Recommendations for Medical Management of Adult Lead Exposure
- 1 March 2007
- journal article
- review article
- Published by Environmental Health Perspectives in Environmental Health Perspectives
- Vol. 115 (3), 463-471
- https://doi.org/10.1289/ehp.9784
Abstract
Research conducted in recent years has increased public health concern about the toxicity of lead at low dose and has supported a reappraisal of the levels of lead exposure that may be safely tolerated in the workplace. In this article, which appears as part of a mini-monograph on adult lead exposure, we summarize a body of published literature that establishes the potential for hypertension, effects on renal function, cognitive dysfunction, and adverse female reproductive outcome in adults with whole-blood lead concentrations < 40 μg/dL. Based on this literature, and our collective experience in evaluating lead-exposed adults, we recommend that individuals be removed from occupational lead exposure if a single blood lead concentration exceeds 30 μg/dL or if two successive blood lead concentrations measured over a 4-week interval are ≥ 20 μg/dL. Removal of individuals from lead exposure should be considered to avoid long-term risk to health if exposure control measures over an extended period do not decrease blood lead concentrations to < 10 μg/dL or if selected medical conditions exist that would increase the risk of continued exposure. Recommended medical surveillance for all lead-exposed workers should include quarterly blood lead measurements for individuals with blood lead concentrations between 10 and 19 μg/dL, and semiannual blood lead measurements when sustained blood lead concentrations are < 10 μg/dL. It is advisable for pregnant women to avoid occupational or avocational lead exposure that would result in blood lead concentrations > 5 μg/dL. Chelation may have an adjunctive role in the medical management of highly exposed adults with symptomatic lead intoxication but is not recommended for asymptomatic individuals with low blood lead concentrations.Keywords
This publication has 92 references indexed in Scilit:
- Cumulative Lead Dose and Cognitive Function in Adults: A Review of Studies That Measured Both Blood Lead and Bone LeadEnvironmental Health Perspectives, 2007
- Lead Exposure and Cardiovascular Disease—A Systematic ReviewEnvironmental Health Perspectives, 2007
- The Epidemiology of Lead Toxicity in Adults: Measuring Dose and Consideration of Other Methodologic IssuesEnvironmental Health Perspectives, 2007
- Adult Lead Exposure: Time for ChangeEnvironmental Health Perspectives, 2007
- No cognitive deficits in men formerly exposed to leadWiener klinische Wochenschrift, 2005
- Effect of Maternal Bone Lead on Length and Head Circumference of Newborns and 1-Month-Old InfantsArchives of environmental health, 2002
- Blood Lead Level and Blood Pressure During Pregnancy in South Central Los AngelesArchives of environmental health, 1999
- Pre- and Postnatal Lead Effect on Head Circumference: A Case for Critical PeriodsNeurotoxicology and Teratology, 1999
- Blood pressure elevation in young dogs during low-level lead poisoningToxicology and Applied Pharmacology, 1988
- National Estimates of Blood Lead Levels: United States, 1976–1980The New England Journal of Medicine, 1982