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1OSHA’s standard for lead in general industry 

expresses blood lead in units of mg/100g of whole 

blood. The standard for lead in construction 

expresses blood lead in units of mg/dL, which the 

agency explained is essentially equivalent to mg/ 

100g of whole blood (29 CFR 1926.62, Appendix A, 

II.B.3: Health Protection Goals of the Standard). For 

simplicity, this ANPRM expresses blood lead in 

units of mg/dL throughout. 

deductible only to the extent that the 

debt for which the guarantee is given 

has not been taken into account in 

computing the value of the gross estate 

under § 20.2053–7 or otherwise. 

* * * * * 

(7) * * * 

(iii) The claimant (C) is not a family 

member, related entity, or beneficiary of 

the estate of decedent (D), unless 

otherwise provided, and is not the 

executor (E). 

* * * * * 

(J) Example 10: Guarantee. On Date 1, 

D entered into a guarantee agreement 

with Bank (C) to secure financing for a 

closely-held business (LLC) in which D 

had a controlling interest. LLC was 

solvent at the time LLC executed a 

promissory note in the amount of $100x 

in favor of C. Prior to D’s death, LLC 

became insolvent and stopped making 

payments on the note. After D’s death, 

C filed a claim against D’s estate for 

payment of the remaining balance due 

under the note and E paid the full 

amount due. Although E had a right of 

contribution against LLC for primary 

payment of the indebtedness, LLC was 

insolvent and no part of the debt was 

collectible at the time E deducted the 

payment. D’s estate may deduct the 

amount paid to C in satisfaction of D’s 

liability under the guarantee agreement. 

The guarantee agreement is considered 

to have been contracted for an adequate 

and full consideration in money or 

money’s worth. The result would be the 

same if D did not have control of LLC 

as long as the fair market value of D’s 

interest in the LLC on Date 1 was at least 

$100x. 

* * * * * 

(f) Applicability date. The rules of this 

section apply to the estates of decedents 

dying on or after [date of publication of 

the final rule in the Federal Register]. 

Paul J. Mamo, 

Acting Deputy Commissioner for Services and 

Enforcement. 

[FR Doc. 2022–13706 Filed 6–24–22; 4:15 pm] 

BILLING CODE 4830–01–P 

DEPARTMENT OF LABOR 

29 CFR Parts 1910 and 1926 

[Docket No. OSHA–2018–0004] 

RIN 1218–AD10 

Advance Notice of Proposed Rule 

Making (ANPRM)—Blood Lead Level 

for Medical Removal 

AGENCY: Occupational Safety and Health 

Administration (OSHA), Labor. 

ACTION: Advance Notice of Proposed 

Rulemaking (ANPRM). 

SUMMARY: OSHA is considering 

rulemaking to revise its standards for 

occupational exposure to lead based on 

medical findings since the issuance of 

OSHA’s lead standards that adverse 

health effects in adults can occur at 

Blood Lead Levels (BLLs) lower than the 

medical removal level (≥60 mg/dL in 

general industry, ≥50 mg/dL in 

construction) and lower than the level 

required under current standards for an 

employee to return to their former job 

status (<40 mg/dL).1 The agency is 

seeking input on reducing the current 

BLL triggers in the medical surveillance 

and medical removal protection 

provisions of the general industry and 

construction standards for lead. The 

agency is also seeking input about how 

current ancillary provisions in the lead 

standards can be modified to reduce 

worker BLLs. 

DATES: Submit comments on or before 

August 29, 2022. 

ADDRESSES: You may submit comments 

and attachments, identified by Docket 

No. OSHA–2018–0004, electronically at 

www.regulations.gov, which is the 

Federal e-Rulemaking Portal. Follow the 

instructions online for making 

electronic submissions. 

Instructions: All submissions must 

include the agency’s name and the 

docket number for this ANPRM (Docket 

No. OSHA–2018–0004). When 

uploading multiple attachments into 

Regulations.gov, please number all of 

your attachments because 

www.regulations.gov will not 

automatically number the attachments. 

For example, Attachment 1—title of 

your document, Attachment 2—title of 

your document, Attachment 3—title of 

your document, etc. When submitting 

comments or recommendations on the 

issues that are raised in this ANPRM, 

commenters should explain their 

rationale and, if possible, provide data 

and information to support their 

comments or recommendations. 

Wherever possible, please indicate the 

title of the person providing the 

information and the type and number of 

employees at your worksite. 

All comments, including any personal 

information you provide, will be placed 

in the public docket without change and 

will be publicly available online at 

www.regulations.gov. Therefore, OSHA 

cautions commenters about submitting 

information they do not want to be 

made available to the public or 

submitting materials that contain 

personal information (either about 

themselves or others) such as Social 

Security Numbers and birthdates. 

Docket: To read or download 

comments or other material in the 

docket, go to Docket No. OSHA–2018– 

0004 at www.regulations.gov. All 

comments and submissions are listed in 

the www.regulations.gov index; 

however, some information (e.g., 

copyrighted material) is not publicly 

available to read or download through 

that website. All submissions, including 

copyrighted material, are available for 

inspection at the OSHA Docket Office. 

Documents submitted to the docket by 

OSHA or stakeholders are assigned 

document identification numbers 

(Document ID) for easy identification 

and retrieval. The full Document ID is 

the docket number plus a unique fourdigit code. OSHA is identifying 

supporting information in this ANPRM 

by author name and publication year, 

when appropriate. This information can 

be used to search for a supporting 

document in the docket at https://

www.regulations.gov. Contact the OSHA 

Docket Office at 202–693–2350 (TTY 

number: 877–889–5627) for assistance 

in locating docket submissions. 

FOR FURTHER INFORMATION CONTACT:

Press Inquiries: Contact Frank 

Meilinger, Director, Office of 

Communications, U.S. Department of 

Labor; telephone (202) 693–1999; email 

meilinger.francis2@dol.gov. 

General and technical information: 

Contact Andrew Levinson, Acting 

Director, Directorate of Standards and 

Guidance, U.S. Department of Labor; 

telephone (202) 693–1950; email 

Levinson.andrew@dol.gov. 

SUPPLEMENTARY INFORMATION: The 

Supplementary Information section 

follows this outline: 

Table of Contents 

I. Background 

A. Events Leading to This Action 

B. Industry Profile Information 

C. Health Effects of Lead Exposure 

II. Request for Input 

A. Blood Lead Triggers for Medical 

Removal Protection 

B. Medical Surveillance Provisions 

C. Permissible Exposure Limit (PEL) 

D. Personal Protective Equipment (PPE), 

Hygiene, and Training 

E. Safe Harbor Compliance Protocols 

F. Environmental Effects 

G. Duplicative, Overlapping, or Conflicting 

Rules 


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2Take-home lead contamination occurs when 

lead dust is transferred from the workplace on 

employees’ skin, clothing, shoes, and other personal 

items to their vehicle and home. Take-home lead 

can be a chronic source of exposure for workers and 

exposures to household members (NIOSH 1995). 

H. Questions for Employers on Current 

Practices 

I. Background 

A. Events Leading to This Action 

OSHA’s lead standard for general 

industry (29 CFR 1910.1025), adopted in 

1978, established a permissible 

exposure limit (PEL) airborne 

concentration of 50 mg/m3 averaged over 

an 8-hour period and was based on 

consideration of health effects, 

feasibility issues, and the goal to keep 

BLLs below 40 mg/dL for the majority of 

workers occupationally exposed to lead 

(43 FR 54191). During approximately 

the same time-frame, the United States 

Congress enacted a law to provide 

Federal financial assistance to help 

cities and communities eliminate the 

causes of lead-based paint poisoning 

and detect and treat incidences of lead 

poisoning (Pub. L., 91–695; 42 U.S.C. 

Ch. 63). Additionally, the Consumer 

Products Safety Commission (CPSC) 

implemented regulations prohibiting 

lead from most consumer products and 

banned lead from residential paint (16 

CFR 1303). The U.S. Environmental 

Protection Agency (EPA) and the U.S. 

Department of Housing and Urban 

Development (HUD) enacted rules to 

reduce human and environmental 

exposure to lead (24 CFR 35; 40 CFR 80; 

40 CFR 745). 

In 1992, OSHA promulgated an 

interim final rule for lead exposure in 

construction (29 CFR 1926.62) as 

required by Title X of the Housing and 

Community Development Act of 1992 

(102 Pub. L. 550). This rule amended 

Subpart D of 29 CFR part 1926 by 

adding a new section, 1926.62, that 

lowered the existing lead PEL in 

construction to 50 mg/m3 and included 

ancillary provisions similar to those in 

the general industry lead standard. 

OSHA’s general industry and 

construction standards contain medical 

removal provisions for workers whose 

BLLs exceed a certain level: in general 

industry, when a periodic and a followup blood test result show BLL ≥60 mg/ 

dL, or an average of the last three blood 

lead tests show BLL ≥50 mg/dL; and in 

construction, when a periodic and a 

follow-up blood test result show BLL 

≥50 mg/dL. These workers must be 

temporarily removed to a job with 

exposures at or below the action level 

(58 FR 26590). 

