ANSWER: Nov 20 2010

Dear Bruce,

Thanks for supplying your mobile number so that I was able to phone you at work this morning. I'm sorry to hear that you had a migraine and had to leave work shortly after our phone call but it was good to get a better idea of the work you do at the lead smelter - using garnet to blast lead and other metals off the anodes. Please find attached our soon-to-be-web-published factsheet: Medical Evaluation Questionnaire For Occupational Lead Exposure If you can print it out and take it ASAP to your doctor, it should throw a lot of light on the issue if your doctor can fill it out for you. Before I can give you any other advice, I require a copy of your latest blood lead test results (the pathology report), and a copy of any previous blood lead test results. Is it possible for you to fax or email all your results to me? Or to ask your doctor or pathology clinic to fax or email them? Even if you have only ever been supplied with your blood lead results by phone by your employer, you are entitled to request a copy of all of them and I would strongly recommend that you do so - especially if you are planning to leave the state and work in South Australia on the construction of the Roxby Downs Desalination Plant. Too many times, patients have been given the wrong number or only a number and no unit for their blood lead result - I need to see the number and the unit and any interpretative number and unit on the report before I really know what your blood lead result is. From what you've reported, your blood lead result MIGHT be 48 micrograms per decilitre (48 µg/dL) and if so, then it is worthy of immediate action to limit further exposure and institute nutritional intervention.

You could also usefully print out our Fact Sheet –Iron Nutrition and Lead Toxicity - and take that to your doctor to discuss its recommendations in your case. It's important to know for instance whether you are iron deficient (and to treat you) before you return to potentially being exposed to lead at work. The doctor may be able to contact the lab to ask for iron studies to be done on the sample of blood used for your recent blood lead test. Giving up smoking will radically reduce your blood lead level, even if you already wash your hands before smoking at work.

Please see "Fact Sheet: Cigarette Smoking & Lead Toxicity" If your employer was serious about keeping blood lead levels down in their workers, they simply would not employ smokers. Although it was written for Indonesia, there is also a good "FACTSHEET: Prevention of Exposure to Lead at Work in Indonesia" which contains useful pointers for your boss. If such recommendations were to come directly from your doctor, do you think your boss would pay more attention or are you actually at risk of being fired because of your blood lead level and because you asked for your own doctor to test the lead in your blood instead of just believing the result reported verbally to you by your employer? I have already made a complaint to your state health department because of your employer's policy of sending worker's blood samples to South Australia in order to avoid the Tasmanian state legislation which requires Tasmanian pathology labs and Tasmanian doctors to report high blood lead levels to the health department?

Would you also like to make a complaint yourself? The number is 03 6222 7651. For the sake of your co-worker who has a blood lead level of 34 (µg/dL?), and for the sake of any less well-informed person who might replace you if you do get fired or leave, I'm thinking it would be good to ensure that South Australia, Western Australia, the Northern Territory and the Australian Capital Territory should all be encouraged to develop regulations which require pathology labs to report all blood lead levels to the state or territory health agency. That way, there'd be no lab left in Australia which could get away with not reporting high blood leads to the proper authorities and there'd be no company that could get away with allowing worker's blood lead levels to get so dangerously high.

Please see Dangers of a blood lead level above 2 and below 10 μg/dL to both adults and children to understand why we recommend that everyone have a blood lead level below 2 µg/dL. Even if you stop working at the lead smelter, you should have regular blood lead tests (and keep the reports), until your blood lead level comes down to 2 µg/dL. I can give much more specific advice if you send me all your blood lead results (and dates of testing in relation to when you began your work) as well as the filled out MEDICAL EVALUATION FOR LEAD EXPOSURE. It's also good to know what blast material you are using for "sand blasting". Sand of course is banned as a blast material, due to the risk of silicosis, but some states still allow the use of lead smelter waste as a blast material. Thus, in addition to the obvious source for the lead in your blood (the anodes that you are blasting), you may also be getting some lead (and other heavy metals) from your exposure to the blast material. Ask your boss for a Material Safety Data Sheet for all materials that you are required to use in your work - it is your right and it is your boss's duty to supply this information. Since the material that you are blasting off the anodes is very likely to also contain arsenic, cadmium and mercury (heavy metals which are all found in the lead concentrates that the smelter processes), you should also request tests for arsenic, cadmium and mercury from your doctor. Please get back to me with more information.

I will be leaving the office at 11am today so I hope this email provides enough advice for you to act on over the weekend if you don't reply before I leave.

Yours Sincerely

Elizabeth O'Brien