In November 2012, demolition and construction at an indoor gun range resulted in the largest outbreak of lead poisoning ever recorded in Washington state. Public Health-Seattle & King County (PHSKC) became aware of this outbreak when Washington state’s Division of Occupational Safety & Health (DOSH) requested assistance to prevent lead exposures in gun range customers. The PHSKC Health Officer and other Public Health staff then learned that medical removal under the current occupational lead standards is not required until employees’ blood lead levels (BLLs) reach 60 mcg/dL (in general industry) or 50 mcg/dL (in construction). Consequently, employees may continue to work while their BLLs are 40 mcg/dL and higher.
Recognizing the disparity between the requirements of the standards and the case definition of an elevated BLL in adults (≥10 mcg/dL), the Health Officer petitioned the Governor of Washington state and DOSH to update Washington state’s occupational lead standards. In response to this petition, DOSH initiated lead safety stakeholder meetings in October 2015, with the goal of developing recommendations to update the current standards.
METHODS:
During the lead stakeholder process, PHSKC requested Adult Blood Lead Epidemiology & Surveillance (ABLES) data for King County residents. The reporting period was January 1st, 2010 through December 31st, 2014.
RESULTS:
The ABLES dataset contained 570 blood lead reports for 182 adult patients; BLLs ranged from 10 mcg/dL to 73 mcg/dL. The majority of reports were associated with occupational exposures to male workers at 33 employers. Further analysis revealed a disproportionate burden of lead poisoning in vulnerable and underserved residents of King County. Overall, 22 percent of patients were Hispanic. In one company engaged in storage battery manufacturing (NAICS code 335911), 62 percent of patients were Hispanic and 35 percent were Asian (mostly Vietnamese). In a company that painted steel bridges (NAICS code 238320: Painting and wall covering contractor), 31 percent of patients were Hispanic.
CONCLUSIONS:
The current occupational lead standards do not provide sufficient protections against lead poisoning at work. Currently allowable work practices also increase the risk of take-home exposures, where lead may impact vulnerable family members, including children. In some industries, communities of color face a disproportionate burden of lead poisoning. Improvements to the occupational lead standards are urgently required, in addition to the development of education and outreach strategies that yield effective interventions in vulnerable populations.