In 1992, the U.S. Congress passed the 

Workers’ Family Protection Act (29 

U.S.C. 671a). The Act required the 

National Institute for Occupational 

Safety and Health (NIOSH) to report on 

take-home contamination from 

workplace chemicals and substances, 

including lead.2 NIOSH found takehome exposure to be a widespread 

problem (NIOSH, 1995). The report 

identified workplace measures that are 

effective in reducing take-home 

exposure such as changing clothes 

before going home and leaving soiled 

clothing at work for laundering, storing 

street clothes in areas separate from 

work clothes, showering before leaving 

work, and prohibiting removal of toxic 

substances or contaminated items from 

the workplace, in addition to citing the 

importance of primary prevention by 

limiting exposure in the workplace. 

NIOSH noted that preventing take-home 

exposure is critical because 

decontaminating homes and vehicles is 

not always effective. 

In 1996, OSHA implemented a 

Special Emphasis Program (SEP) for 

lead in construction (CPL 2.105) in 

response to documented elevated BLLs 

in construction workers. The SEP 

established a mechanism for 

programmed health inspections of 

construction sites where lead may be 

present. In 2001, OSHA implemented a 

National Emphasis Program (NEP) for 

lead (CPL 2–0.130). The NEP was 

implemented to direct OSHA’s field 

inspection efforts to reduce 

occupational exposures to lead. This 

ongoing NEP includes general industry, 

construction, longshoring, and marine 

terminals. OSHA updated its NEP for 

lead in 2008 and expanded its targeting 

in 2013 to include indoor and outdoor 

firing ranges and recycling industries 

(OSHA, 2008; OSHA, 2013). In 2007, 

OSHA completed a Regulatory 

Flexibility Act Section 610 review and 

Executive Order 12866 lookback review 

of 29 CFR 1926.62 Lead in Construction 

(OSHA, 2007). The agency found that 

for the hazards associated with lead in 

the construction industry, a mandatory 

standard remains necessary to 

adequately protect employees. The 

lookback study also concluded that the 

lead in construction standard has not 

had negative economic impacts on 

business, including small businesses, 

and therefore remains economically 

feasible. 

Exposure to lead is associated with 

adverse health effects, including but not 

limited to effects on the reproductive, 

cardiovascular, neurological, 

respiratory, and immune systems. Since 

promulgation of OSHA’s lead standards, 

extensive research has been published 

indicating adverse health effects in 

adults at lower levels than had been 

previously documented (see, e.g., AOEC 

2007; NTP 2012; ATSDR 2020; ACGIH 

2013; EPA 2013). A variety of public 

health and government organizations 

have developed recommendations or 

revisions to standards to more 

stringently limit occupational exposures 

to lead and manage the effects of 

exposure in exposed workers. In 2007, 

the Association of Occupational and 

Environmental Clinics (AOEC) 

published guidelines for medical 

management of lead exposed adults 

(with special emphasis on those 

exposed to lead at work). The 

recommendations included: clinical 

assessment with detailed medical, 

occupational, and environmental 

history, physical exam, BLL 

determination, and other labs (CBC, 

BUN, Creatinine, Urine Analysis, EP); 

medical surveillance with follow-up 

BLL; and medical management with 

evaluation of exposures and risk factors, 

family and social context, and 

consideration for potential removal from 

exposure (AOEC, 2007). In 2016, the 

American College of Occupational and 

Environmental Medicine (ACOEM) 

released a Position Statement on 

Workplace Lead Exposure 

recommending revisions to OSHA’s AL 

and PEL; workplace hygiene 

requirements; medical surveillance and 

medical removal protection provisions; 

and introduction of surface lead dust 

requirements (ACOEM 2016, p. e371). 

The Department of Defense (DOD) 

commissioned the National Research 

Council (NRC) to conduct a study to 

determine whether current OSHA 

exposure standards used on firing 

ranges are protective. The committee 

concluded that the current OSHA 

standard of a BLL of under 40 mg/dL is 

not sufficiently protective of personnel 

who have repeated lead exposures on 

firing ranges (NRC, 2013). DOD 

subsequently lowered the medical 

removal triggers for BLLs in military 

and civilian DOD personnel. DOD’s 

medical removal is based on BLLs at or 

greater than 20 mg/dl, and employee 

return to work when BLL is at or below 

15 mg/dL (DOD, 2018, p. 55; Table 

C4.T2, pp. 57–61). In 2018, NIOSH 

published a Request for Information 

(RFI) indicating NIOSH’s intent to 

update its recommended exposure limit 

(REL) for inorganic lead and to develop 

updated recommendations for handling 

of inorganic lead and medical 

surveillance in the workplace (NIOSH 

2018). 

Several states have initiated updates 

to their occupational lead standards. In 

2018 Michigan OSHA’s State Plan 


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(MIOSHA) in the Michigan Department 

of Licensing & Regulatory Affairs 

revised its lead standards for general 

industry and construction. The 

revisions included changing the BLL at 

which an employee is required to be 

removed from lead exposure, previously 

50 mg/dL, to 30 mg/dL for both 

standards. In addition, the BLL at which 

an employee may be returned to work 

involving lead exposure was changed 

from < 40 mg/dL to 15 mg/dL in both 

standards. MIOSHA also removed a 

previous requirement to analyze for the 

zinc protoporphyrin (ZPP) level. 

MIOSHA’s revisions followed 

recommendations developed by a group 

of stakeholders over the course of 

meetings held in 2017 and 2018. The 

group’s proposed revisions to the 

occupational standards were the subject 

of public hearings in August 2018 and 

became effective in December 2018 

(MOEMA 2019, p. 8). Michigan’s 

revisions did not alter the PEL for lead. 

The California Department of Public 

Health (CDPH) Occupational Lead 

Poisoning Prevention Program made 

recommendations for revisions to the 

California OSHA (Cal/OSHA) lead 

standards for general industry in 2010 

and construction in 2011, including 

recommendations to lower the BLLs for 

medical removal and return to former 

job status; require more frequent BLL 

testing; broaden the provision and 

notification processes for BLL testing for 

exposed workers; and lower the 8-hour 

time-weighted average (TWA) PEL 

(CDPH, 2010; CDPH, 2011). CDPH’s 

recommendation for lowering the PEL 

was based on a report produced by the 

California Environmental Protection 

Agency (Cal/EPA, Office of 

Environmental Health Hazard 

Assessment (OEHHA)) that used an 

updated physiologically-based 

pharmacokinetic (PBPK) model to 

characterize the relationship between 

air lead levels and BLLs (OEHHA, 

2014). 

Cal/OSHA has held advisory meetings 

to discuss potential changes to its lead 

standards and has published a 

discussion draft of possible 

amendments to the existing regulations 

in general industry and construction 

operations. California’s most recent 

discussion draft includes a medical 

removal level of 30 mg/dL for a single 

test result; or when the last two monthly 

blood lead tests are ≥ 20 mg/dL; or when 

the average of the results of all blood 

lead tests conducted in the last 6 

months is at or above 20 mg/dL of whole 

blood. The discussion draft includes a 

return to former job status when two 

consecutive blood lead tests are ≤ 15 mg/ 

dL. The discussion draft also includes a 

reduction in the PEL from 50 mg/m3 to 

10 mg/m3 and the AL from 30 mg/m3 to 

2 mg/m3, among other changes. The 

discussion draft and related documents 

are available at https://www.dir.ca.gov/ 

dosh/DoshReg/5198Meetings.htm. 

Washington State Department of 

Labor & Industries, Division of 

Occupational Safety and Health 

(Washington DOSH), is also developing 

a variety of updates to Washington 

State’s occupational lead standards. In 

2012, Public Health—Seattle and King 

County (PHSKC) petitioned the 

Washington State Department of Labor 

& Industries to update the occupational 

lead standards, including the BLLs for 

medical removal and return to former 

job status; the AL and PEL; and 

provisions for protective clothing, 

hygiene, medical surveillance, training, 

and education. Washington DOSH has 

proposed lowering its medical removal 

BLL to ≥ 30 mg/dL for a single test result, 

≥ 20 mg/dL for multi-test results, and a 

return to former work status BLL of < 15 

mg/dL. Washington DOSH has also 

proposed a reduction in the PEL from 50 

mg/m3 to 20 mg/m3, among other changes 

to the lead standard. Washington 

DOSH’s stakeholder review draft (2019) 

and other information related to its 

stakeholder meetings on the lead rule 

revision process are available at https:// 

lni.wa.gov/safety-health/safety-rules/ 

rulemaking-stakeholder-information/shrules-stakeholder-lead. 

OSHA is also considering revisions to 

its lead standards. Through this 

ANPRM, OSHA seeks input on the BLL 

triggers used for medical removal and 

return to work status. The agency also 

requests information on other potential 

changes to the current standards to 

reduce the risk of adverse health effects 

from occupational lead exposure. 

