put under considerable strain, but knowing the cause of his problems has made it easier for him and his wife to cope with them.

He has since been attending the same doctor who is treating the senior sergeant, and has been told he is "at a stage where he is going to be having some problems" and should consider chelation treatment, but he is self-employed and can’t afford to be out of work. Also he "has been told that there is a 50/50 chance of necrosis of the kidneys." He is trying to handle the situation by "keeping the gun work to a minimum" - he has not been back to the indoor range since his diagnosis, though he understands the people there have been making more of an effort to clean up the place, by "wetting down and sweeping."

When LEADLINE contacted the senior sergeant to obtain a copy of the Firearms Registry information on lead poisoning, he said that when he had been to the US for training he had been impressed with the ventilation of the indoor rifle/shooting ranges. He came back to teach for the Police Academy at the first Victorian indoor range and "It was a hole in the ground - they will not pay for ventilation or filtration. The Academy staff was lead poisoned from day one." He said that most pistol and rifle shooters would not know they could be at risk of lead poisoning, and would not know of the need for blood lead testing.

Case H is a 41 year old serving member of the Victorian Police Force who was a police pistol instructor for two years. Shortly after he commenced work at the range he had a blood lead level reading of 0.72 µmol/L (15 µg/dL).

After 2 years, his health began to fail He became ill and after a lengthy delay and numerous prescriptions of antibiotics he finally collapsed. He was lead tested and found to have a blood lead reading of 3.6 µmol/L (74.5 µg/dL). During his time at the pistol range he had requested from the Police Medical Branch that he be supplied with a copy of his readings, or at least be informed of his lead levels. His requests were rejected. He eventually took an action out in the Supreme Court, settled out of court and was awarded $10,000. He was tested again twelve months after leaving the range and still had a reading of 2.6 µmol/L (53.82 µg/dL). His doctor at that stage advised him that this reading was acceptable. It was subsequently found that this haematologist was referring to the old standard of 25 µg/dL.

He changed doctors and after two years of being "free from working at the range" he still had a reading which the doctor described as "very high". The new doctor, who contacted the LEADLINE Project, said that he had undertaken medical training during the 50’s and "knew a bit about lead probably because of the war." He had undertaken some research when the officer had presented and contacted the Flinders Medical Centre who told the doctor that there was no treatment. The doctor admitted his patient to hospital after the patient experienced a severe bout of depression and a treatment regime was undertaken involving BAL (British Anti Lewisite) This treatment of intramuscular injections was described by the patient as "excruciatingly painful, but I did feel better afterwards." The doctor commented that perhaps he should have given massive doses of Vitamin D to mobilise the lead during the treatment.

Seven years later the police officer has just had a normal reading of 0.40 µmol/L (8.28 µg/dL). He still has severe headaches that can last for two weeks, and is aware that he is sunlight sensitive. As a serving member of the Police Force he cannot always avoid sun exposure and this often leads to debilitating "migraine style headaches". He has been treated with morphine, pethidine and more recently with cortisone for the headaches. The cortisone is to reduce the brain swelling which the doctor attributes to the lead poisoning.

The police officer stated that "I didn’t realise that there was a problem. It just creeps up on you. One minute you are mad crazy and the next you are in a corner crying. I had mood swings from severe aggression to severe depression." He stated that his wife had commented in the past that "he was not the man she married" because of his mood swings. These had now improved as his blood lead levels decreased. He stated that they had no trouble conceiving their first child, who was 18 months old when he began work at the pistol range, but they did have difficulty conceiving their second child which was when he would have had high levels. He had also experienced a drop in libido for about two years, but that he just hadn’t recognised it as a problem at the time.

After the officer was transferred the range was "gutted" and the insulation bats which were about 10-12 cms thick were removed. "You can usually pick up a pack of twenty bats with no trouble." However, these bats were so heavy with impregnated lead that it took two men to lift each bat. He remembered that the ventilation system used to often be clogged up. He and other officers were provided with overalls, boots and a mask with a filter on the sides, but the mask was very uncomfortable to wear while cleaning out the bullet traps and "we didn’t wear them much. A helmet type mask would have been better". The range was cleaned by a civilian cleaner, but he did not clean the bullet traps, the police did. The office which they used was adjacent to the range and was their rest room, meal room, their total environment. It was often covered in a fine black dust.

He recently arrested a local man for assault and a domestic violence offence. Upon questioning, the offender was identified as a painter of some twenty five years experience who did a lot of work renovating old cottages, stripping back old paint. The officer referred him to his doctor, who subsequently attributed the painter’s "sudden, aberrant behaviour" to lead poisoning.

This police officer still has severe effects some seven years after being poisoned. He has recently received a call from the sergeant who took over his position at the range after he left, asking about his symptoms. He advised his replacement to have a medical check.

The police officer was being visited by a friend who was a pistol instructor for the security industry when the friend complained of a severe "across the front of the head" headache. Once again the officer recommended a visit to his doctor and the friend was found to have blood lead levels even higher than himself (see Lead Workers: Case G). The pistol instructor told the doctor that he had noticed he was having aggressive mood swings.