# Presentation: 726142

## Trends in Occupational and Adult Lead Exposure in Wisconsin 1988 - 2005

- By
- Henry Anderson, MD
- Monirul Islam, MD, PhD
- Wisconsin Division of Public Health
- Bureau of Environmental and Occupational Health

##  Objectives Wisconsin Adult Blood Lead Epidemiology and Surveillance (ABLES) Program: 1988-2005

- Reduce Wisconsin’s burden of adult lead poisoning
- Track the screened individuals and their BLL over time
- Early identification of emerging industries and exposures needing technical assistance and education

## Wisconsin ABLES Programs Activities:

- The program receives statutorily required laboratory reports of blood lead testing of adult Wisconsin residents aged 16 and older.
- 1. Maintains a database of reported laboratory lead results which is used by all states participating in ABLES;
- 2. Through employer questionnaires and employee interviews Investigates the circumstances associated with adult blood lead levels greater than 40g/dL including employer awareness of lead hazards and regulatory requirements;

## Wisconsin ABLES Programs Activities (cont.):

- 3. Provides education about the health effects of lead and regulatory requirements to employers, employees, and the general public and;
- 4. Refers employers needing technical assistance to the Wisconsin OSHA Consultation Program.

## Wisconsin ABLES Program: Partnerships

- Wisconsin ABLES Program has the following Partnership Programs:
- Wisconsin OSHA Consultation Program
- WI State Laboratory of Hygiene
- Participating Employers throughout Wisconsin
- WI Childhood Lead Poisoning Surveillance
- WI Environmental Public Health Tracking Program
- WI Occupational Health and Surveillance Program

## Wisconsin Blood Lead Test 

- _Reports: 1988-2005_

**Notes:**
CSTE Occupational Health Indicators Workgroup

Total of 19 topic areas for Occupational Health
over 50 data measures

## Adult Blood Lead Level by Age 

| Age 
 | 0-24 
μg/dl (%) | 25-39
μg/dl (%) | 40-49
μg/dl (%) | 50-59
μg/dl (%) | >=60
μg/dl (%) |
| --- | --- | --- | --- | --- | --- |
| 15-24 yrs | 4,807 (95.0) | 202 (4.0) | 28 (0.6)  | 8 (0.2) | 10 (0.2) |
| 25-44 yrs | 17,940 (93.2) | 1,056 (5.5) | 147 (0.8) | 50 (0.2) | 54 (0.3) |
| 45-64 yrs | 9,949 (94.5) | 443 (4.2) | 87 (0.8)
 | 27 (0.3) | 17 (0.2) |
| 64+ yrs | 2,750 (98.6) | 29 (1.0) | 4 (0.2)
 | 1 (0.1) | 2 (0.1) |
| Total | 35,446 (94.3) | 1,730 (4.6) | 266 (0.7) | 86 (0.2) | 83 (0.2) |

- Adult Blood Lead Level by Age
- _WI Residents:1988-2005_

**Notes:**
CSTE Occupational Health Indicators Workgroup

Total of 19 topic areas for Occupational Health
over 50 data measures

## Percent of Adult Blood Lead by Employer 

|  | 0-24 μg/dl
Percent  | 25-39 μg/dl
Percent   | 40-49 μg/dl 
Percent | 50-59 μg/dl
Percent | >=60 μg/dl 
Percent |
| --- | --- | --- | --- | --- | --- |
| Electronic & Electrical Equip | 85.5 | 13.5 | 0.9 | 0.0 | 0.1 |
| Fabricated Metal Products | 77.7 | 18.6 | 2.3 | 0.7 | 0.7 |
| Primary Metal Industries | 65.2 | 26.1 | 4.9 | 1.7 | 2.1 |
| Construction Industries | 91.3 | 4.9 | 1.4 | 1.0 | 1.4 |
| Rubber & Misc Plastic Products | 66.9 | 28.7 | 3.6 | 0.8 | 0.0 |
| Machinery & Computer Equip | 96.0 | 2.8 | 0.6 | 0.3 | 0.3 |
| All Other Industries | 89.3 | 5.8 | 3.2 | 0.4 | 0.4 |

- Percent of Adult Blood Lead by Employer
- Standard Industrial Code Classification
- _WI Residents: 1988-2005_

**Notes:**
CSTE Occupational Health Indicators Workgroup

Total of 19 topic areas for Occupational Health
over 50 data measures

## Change in Blood Lead Level (BLL) Subsequent to Identified Elevated BLL 

| 
 | Number of 
Individuals | BLL
Decreased | BLL 
Increased |
| --- | --- | --- | --- |
| BLL >50 μg/dl | 110 | 70% | 24% |
| BLL >40 μg/dl | 360 | 62% | 28% |
| All cases with
multiple tests | 8,962 | 47% | 33% |

- Change in Blood Lead Level (BLL) Subsequent to Identified Elevated BLL
- _WI Residents:1988-2005_

**Notes:**
CSTE Occupational Health Indicators Workgroup

Total of 19 topic areas for Occupational Health
over 50 data measures

## Wisconsin Blood Lead Reports 

- _>39 __μg/dl: __1988-2005_

**Notes:**
CSTE Occupational Health Indicators Workgroup

Total of 19 topic areas for Occupational Health
over 50 data measures

## Wisconsin Mean Blood Lead (μg/dl) by Year: 1988-2005 

**Notes:**
CSTE Occupational Health Indicators Workgroup

Total of 19 topic areas for Occupational Health
over 50 data measures

## Wisconsin ABLES Program: Strengths

- Can passively track the time trend for individuals in a medical monitoring program and indirectly assess the success of employer efforts to reduce individual lead exposures
- Provides a means to evaluate the efforts to control and reduce occupational lead exposure
- Identify emerging hazardous circumstances and provide information to employees, employers and health care providers

## Wisconsin ABLES Program:  Limitations

- We should recognize several limitations of this surveillance system. The most important one is due to the passive data collection process, which makes longer gap between the actual data and the reporting.
- It also requires being cautious when interpreting the results due to the following facts:
- Underreporting of adult lead poisoning by employees, physicians, and employers
- Inadequate health care provider recognition of adult lead poisoning
- Possible exclusion of at-risk populations from surveillance (e.g. self-employed)

## Questions?