B. Industry Profile Information 

In accordance with OSHA’s intent to 

assess the potential impacts of revising 

blood lead triggers for medical removal 

protection, the agency made preliminary 

estimates of the annual number of firms, 

by industry, expected to have workers 

with elevated BLLs. For these estimates, 

OSHA used the reporting levels in 

CDC’s Adult Blood Lead Epidemiology 

and Surveillance (ABLES) dataset of 5 

mg/dL, 10 mg/dL, and 25 mg/dL, and 

OSHA’s lead standards’ medical 

removal levels (50 mg/dL for 

construction and 60 mg/dL for general 

industry). 

OSHA identified the industry sectors 

associated with lead exposure as those 

found in the ABLES dataset. This 

dataset shows that the national 

prevalence rate of BLLs ≥10 mg/dL for 

adults declined from 26.6 adults per 

100,000 employed in 2010 (among 37 

reporting states) to 15.8 in 2016 (among 

26 reporting states). For context, the 

geometric mean BLL for all adults in the 

US (including workers) was 0.855 mg/dL 

in 2018 (HHS, 2022). Historically, in the 

U.S., most lead exposures among adults 

have been occupational. Among the 

11,695 adults with known lead 

exposures at BLL of ≥10 mg/dL in 2016, 

90.3% had occupational exposures. The 

majority of these adults were employed 

in four main industry sectors: 

manufacturing, construction, services, 

and mining (NIOSH, 2016). 

To help inform the rulemaking 

process, OSHA contracted with Abt 

Associates to generate preliminary 

estimates of the number of 

establishments and cases across all 

states at the ABLES reporting levels of 

5 mg/dL, 10 mg/dL, 25 mg/dL, and the 

lead standards’ medical removal levels 

(50 mg/dL for construction and 60 mg/dL 

for general industry). The first step was 

to identify industry sectors associated 

with lead exposure by 4-digit NAICS 

that were identified in a 2017 CDPH 

report (Payne, 2017), industries 

identified by OSHA in the personal 

sampling data reported by the OSHA 

Information System (OIS) (OSHA, 

2020a), and industries with violations of 

lead exposure medical surveillance 

requirements in the last 10 years of 

OSHA inspections and violations 

(OSHA, 2020b; OSHA, 2020c). To 

estimate the number of workers with 

BLLs at or above each ABLES reporting 

level and the OSHA standards’ medical 

removal levels by NAICS, BLL data from 

the ABLES program and the CDPH 

Occupational Blood Lead Registry for 

the years 2012–2014 and 2015–2018 

(Payne, 2017; CDPH, 2020a; CDPH, 

2020b) were pooled. Because ABLES 

data are limited to those states that 

report testing results to ABLES, the next 

step was to use U.S. Census data to 

extrapolate a preliminary estimate of the 

national number of cases from the 

ABLES state data. The method and 

results are described in full in the 

memorandum entitled Estimated 

Number of Work-Related BLL Cases and 

Firms (Abt Associates, 2021). This 

memorandum includes a table that 

provides the number of firms with 

preliminary BLL estimates at or above 

the relevant levels (the ABLES reporting 

levels and the OSHA standards’ medical 

removal levels) and a table that provides 

the number of workers with preliminary 

BLL estimates at or above the relevant 

levels; the preliminary BLL estimates 

are presented by industry. In Appendix 

A at the end of this ANPRM, Table 1 

‘‘Summary of Annual Number of Firms 


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with BLL Tests and Cases’’ presents the 

estimated number of firms where 

employees received test results that 

were at or above each ABLES reporting 

level and the OSHA standards’ medical 

removal levels. 

Of 44,144 firms where employee BLLs 

are tested, 8,611 firms were estimated to 

have recorded BLLs equal to or above 5 

mg/dL, while 2,087, were estimated to 

have recorded BLLs at or above 25 mg/ 

dL; only 137 firms were estimated to 

have baseline BLL cases annually 

resulting in medical removal protection 

under OSHA’s existing requirements 

(BLLs greater than or equal to 50 and 60 

mg/dL for construction and general 

industry, respectively). 

This preliminary analysis shows that, 

among all affected employers, 

approximately 44 percent of firms 

where employee BLL is tested are in five 

industry groups: NAICS 7139: Other 

Amusement and Recreation Industries 

(6,656 firms); NAICS 3272: Glass and 

Glass Product Manufacturing (5,156 

firms); NAICS 8111: Automotive Repair 

and Maintenance (3,333 firms); NAICS 

2383: Building Finishing Contractors 

(2,746 firms); and NAICS 5629: 

Remediation and Other Waste 

Management Services (1,663 firms). 

OSHA requests public input on the 

agency’s preliminary profile of affected 

industries, in particular the list of 

affected NAICS industries and the 

estimated number of firms that have 

workers with BLLs at or above the 

selected thresholds. 

C. Health Effects of Lead Exposure 

Exposure to lead is associated with 

adverse health effects, including but not 

limited to effects on the reproductive, 

cardiovascular, neurological, 

respiratory, and immune systems. As 

highlighted by a National Research 

Council report (NRC, 2013), lead has 

been shown to have both acute and 

chronic toxic effects, affecting virtually 

every organ and system in the body 

(ATSDR, 2020). Since OSHA’s lead 

standard for general industry was 

promulgated, BLLs in the general adult 

population have declined from an 

overall mean blood-lead level of 15.8 

mg/dL (1976–1980) to 0.855 mg/dL in 

2018, primarily reflecting the decrease 

in lead used in gasoline production, as 

well as the removal of lead from 

consumer paint (CDC, 1982; HHS, 2022, 

p. 212; ATSDR, 2020, p. 2). However, 

extensive research has emerged 

indicating that adverse health effects 

can occur in adults with lower BLLs 

than was previously recognized 

(ATSDR, 2020; ACGIH, 2013; CDPH, 

2009 and 2013; EPA, 2013; NTP, 2012). 

For example, BLLs as low as 5 mg/dL 

have been associated with impaired 

kidney and reproductive function, high 

blood pressure, and cognitive effects 

attributed to prenatal exposure. Poorer 

performance on neurocognitive and 

neuropsychologic assessments were 

observed in adults with BLLs as low as 

5–19 mg/dL compared with adults with 

BLLs below 5 mg/dL (Kosnett, 2007, pp. 

464, 466; EPA, 2013, pp. 4–311—4–313, 

2013; NTP, 2012, pp. 19–42). While 

there is also evidence of adverse health 

effects in adults with BLLs below 5 mg/ 

dL, those are not discussed in OSHA’s 

literature review (please see ATSDR, 

2020). Table 1 provides an overview of 

the adverse health effects associated 

with adult lead exposure, including the 

effects of exposure on pregnant workers 

and their developing fetuses, and 

longer-term effects on children/ 

adolescents exposed in utero to lead. 

TABLE 1—OVERVIEW OF ADVERSE HEALTH EFFECTS ASSOCIATED WITH EXPOSURE TO LEAD IN ADULTS

Health Effect Descriptive Detail of Health Effect 

Reproductive and Developmental 3 ................... Reduced fertility, low sperm mobility, increased risk of miscarriage. 

Effects on developing fetus due to lead exposure in utero—decreased birth size, adverse effects on developing brain, kidney, nervous system, cognitive and learning disabilities, decreased child growth, delayed onset puberty. 

Vascular/Cardiovascular .................................... Hypertension .................................................... Increased systolic and/or diastolic pressure, 

stroke, heart disease. 

Cerebrovascular ............................................... Stroke. 

Cardiac/cardiovascular ..................................... Heart disease, atherosclerosis, altered cardiac 

conduction. 

Hematological .................................................... Heme synthesis (interference with iron uptake), anemia, altered levels of plasma erythropoietin. 

Neurological ....................................................... Reduced performance on neurocognitive and neuropsychological tests, peripheral neuropathy, 

psychiatric symptoms (depression, panic disorders, anxiety, hostility, anger, schizophrenia) 

cognitive decrements, lead intoxication, dementia, hearing loss. 

Renal .................................................................. Nephrotoxicity (proximal tubular nephropathy, glomerular sclerosis, interstitial fibrosis, tubular 

necrosis). 

Respiratory ......................................................... Decreased lung function, increased bronchial hyperreactivity, increased risk of asthma and obstructive lung disease. 

Endocrine (excluding reproductive) ................... Alteration of serum thyroid levels (T3, T4, TSH), decreased levels of serum vitamin D. 

Hepatic ............................................................... Liver enlargement, increased gall bladder wall thickness, increased total cholesterol. 

Musculoskeletal .................................................. Bone loss, increased bone metabolism/turnover, adverse periodontal and dental effects. 

Gastrointestinal .................................................. Constipation, colic, abdominal cramps. 

Body weight ....................................................... Decreased body mass index (BMI) in adolescents and adults. 

Immunological .................................................... Decreased complement, changes in indicators of inflammation (monocytes, macrophages, 

neutrophils) and cell-mediated immunity (T cells, natural killer cells). 

Cancer ................................................................ Lung, stomach, kidney, and brain cancer. 

Based on information contained in ATSDR, 2020. 


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3For more information on pregnancy and lead 

exposure please see https://www.cdc.gov/nceh/ 

lead/publications/leadandpregnancy2010.pdf. 

4The phrase ‘95th percentile worker’ in this 

context means that ninety five percent of the 

workers removed from lead exposure after a 40-year 

work life of lead exposure resulting in a BLL of 20 

mg/dL would be expected to take 10 weeks for their 

BLLs to decline 5 mg/dL to 15 mg/dL. 

