Elevated Blood Lead Levels in Adults — Missouri, 2012

BACKGROUND: Overexposure to lead, which is entirely preventable, may result in acute and chronic adverse health effects in multiple organ systems. Over 90% of adults with elevated blood lead levels (BLLs) in the United States are exposed occupationally. We characterized cases of elevated BLLs among Missouri adults because Missouri has historically had one of the highest prevalences of elevated adult BLLs. This information is useful to target interventions to prevent lead exposures.

METHODS: We reviewed 2012 data on Missouri residents ≥16 years from the Missouri Adult Blood Lead Epidemiology and Surveillance system, which receives reports of all BLLs from testing laboratories. We defined an elevated BLL as ≥10 µg/dL, the CDC reference level for adults, and used the highest reported value for residents tested more than once. We analyzed characteristics of those with elevated BLLs and calculated the prevalence of elevated BLLs among Missouri adults.  

RESULTS: Of the 15,286 residents with a BLL in 2012 (median: 2µg/dL, range: 0–178µg/dL), 2,973 (19.5%) had BLLs ≥10µg/dL. Most residents with an elevated BLL were > 35 years (70%), male (88%), and worked in Johnson, Jefferson, Dent, or Iron counties (55%). The majority of residents (78%) with an elevated BLL reported work-related exposures, most commonly from manufacturing (including storage battery manufacturing and smelting/refining [64%]) and mining industries (including lead and zinc ore mining [26%]). The prevalence of elevated BLLs among Missouri was 106 per 100,000 persons, markedly higher than the U.S. national average of 22 per 100,000 persons in 2012.

CONCLUSIONS: Interventions to prevent occupational exposure to lead should target high-risk industries like manufacturing and mining and should ultimately reduce the prevalence of elevated adult BLLs in Missouri.