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BACKGROUND: The state-based Adult Blood Lead Epidemiology and Surveillance (ABLES) program is a network of 34 states conducting lead exposure surveillance and prevention. The National Institute for Occupational Safety and Health (NIOSH), an institute of the Centers for Disease Control and Prevention (CDC), provides guidance, and technical support to state health departments to build and maintain adult lead exposure surveillance capacity.
METHODS: State ABLES programs collect, analyze, and disseminate lead exposure data; identify new and high-risk lead exposures; follow-up with physicians, workers and employers; target workplaces for site visits where needed; provide referrals for consultation and enforcement; and target educational materials for employers, workers, and health care providers. NIOSH provides guidance to conduct lead exposure surveillance and prevention activities; calculates national and state rates and distribution by industry; disseminates findings and recommendations to stakeholders; and collaborates with State and Federal partners and worker-affiliated organizations to reduce lead exposures.
RESULTS: In the United States, 95% of BLLs ≥25 μg/dL in adults is work-related. Occupational lead exposure occurs mainly in the battery manufacturing, lead and zinc ore mining, and painting and paper hanging industries. The prevalence of elevated BLLs (≥10 µg/dL) declined from 26.6 adults tested per 100,000 employed in 2010 to 22.5 in 2012. The prevalence of BLLs ≥25µg/dL declined from 14 adults tested per 100,000 employed in 1994 to 5.7 in 2012.
CONCLUSIONS: There has been a reduction in environmental and occupational sources of lead exposure over the past several decades, but occupational lead exposures remains a national problem, and continued efforts to reduce lead exposures are needed. In addition, under-testing continues to occur in many industries where testing is required. Although federal funding for state ABLES programs was discontinued in 2013, several states continue to maintain their ABLES programs to address the persistent problem of occupational lead exposure. In this 30-minute discussion session, the State ABLES Program principal investigators, staff, and the NIOSH ABLES program will discuss strategies to continue lead surveillance and prevention, possible methods to increase employer testing, and how to improve ABLES data quality and ABLES data usage.