1. Routes and Kinetics of Lead Exposure 

Lead exposures in adults above 

background or baseline levels are 

typically associated with occupational 

exposures. Background or baseline 

levels occur from incidental exposures 

through ambient air, foods, drinking 

water, soil, and dust and result in an 

average BLL for adults of 0.855 mg/dL 

(geometric average) (ATSDR, 2020; 

HHS, 2022). Occupational exposure to 

lead can occur through inhalation, oral, 

and/or dermal routes (EPA, 2013, pp. 

7–18; NAS, 2013, pp. 9, 15–17, 47). The 

Agency for Toxic Substances and 

Disease Registry (ATSDR) has stated 

that all the health effects discussed here 

can result from all three of these routes 

of exposure (ATSDR, 2020). 

Lead accumulates in the body with 

continued or chronic exposure (ATSDR, 

2020; AOEC, 2007; EPA, 2013; NTP, 

2012; Shih, 2007). In adults, 90 percent 

of lead is stored in bone, with only 1 

percent in blood (EPA, 2013, pp. 

4–324—4–326). Lead can be released 

from bone to blood and other soft 

tissues over time. In particular, lead can 

be mobilized from bone even after 

removal from occupational exposure; 

after use of chelation therapy to reduce 

BLLs; during age-related bone loss, 

especially menopause and osteoporosis; 

and during pregnancy and lactation 

(EPA, 2013; NTP, 2012). Because lead is 

retained in the bones and can be 

released into the bloodstream over time, 

it is difficult to predict individuals’ 

BLLs from their recent external 

exposures (NAS, 2013; ATSDR, 2020). 

Multiple factors can influence the 

toxico- and pharmacokinetics of lead in 

the body, including genetic 

polymorphisms, nutrition and diet, 

smoking, gender, and age (NAS, 2013). 

California OEHHA developed a 

pharmacokinetic model which indicated 

that when BLLs during the working 

lifetime (characterized in the model as 

40 hours per week over a 40-year 

working life) are maintained below 20 

mg/dL, medical removal is expected to 

result in a fairly rapid decline to a BLL 

of 15 mg/dL, which was selected as an 

acceptable BLL for the purposes of the 

model (OEHHA, 2014, pp. 3–4). For 

example, the 95th percentile worker 4

removed after forty years of exposure 

with a BLL of 20 mg/dL would be 

expected to decline to 15 mg/dL within 

ten weeks. If BLLs are allowed to reach 

the 50 mg/dL currently allowed under 

OSHA standards, the California OEHHA 

model estimates that medical removal 

periods greater than 18 months would 

be generally necessary to reduce BLLs to 

15 mg/dL, even among workers with 

only one year of occupational exposure 

(OEHHA, 2014, pp. 3–4). 

Table 2 highlights some of the adverse 

health effects associated with various 

BLLs. While these findings are based on 

clinical assessments from 

comprehensive reviews, they do not 

necessarily represent strict threshold 

values as certain health endpoints may 

manifest at lower or higher levels in 

some individuals or groups. 

TABLE 2—OVERVIEW OF HEALTH EFFECTS ASSOCIATED WITH ELEVATED BLL IN ADULTS

BLL 

(μg/dL) Health effects 

5–10 ................................................ Acute decrease in renal function. 

Elevated blood pressure. 

Altered heme synthesis. 

Impaired neurocognitive and neuropsychological assessment. 

Developmental effects (e.g., decreased cognitive and reduced birthweights)—fetuses exposed to lead in 

utero through pregnant worker lead exposure. 

10–20 .............................................. Spontaneous abortion (miscarriage). 

Hypertension. 

Decreased renal function. 

Decreased platelet count. 

Decreased blood hemoglobin. 

20–40 .............................................. Headache. 

Fatigue. 

Anemia. 

Sleep disturbance. 

Anorexia. 

Bowel changes. 

Arthralgia. 

Myalgia. 

Decreased libido. 

Personality changes 

40–60 .............................................. Sperm effects (decreased number and function). 

Subclinical peripheral neuropathy. 

Altered red blood cell function. 

Renal damage. 

Cognitive dysfunction. 

60–80 .............................................. Hemolytic anemia. 

Renal failure. 

Stroke. 

Above 80 ......................................... Central Nervous System (CNS) effects. 

Nephropathy. 

Gout. 

Hearing loss. 

Encephalopathy. 

Adapted from AOEC, 2007. For additional resources please also see: NTP Monograph on Health Effects of Low-Level Lead, available at 

https://ntp.niehs.nih.gov/ntp/ohat/lead/final/monographhealtheffectslowlevellead_newissn_508.pdf. 


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5 In a memorandum to OSHA Regional 

Administrators, the agency specified that in lieu of 

approval by OSHA or CDC, the agency will accept 

the use of a blood lead analysis laboratory that has 

been approved under the U.S. Department of Health 

and Human Services (HHS), Centers for Medicare 

and Medicaid Services (CMS), blood lead laboratory 

monitoring system pursuant to the Clinical 

Laboratory Improvement Amendments (CLIA) 

regulations, 42 CFR part 493 (OSHA 2018). 

2. Medical Surveillance and 

Management for Elevated Blood Lead 

A comprehensive medical 

surveillance program can be an 

invaluable tool in assessing the 

healthfulness of a workplace. Medical 

surveillance incorporates a systematic 

assessment of employees’ health 

through medical monitoring and 

management practices (NIOSH, 2018). 

OSHA included a medical surveillance 

provision in the 1978 lead standard in 

part to mitigate some of the most 

detrimental effects of lead exposure to 

workers. However, since OSHA 

promulgated the standard, much more 

has become known regarding acute and 

chronic exposures (especially at low 

levels) and susceptible populations. 

Measurement and Management of Blood 

Lead Levels (BLLs) 

OSHA, as well as a number of 

agencies and public health groups state 

that the BLL is the best method 

available to monitor lead exposure 

(1910.1025, Appendix C; ACOEM 2016, 

p. e372; AOEC 2007, p. 4; CDPH 2009, 

p. 4; CSTE 2015, p. 2). OSHA and others 

have noted that BLL is generally a good 

indicator of current or recent external 

lead exposure; however, it is not 

necessarily correlated with total body 

burden of lead or cumulative exposure 

(29 CFR 1910.1025, Appendix C; AOEC 

2016, pp. 4–7; CDPH 2009, p. 4; NAS 

2013, pp. 48–56). This is because, over 

time, a high percentage of lead is 

deposited in bone, and after exposure 

ends, mobilization from bone occurs 

very slowly. As a result, a high BLL may 

represent a high recent exposure 

without an excess of total body burden, 

and a low BLL does not necessarily 

mean that total body burden is low (29 

CFR 1910.1025). For long-term, longlatency, or cumulative exposures, lead 

body burden is generally considered the 

most adequate method (NAS 2013, p. 

64). Lead body burden can be measured 

using x-ray fluorescence techniques but 

such methods are currently not widely 

or readily available (ACOEM 2016, p. 

e372; CSTE 2015, p. 2). 

Medical management guidelines for 

adult lead exposure were developed by 

a national expert panel coordinated by 

the Association of Occupational and 

Environmental Clinics (AOEC 2007, pp. 

5–9, 13), in collaboration with the 

ABLES program. The authors 

recommend that maintaining BLLs 

below 20 mg/dL over a twenty-year 

period, or under 10 mg/dL over a fortyyear period, would be sufficient to 

prevent chronic effects associated with 

adult lead exposure. They further 

recommend maintaining BLLs below 20 

mg/dL in order to prevent recognized 

acute health effects (Schwartz and Hu, 

2007). ACOEM states that the most 

compelling evidence for adverse health 

effects occurs at moderate levels of 

blood lead ranging from 10 to 20 mg/dL 

(ACOEM 2016, p. 1). In the context of 

general population screening, the CDC 

recommends adult BLLs (persons ≥16 

years of age) from a venous blood 

specimen of ≥5 mg/dL be considered for 

case classification for the purposes of 

medical surveillance (CDC 2016, p. 

260); ABLES uses 5 mg/dL to indicate an 

elevated BLL for surveillance purposes 

(ABLES, 2021). NIOSH additionally 

provides a reference guide to BLL 

regulations and recommendations 

(ABLES, 2021). 

The following sections outline the 

current medical management and 

monitoring practices required under 

OSHA’s lead standards, in order to 

contextualize OSHA’s later questions 

regarding possible changes to these 

requirements in Section II, Request for 

Input. 

Methods for Monitoring Blood Lead 

Levels in OSHA’s Standards 

OSHA’s lead standards do not specify 

a particular method for analyzing BLL 

but require that the method of sampling 

and analysis used is accurate to plus or 

minus 15 percent or 6 mg/100 ml, 

whichever is greater (to a 95 percent 

confidence level). The general industry 

standard once required the analysis to 

be conducted by a laboratory licensed 

by the CDC or which has received a 

satisfactory grade in blood lead 

proficiency testing from the CDC within 

the previous 12 months (per 29 CFR 

1910.1025(j)(2)(iii)), but now allows 

testing to be conducted in a CLIA 

compliant laboratory (OSHA, 2018).5

The construction standard requires the 

analysis to be conducted by a laboratory 

approved by OSHA (29 CFR 

1926.62(j)(2)(iii)). The medical 

surveillance guidelines in Appendix C 

of OSHA’s lead standards indicate that 

any method that meets the accuracy 

specified by the standards can be used 

to analyze the blood sample. 

OSHA’s Requirements for Blood Lead 

and Zinc Protoporphyrin Testing, 

Worker Notification of Blood Lead 

Levels, Medical Removal, and Return to 

Work 

The medical surveillance and medical 

removal protection provisions in 

OSHA’s lead standards contain BLL 

triggers for medical removal, return to 

work status, and employee notification 

of blood test results. The general 

industry standard requires employers to 

institute a medical surveillance program 

for all employees who are or may be 

exposed at or above the action level of 

30 mg/m3 for more than 30 days per year 

(29 CFR 1910.1025(j)). Employers must 

make biological monitoring in the form 

of blood lead testing and ZPP levels 

available to these employees in 

accordance with the following schedule 

provided in 29 CFR 1910.1025(j)(2)(i): 

• At least every six months to each 

employee covered under paragraph 

(j)(1)(i) of the standard; 

• At least every two months for each 

employee whose last blood lead test 

indicated a BLL at or above 40 mg/dL. 

This frequency shall continue until two 

consecutive blood lead tests indicate a 

BLL below 40 mg/dL; and 

• At least monthly during the 

removal period of each employee 

removed from exposure to lead due to 

an elevated BLL. 

OSHA’s lead standard for 

construction requires the employer to 

make blood sampling and analysis for 

lead and ZPP levels available to 

employees occupationally exposed on 

any day to lead at or above the action 

level (29 CFR 1926.62 (j)(1)(i)). It further 

requires the employer to institute a 

medical surveillance program for all 

employees who are or may be exposed 

by the employer at or above the action 

level for more than 30 days in any 

consecutive 12 months (29 CFR 1926.62 

(j)(1)(ii)) and requires employers to 

provide blood lead testing to employees 

in the medical surveillance program at 

least every two months for the first six 

months, and every six months thereafter 

(29 CFR (1926.62 (j)(2)(i)(A)). 

Furthermore, the employer is required 

to provide blood lead testing at least 

every two months for employees 

covered under (j)(1)(i) or (ii) whose last 

test indicated a BLL at or above 40 mg/ 

dL, until two consecutive tests show the 

BLL has declined below 40 mg/dL. And, 

the standard requires the employer to 

provide blood lead testing at least 

monthly during the removal period of 

each employee removed from exposure 

to lead due to an elevated BLL (29 CFR 

1926.62(j)(2)(i)(C)). 


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6California’s most recent discussion draft and 

other materials related to the advisory meetings are 

available at https://www.dir.ca.gov/dosh/DoshReg/ 

5198Meetings.htm. 

7The California Department of Public Health 

(CDPH) Occupational Lead Poisoning Prevention 

Program (OLPPP) made recommendations to Cal/ 

OSHA for revising its General Industry Lead 

Standard and Construction Industry lead standards 

for the protection of workers who are exposed to 

lead on the job, available at https://

www.cdph.ca.gov/Programs/CCDPHP/DEODC/ 

OHB/OLPPP/Pages/LeadStdRecs.aspx. 

8Washington DOSH’s stakeholder review draft 

(2019) and other information related to its 

stakeholder meetings on the lead rule revision 

process are available at https://lni.wa.gov/safetyhealth/safety-rules/rulemaking-stakeholderinformation/sh-rules-stakeholder-lead. 

OSHA’s general industry standard 

requires the employer to notify each 

employee whose BLL is at or above 40 

mg/dL within five working days after the 

receipt of biological monitoring results. 

OSHA’s construction standard requires 

the employer to notify each employee in 

writing of their BLL within five working 

days after the receipt of biological 

monitoring results, regardless of the BLL 

detected. 

The general industry standard 

requires an employer to remove an 

employee from work involving exposure 

to lead at or above the action level when 

two consecutive blood lead tests are at 

or above 60 mg/dL; or when the average 

of the last three tests (or the average of 

all tests conducted over the previous six 

months, whichever period is longer) is 

at or above 50 mg/dL, with the exception 

that medical removal is not required if 

the last test indicates a BLL below 40 

mg/dL. It also requires medical removal 

when a final medical determination 

concludes that an employee has a 

medical condition that places the 

employee at increased risk of material 

impairment to health from exposure to 

lead (29 CFR 1910.1025(k)). The 

construction standard requires an 

employer to remove an employee from 

work involving exposure to lead at or 

above the action level when the 

employee’s BLL is at or above 50 mg/dL 

for two consecutive tests or a final 

medical determination concludes that 

the employee has a medical condition 

that places the employee at increased 

risk of material impairment to health 

from exposure to lead (29 CFR 

1926.62(k)). Both standards specify that 

the employer shall return an employee 

to the employee’s former job status 

when two consecutive blood sampling 

tests indicate that the BLL is below 40 

mg/dL (29 CFR 

1910.1025(k)(1)(iii)(A)(1); 29 CFR 

1926.62(k)(1)(iii)(A)(1)). 

Zinc Protoporphyrin (ZPP) Testing 

Along with BLLs, ZPP testing is 

required by OSHA’s lead standards as 

part of its medical surveillance and 

management plan (29 CFR 

1910.1025(j)(2); 29 CFR 1926.62(j)(2)). 

ZPP is a metabolite found in 

erythrocytes during hemoglobin 

synthesis. The zinc in ZPP replaces iron 

in hemoglobin synthesis during times of 

iron deficiency. Elevated lead levels in 

the blood interfere with iron ion 

transfer, creating a condition similar to 

iron deficiency, thus elevating zinc in 

the production of hemoglobin and ZPP. 

The clinical utility of ZPP testing to 

identify elevated BLL is now 

understood to be limited by several 

factors: 

• Low sensitivity: ZPP is generally not 

elevated until BLLs exceed 25 mg/dL 

(Kosnett et al 2007, p. 468). Thus, 

workers may reach harmful BLLs well 

before the ZPP level registers as 

abnormal. 

• Low specificity: ZPP is not specific 

to lead. In other words, elevated levels 

of ZPP can be caused by conditions 

other than blood lead, such as iron 

deficiency anemia, jaundice, and sickle 

cell anemia (ATSDR 2020, p. 336). 

Thus, an elevated ZPP does not always 

mean that a worker has an elevated BLL. 

• Lag time: ZPP levels generally lag 

behind BLLs by two to six weeks (CDPH 

2009, p. 4). Thus, a worker may have an 

elevated BLL while the ZPP level is still 

within normal range. The reverse is also 

true; a worker’s BLL may begin to 

decline, while the lagging ZPP level 

remains elevated (Martin 2004, pp. 589– 

590). This delay limits the utility of ZPP 

as a screening or biomonitoring tool. 

• High individual variability: 

Individuals with the same BLL can have 

widely differing ZPP levels (Martin 

2004, pp. 588–590). This may be due to 

differences in individual susceptibility 

to lead (Grandjean 1991, pp. 111–112) 

or other factors. However, such 

variations can complicate interpretation 

of test results. 

Both AOEC and CDPH recommend 

against routine clinical use of ZPP— 

unless legally required—for monitoring 

lead-exposed patients (AOEC, 2007; 

CDPH 2009, p. 4). Similarly, ATSDR 

notes that ‘‘ZPP is not sufficiently 

sensitive at lower BLLs and therefore is 

not as useful a screening test for lead 

exposure as previously thought’’ 

(ATSDR 2007, pp. 232–233). OSHA’s 

enforcement policy currently allows 

employers to use methods other than 

the ZPP test for determining lead 

toxicity. See www.osha.gov/laws-regs/ 

standardinterpretations/1996–03–04–1. 

Due to these issues, OSHA is requesting 

input on whether to eliminate the 

requirement for ZPP monitoring (see 

Section II, Request for Input). 

II. Request for Input 

This ANPRM seeks input on the 

following areas: OSHA’s triggers for 

medical removal of workers with 

elevated BLLs and their return to leadexposed work; OSHA’s requirements for 

medical surveillance and management 

of lead-exposed employees; several 

additional provisions and compliance 

protocols that are undergoing public 

review in State Plans’ ongoing work to 

update their occupational lead 

standards; and the costs and 

effectiveness of lead exposure 

identification and control strategies. 

This Request for Input section includes 

a series of questions on the OSHA 

standards’ requirements and possible 

revisions to them, followed by a series 

of questions on employers’ 

requirements, which may in some cases 

be more protective than OSHA 

standards. While the questions 

pertaining to current requirements are 

primarily addressed to employers, 

OSHA will review and consider all 

information submitted in response to 

these questions. 

This section includes questions about 

several provisions of OSHA’s lead 

standards that are addressed in recent or 

proposed changes to State Plan lead 

standards in Michigan, Washington 

State, and California. As previously 

discussed, in January 2019 MIOSHA 

revised its lead standards for general 

industry and construction, changing the 

BLL at which an employee is required 

to be removed from lead exposure and 

the BLL at which an employee may be 

returned to lead exposure. Cal/OSHA 

has held advisory meetings to discuss a 

variety of potential changes to its lead 

standards and has published a draft of 

possible amendments to the existing 

regulations in general industry and 

construction operations. 6 7 Washington 

DOSH is also developing a variety of 

updates to DOSH’s occupational lead 

standards.8 For several lead standard 

provisions that State Plans have made or 

proposed changes to, this section 

describes the changes in the relevant 

State Plan(s) and requests input on 

whether similar revisions to federal lead 

standards should be considered. The 

State Plan changes and proposals 

include revisions to state blood lead 

triggers for medical removal protection 

and return to work; permissible 

exposure limits; and several ‘‘safe 

harbor’’ protocols that employers in 

certain industries, or who meet 

specified requirements, may opt to use 

as alternatives to complying with the 

main rule. 

Several questions in this section also 

relate to recommendations made by the 


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Association of Occupational and 

Environmental Clinics (AOEC, 2007) 

and ACOEM (2016, pp. e371-e372) for 

updates to OSHA’s Lead standards. 

ACOEM’s recommendations refer to 

‘‘significant lead exposure’’, defined as 

an airborne or surface lead content 

known or reasonably anticipated to 

cause elevated BLL (ACOEM 2016, p. 

e372, Table 1); and refer to a ‘‘leadexposed worker’’, defined as ‘‘any 

worker who is handling or disturbing 

materials with a significant lead content 

in a manner that could reasonably be 

expected to cause potentially harmful 

exposure through lead dust inhalation 

or ingestion, regardless of airborne lead 

concentrations or surface contamination 

levels’’ (ACOEM 2016, p. e372). 

OSHA notes that this ANPRM focuses 

primarily on medical surveillance/ 

medical removal protection and on 

state-based innovations. Therefore, it 

does not request input on every 

provision OSHA might seek to 

modernize or otherwise revise in its 

lead standards through a Notice of 

Proposed Rulemaking (NPRM) in the 

future. 

When answering the numbered 

questions below, please label your 

responses with the number of the 

question, explain the reasons supporting 

your views, and identify and provide 

relevant information on which you rely, 

including, but not limited to, data, 

studies, and articles. 

A. Blood Lead Triggers for Medical 

Removal Protection 

1. Requirements for Medical Removal 

OSHA’s general industry standard for 

lead requires an employer to remove an 

employee from work involving exposure 

to lead at or above the action level (30 

mg/m3) when two consecutive blood 

lead tests are at or above 60 mg/dL or 

when the average of the last three tests 

is at or above 50 mg/dL. OSHA’s 

construction standard requires an 

employer to remove an employee from 

work involving exposure to lead at or 

above the AL when the employee’s BLL 

is at or above 50 mg/dL for two 

consecutive tests. (See Section I.C, 

Health Effects of Lead Exposure, for a 

full description of OSHA’s blood lead 

requirements for Medical Removal 

Protection (MRP)). 

ACOEM has recommended medical 

removal of workers who have repeat 

BLLs over 20 mg/dL (measured in four 

weeks), or if any single BLL exceeds 30 

mg/dL (ACOEM 2016, p. e372, Table 1). 

MIOSHA’s 2019 update to Michigan’s 

occupational lead standard changed the 

BLL at which an employee in general 

industry or construction is to be 

removed from lead exposure, previously 

50 mg/dL, to 30 mg/dL for both 

standards. Cal/OSHA’s discussion draft 

includes a medical removal BLL of ≥ 30 

mg/dL; when the last two monthly blood 

lead tests are ≥ 20 mg/dL; or when the 

average of the results of all blood lead 

tests conducted in the last six months is 

at or above 20 mg/dL of whole blood. 

Washington DOSH’s stakeholder review 

draft would lower its medical removal 

BLL to ≥ 30 mg/dL for a single test result 

and ≥ 20 mg/dL for multi-test results for 

both general industry and construction 

lead standards. After commissioning the 

National Research Council (NRC) to 

conduct a study to determine whether 

current OSHA exposure standards used 

on firing ranges are protective (NRC, 

2013), DOD lowered the medical 

removal triggers for BLLs in military 

and civilian DOD personnel, which 

previously were aligned with OSHA’s 

standards. DOD’s medical removal is 

now based on BLLs at or greater than 20 

mg/dL (DOD, 2018, p. 55; Table C4.T2, 

pp. 57–61)). 

(1) Should OSHA consider changing 

the BLL at which an employee in 

general industry or construction is to be 

removed from lead exposure to match 

any of the approaches described above? 

Is there a different BLL trigger for 

removing a worker from lead-exposed 

work that you would suggest? Please 

explain your answer and provide 

supporting information or data, if 

available. 

2. Requirements for Return to LeadExposed Work 

OSHA’s lead standards for general 

industry and construction both specify 

that the employer shall return an 

employee to their former job when two 

consecutive blood-sampling tests 

indicate that the BLL is below 40 mg/dL. 

ACOEM has recommended that return 

to lead-exposed work should be 

considered after two BLLs are below 15 

mg/dL (ACOEM 2016, p. e372, Table 1). 

MIOSHA changed the BLL at which an 

employee may return to lead exposure 

from below 40 mg/dL to below 15 mg/dL 

in both general industry and 

construction. Cal/OSHA’s discussion 

draft would provide that a removed 

worker may return to former job status 

when two consecutive blood lead tests 

are below 15 mg/dL. Washington 

DOSH’s stakeholder review draft 

similarly includes a return-to-work BLL 

of below 15 mg/dL for both general 

industry and construction lead 

standards. DOD’s updated policy 

provides for employee return to work 

when BLL is at or below 15 mg/dL (DOD, 

2018, p. 55; Table C4.T2, pp. 57–61)). 

(2) Should OSHA consider changing 

the BLL below which an employee shall 

be returned to lead exposure to 15 mg/ 

dL? Is there a different BLL trigger for 

returning a worker to lead-exposed work 

following medical removal that you 

would suggest? Please explain your 

answer and provide supporting 

information or data, if available. 

B. Medical Surveillance Provisions 

1. Medical Examination and 

Consultation Requirements 

OSHA’s lead standards require 

employers to make a full medical 

examination and consultation available 

to an employee: (1) before the first 

assignment to an area that has lead at or 

above the action level; (2) at least once 

a year for an employee who had a BLL 

of 40 mg/dL or over at any time during 

the preceding 12 months; and (3) as 

soon as possible on notification by an 

employee that they have developed 

signs or symptoms of lead intoxication, 

desire medical advice concerning the 

effects of lead (past or current) and the 

ability to procreate a healthy child, or 

who has difficulty in breathing during 

respirator fit test or use. In addition, an 

examination must be made available as 

medically appropriate for each 

employee either removed from exposure 

to lead due to a risk of sustaining 

material impairment to health, or whose 

lead exposure is otherwise limited 

based on a final medical determination. 

For the purposes of the lead standard, 

a full medical examination includes: (1) 

a detailed work and medical history; (2) 

a thorough physical examination; (3) 

measurement of blood pressure; (4) 

analysis of BLL, hemoglobin and 

hematocrit, erythrocyte indexes, 

peripheral smear morphology, zinc 

protoporphyrin (ZPP), blood urea 

nitrogen and creatinine, and urinalysis 

with microscopic examination; and (5) 

any other tests that a physician thinks 

are appropriate, including a pregnancy 

test or laboratory evaluation of male 

fertility if requested by the employee. 

(3) Are these still appropriate tests or 

should a full medical examination 

include any other tests? OSHA is also 

requesting comment on the 

appropriateness of including the ZPP 

given its limitations (see also Section 

#6, ‘‘ZPP’’, below). 

2. Triggers for Routine Blood Lead 

Monitoring 

OSHA’s lead standards require the 

employer to institute a medical 

surveillance program, including blood 

lead testing prior to lead exposure and 

at regular intervals thereafter, for 

employees who are or may be exposed 


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9See Surface Sampling and Material Content 

Requirements below for percentage and 

contamination specifications. The Washington 

DOSH Stakeholder Review Draft states that ‘‘work 

is timed from beginning the contact or disturbance 

activity to the time when the worker accesses 

washing facilities where personal protective 

equipment can be doffed properly and the worker 

can thoroughly wash off lead contamination.’’ 

10ACOEM’s recommendations refer to 

‘‘significant lead exposure’’, defined as an airborne 

or surface lead content known or reasonably 

anticipated to cause elevated BLL (ACOEM 2016, p. 

e372, Table 1); and refer to a ‘‘lead-exposed 

worker’’, defined as ‘‘any worker who is handling 

or disturbing materials with a significant lead 

content in a manner that could reasonably be 

expected to cause potentially harmful exposure 

through lead dust inhalation or ingestion, regardless 

of airborne lead concentrations or surface 

contamination levels’’ (ACOEM 2016, p. e372). 

11The proposed return-to-work level is 15 mg/dL 

in Washington and 10 mg/dL in California. 

to airborne lead at or above 30 mg/m3 for 

more than 30 days per year. 

Airborne Lead Exposure Trigger for 

Blood Lead Monitoring 

The Washington DOSH stakeholder 

review draft would require employers to 

provide ongoing blood lead monitoring 

for employees exposed to lead for more 

than 10 days per year, including any 

day with airborne exposure totaling 10 

mg/m3 as an 8-hour TWA or greater or 

any day with a task lasting 30 minutes 

or more that involves exposure above 20 

mg/m3. Cal/OSHA’s discussion draft 

would require employers to institute a 

medical surveillance program, including 

blood lead testing, for employees who 

are or may be exposed at or above a 

revised action level of 2 mg/m3 for 10 or 

more days per year. 

(4) Should OSHA consider expanding 

its criteria for blood lead monitoring to 

resemble the ongoing blood lead 

monitoring criteria that Washington 

DOSH and/or Cal/OSHA is considering? 

Are there different criteria you would 

suggest? Please explain your answers. 

Additional Triggers 

In OSHA’s lead standards, worker 

eligibility for blood lead monitoring is 

based solely on airborne lead exposure 

criteria. In contrast, the Washington 

DOSH stakeholder review draft would 

require employers to provide ongoing 

blood lead monitoring for employees 

exposed at or above any action level for 

more than 10 days per year, including 

any day involving a combined total of 

at least one hour of: (1) activity 

disturbing or touching metals 

containing 20 percent or more lead (by 

weight); (2) activity disturbing nonmetals containing 0.5 percent or more 

lead by weight; (3) creating aerosols or 

fumes from materials containing 0.1 

percent or more lead by weight; or (4) 

work in areas with surfaces at a 

‘‘Surface Action Level’’ of 1000 mg/dm2

(equivalent to 9290 mg/ft2).9

Cal/OSHA’s discussion draft includes 

a requirement that employers must 

institute a medical surveillance 

program, including blood lead testing, 

for employees who perform a ‘‘trigger 

amount of lead work’’, defined as 

altering or disturbing material that is 

known or reasonably anticipated to 

contain at least 0.5 percent lead by 

weight, or torch cutting any scrap metal, 

for a combined total of at least 8 hours 

during any 30-day period. 

In addition, ACOEM has 

recommended that BLL be measured 

routinely for all lead workers, where a 

‘‘lead-exposed worker’’ is defined as 

‘‘any worker who is handling or 

disturbing materials with a significant 

lead content in a manner that could 

reasonably be expected to cause 

potentially harmful exposure through 

lead dust inhalation or ingestion, 

regardless of airborne lead 

concentrations or surface contamination 

levels’’ (ACOEM 2016, p. e372). 

(5) Should OSHA consider adding 

criteria other than airborne lead 

exposure to its requirements for blood 

lead testing, such as contact with leadcontaminated surfaces, disturbance of 

lead-containing materials or direct 

contact with high-percentage lead 

materials? In particular, should OSHA 

consider adopting criteria based on 

contact with lead-contaminated 

surfaces, disturbance of lead-containing 

materials, or contact high lead-content 

metals, as Washington DOSH’s 

stakeholder review draft and Cal/ 

OSHA’s discussion draft contemplate? 

Please explain your answer. 

3. Frequency of Blood Lead Monitoring 

OSHA’s lead standard for general 

industry requires employers to provide 

blood lead testing to employees in the 

medical surveillance program at least 

every six months, with the following 

exceptions: (1) every two months if a 

previous BLL was at or above 40 mg/dL 

of whole blood, until two consecutive 

results are below 40 mg/dL and (2) at 

least monthly during the removal period 

of each employee removed from 

exposure to lead due to an elevated BLL. 

For those employees who are in the 

medical surveillance program because 

they are or may be exposed to airborne 

lead at or above the action level (30 mg/ 

m3) for more than 30 days in any 

consecutive 12 months, OSHA’s lead 

standard for construction requires the 

employer to provide blood lead testing 

at least every two months for the first 

six months, and every six months 

thereafter. In addition, for employees 

who were exposed on any day to lead 

at or above the action level, and for 

employees who have been exposed to 

lead at or above the action level for 

more than 30 days in a 12 month period 

and whose last blood sample indicated 

a BLL at or above 40 ug/dL, the standard 

requires blood testing at least every two 

months until two consecutive results 

indicate a BLL below 40 mg/dL. The 

standard also requires the employer to 

provide blood lead testing at least 

monthly during the removal period of 

each employee removed from exposure 

to lead due to an elevated BLL. (See 

Section I.C, Health Effects of Lead 

Exposure, for a full description of 

OSHA’s blood lead requirements for 

MRP). 

ACOEM has recommended that lead 

workers’ BLLs be measured every two 

months for the first six months of 

placement, or upon change to tasks 

resulting in higher exposure, and that 

BLLs should be measured every six 

months thereafter (ACOEM 2016, p. 

e372, Table 1). In addition, ACOEM has 

recommended BLL measurement every 

two months for workers with results 

between 10 and 19 mg/dL and monthly 

measurement for workers with results of 

at least 20 mg/dL.10

The Washington DOSH stakeholder 

review draft and Cal/OSHA’s discussion 

draft would require that blood lead 

testing be made available every two 

months for a worker’s first six months 

of testing, and every six months after 

that. In addition, testing would be made 

available at least every two months if a 

worker’s BLL is greater than 10 mg/dL. 

The Washington DOSH stakeholder 

review draft would require testing to be 

offered monthly if an employee has 

been medically removed, until two 

consecutive tests show the worker’s BLL 

has decreased to below the proposed 

return-to-work level.11 Cal/OSHA’s 

discussion draft stipulates testing at 

least monthly for each employee whose 

last BLL was at or above 20 mg/dL of 

whole blood, and during the removal 

period of each employee removed from 

exposure to lead due to an elevated BLL. 

(6) Should OSHA consider revising 

the required frequency and the BLLs 

related to the schedule of blood lead 

testing? Would requirements similar to 

those included in Washington DOSH 

and Cal/OSHA’s drafts be appropriate? 

If not, what would be an appropriate 

frequency for blood lead testing? Please 

explain your answer. 

4. Analytical Methods for BLL Testing 

As discussed previously in Section 

I.C.2, Medical Surveillance and 

Management for Elevated Blood Lead, 

OSHA standards do not specify a 


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12CDPH contracted with Cal/EPA to evaluate the 

relationship between occupational airborne lead 

exposure and BLLs. Using health-based biokinetic 

modeling, Cal/EPA found that workplace air lead 

levels should be limited to an 8-hour time-weighted 

average (TWA) of 2.1 mg/m3 in order to prevent 

BLLs exceeding 10 mg/dL in at least 95% of workers 

with regular and long-term exposure. See CDPH 

2013 for further details. CDPH’s PEL 

recommendation can be viewed at: https://

www.cdph.ca.gov/Programs/CCDPHP/DEODC/ 

OHB/OLPPP/CDPH%20Document%20Library/ 

LeadStdPELRec.pdf. 

particular method for analyzing BLL but 

require that the method of sampling and 

analysis used is accurate to plus or 

minus 15 percent or 6 mg/100 ml, 

whichever is greater (to a 95 percent 

confidence level). In a memorandum to 

OSHA Regional Administrators, the 

agency specified that in lieu of approval 

by OSHA or CDC, the agency will accept 

the use of a blood lead analysis 

laboratory that has been approved under 

the U.S. Department of Health and 

Human Services (HHS), Centers for 

Medicare and Medicaid Services (CMS), 

blood lead laboratory monitoring system 

pursuant to the Clinical Laboratory 

Improvement Amendments (CLIA) 

regulations, 42 CFR part 493 (OSHA 

2018). All blood lead analysis 

performed in a CLIA-compliant lab must 

meet the Proficiency Testing 

requirement of ±4 mg/dL or 10%, 

whichever is greater. 

(7) Should OSHA consider revising its 

standard to require the use of a blood 

lead analysis laboratory that has been 

approved under the CMS blood lead 

laboratory monitoring system pursuant 

to the CLIA regulations, consistent with 

OSHA’s 2018 memorandum? Please 

explain your answer. 

(8) Are there methods other than 

collecting a venous sample that would 

meet the accuracy requirements of the 

lead standard? Please describe the 

advantages and limitations of such 

methods. 

(9) Are portable direct reading 

instruments for measuring BLL available 

that meet the accuracy requirements of 

the OSHA lead standards and would be 

considered equivalent to an analysis 

conducted by a laboratory approved by 

OSHA or CDC? 

(10) Do you use or have knowledge of 

other measures of lead in the body? 

Please describe and explain whether 

and how they could be used effectively 

for medical monitoring of workers 

exposed to lead and the relative costs of 

those measures (i.e., cost-effectiveness). 

5. Employee Notification of BLL Results 

OSHA’s general industry standard 

requires the employer to notify each 

employee whose BLL is at or above 40 

mg/dL within five working days after the 

receipt of biological monitoring results. 

OSHA’s construction standard requires 

the employer to notify each employee in 

writing of their BLL within five working 

days after the receipt of biological 

monitoring results, regardless of the BLL 

detected. 

The Washington DOSH stakeholder 

review draft and Cal/OSHA’s discussion 

draft include a requirement that 

employers must make sure workers 

receive all blood testing results, 

regardless of level, within five days of 

receiving them from the medical 

providers. 

(11) Should OSHA revise its general 

industry standard to require employers 

to notify all employees who receive 

blood lead testing of their results, 

similar to the requirements of its 

construction standard and requirements 

under consideration by Washington 

DOSH and Cal/OSHA? If not, what 

criteria should be used to determine 

which employees should be notified of 

their results? Please explain your 

answer. 

6. ZPP 

ACOEM’s Position Statement (2016) 

advised OSHA that ZPP testing is 

insufficiently sensitive as a measure of 

lead exposure when BLLs are below 25 

mg/dL and is no longer needed since 

BLL testing is superior and readily 

available (ACOEM 2016, p. e372). In 

January 2019, MIOSHA removed a 

previous requirement to analyze for the 

zinc protoporphyrin level. Washington 

DOSH’s stakeholder review draft and 

Cal/OSHA’s discussion draft also would 

eliminate ZPP testing requirements. 

(12) Should OSHA remove the 

requirement for ZPP testing currently 

included in its lead standards? Please 

explain your recommendation to 

continue or discontinue ZPP testing as 

part of medical surveillance for leadexposed workers. 

7. Provisions for Worker Privacy 

Under the medical surveillance 

provisions of OSHA’s lead standards, 

employers are provided with the results 

of an individual employee’s BLL 

measurements, in addition to the 

physician’s opinion as to whether the 

employee has any detected medical 

condition that would place the 

employee at increased risk from lead 

exposure; recommended special 

protective measures or lead exposure 

limitations; and any recommended 

limitation upon the employee’s use of 

respirators. Physicians are prohibited 

from revealing to the employer any 

findings, including laboratory results, or 

diagnoses unrelated to an employee’s 

occupational exposure to lead. 

More recent OSHA standards include 

measures to enhance employee privacy 

and encourage employees to participate 

in medical surveillance by minimizing 

fears about retaliation or discrimination 

based on medical findings. In OSHA’s 

beryllium standard, for example, the 

information provided to the employer 

may not contain the results of medical 

exams performed. The physician may, if 

authorized by the employee in writing, 

inform the employer of any 

recommendations for limitations on 

exposure to beryllium and for further 

testing at another facility and/or 

continued medical surveillance. 

(13) Should OSHA update the lead 

standards’ employee privacy 

protections, including restriction of 

employer access to an individual 

employee’s BLL measurements? Please 

explain your recommendation. 

C. Permissible Exposure Limit (PEL) 

For workers exposed to lead above the 

PEL of 50 mg/m3 for more than 30 days 

per year, OSHA’s general industry lead 

standard requires employers to 

implement engineering and work 

practice controls (including 

administrative controls) to maintain 

exposures at or below the PEL. For 

workers exposed to lead above the PEL 

for 30 days or less per year, the standard 

requires employers to implement 

engineering controls to reduce 

exposures to lead to 200 mg/m3 and then 

allows the use of any combination of 

controls (engineering, work practice, 

respiratory controls) to maintain 

exposures at or below 50 mg/m3. 

California and Washington State’s 

drafts include revisions to their 

permissible exposure limits. Cal/ 

OSHA’s discussion draft includes a 

reduction in the PEL from 50 mg/m3 to 

10 mg/m3 and the action level from 30 

mg/m3 to 2 mg/m3.12 The Washington 

DOSH stakeholder review draft includes 

a reduction in the PEL from 50 mg/m3

to 20 mg/m3. 

(14) Should OSHA consider reducing 

its PEL of 50 mg/m3 for occupational 

lead exposure or its action level of 30 

mg/m3? At what level do you believe the 

PEL should be set to reduce the harmful 

effects of lead exposure in exposed 

workers? Do you think this level would 

be technologically and economically 

feasible for affected industries (see OSH 

Act Sec. 6(b)(5), 29 U.S.C. 655(b)(5))? 

Please explain your answer and, if 

available, provide data pertinent to the 

benefits, feasibility, and expected 

increase in costs of revising the federal 

PEL or action level for airborne lead. 

(Please note that OSHA requests 

detailed information on costs of alreadyexisting requirements and voluntary 


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13Specifically, the Cal/OSHA Discussion Draft’s 

SECAL for oxide production, paste mixing, grid 

pasting and parting, and battery assembly would 

require employers to comply with a 50 mg/m3

exposure limit at the effective date, then with a 

limit of 40 mg/m3 at five years from the effective 

date. The Cal/OSHA Discussion Draft SECAL for 

grid production and small parts casting, and plate 

formation would require employers to comply with 

an exposure limit of 50 mg/m3 at the effective date, 

then with a limit of 30 mg/m3 at five years from the 

effective date. 

14The Washington DOSH stakeholder review 

draft defines surface contamination as ‘‘free lead in 

dust or residues on a surface that can be transferred 

to other surfaces on contact’’ and specifies that 

single sample testing is sufficient for determining 

whether surfaces are contaminated. 

practices in a series of provisionspecific questions in Section H, 

Questions for Employers on Current 

Practices). 

(15) Cal/OSHA’s discussion draft 

includes a Separate Engineering Control 

Airborne Limit (SECAL) for selected 

processes in lead acid battery 

manufacturing.13 Should OSHA 

consider implementing a SECAL for 

occupational lead exposure for specific 

processes if industry-wide compliance 

with a proposed revision to the PEL is 

demonstrably infeasible for specific 

processes? 

(16) Should OSHA consider removing 

the provision of OSHA’s general 

industry lead standard that allows 

employers to use respiratory protection 

to comply with the PEL for workers 

exposed to lead above the PEL for 30 

days or less per year? Please explain 

your answer and, if applicable, your 

recommendation on how employers 

should be required to limit exposures of 

workers exposed above the PEL for 30 

days or less per year. 

D. Personal Protective Equipment (PPE), 

Hygiene, and Training 

(17) The Washington DOSH 

stakeholder review draft would require 

employers to provide and ensure the use 

of impermeable PPE when employees 

are working with lead compounds that 

may be absorbed through the skin for 

any work covered by the scope of the 

rule. Should OSHA consider a similar 

requirement for its lead standards? 

Please explain your answer and any 

evidence available on the feasibility and 

cost of this requirement if adopted by 

OSHA. 

(18) The Washington DOSH 

stakeholder review draft would require 

employers to prohibit workers covered 

by the scope of the rule from cleaning 

or laundering protective clothing or 

equipment at home. Should OSHA 

consider a similar requirement for its 

lead standards? Please explain your 

answer and any evidence available on 

the feasibility and cost of this 

requirement if adopted by OSHA. 

(19) The Washington DOSH 

stakeholder review draft includes 

requirements that employees be 

provided with hygiene facilities and 

PPE when any of the following criteria 

are met: 

1. Employees work in areas with 

surfaces at a ‘‘Surface Action Level’’ of 

1000 mg/dm2 (equivalent to 9290 mg/ 

ft2); 14

2. Employees disturb or touch metals 

with a ‘‘Metals Action Level’’ of 20 

percent or more lead content by weight; 

3. Employees disturb any materials 

with a ‘‘Non-metal Action Level’’ of 0.5 

percent or more lead content by weight 

(5000 ppm); or 

4. Employees welding, burning, or 

grinding, or otherwise creating aerosols 

or fumes from materials with a 

‘‘Burning/Grinding/Blasting Action 

Level’’ of 0.1 percent or more lead 

content by weight (1000 ppm). 

Material content criteria (items #2 

through 4) are applied during any 

activity that could release lead or lead 

compounds from the material in a form 

that could be inhaled, ingested, or 

absorbed through the skin. The metals 

action level (item #2) also applies when 

workers directly contact the metal with 

skin, personal protective equipment, or 

clothing. 

Should OSHA add hygiene and PPE 

provisions similar to any or all of those 

described above, which are being 

considered for adoption by Washington 

DOSH? Please explain your answer and, 

if available, provide information on the 

feasibility and cost of these 

requirements if adopted by OSHA. 

(20) Are there issues or concerns 

related to surface contamination or 

material content criteria for hygiene and 

PPE requirements that OSHA should 

consider? 

OSHA’s lead standards require 

employers to provide PPE in a clean and 

dry condition daily to employees whose 

exposure levels (without regard to 

respirator use) are over 200 mg/m3 of 

lead as an 8-hour TWA, and weekly for 

other lead-exposed employees. Cal/ 

OSHA’s discussion draft would require 

the employer to provide PPE in a clean 

and dry condition daily to employees 

whose exposure levels (without regard 

to respirator use) exceed 30 mg/m3 of 

lead as an 8-hour TWA. It would 

maintain the requirement to provide 

required PPE at least weekly for all 

other lead workers exposed above the 

proposed PEL (10 mg/m3). Washington 

DOSH’s stakeholder review draft would 

require the employer to replace or 

launder PPE at least daily for employees 

whose exposure levels exceed 50 mg/m3

of lead as an 8-hour TWA. In addition, 

it would require the employer to repair, 

replace, or launder protective clothing 

at least weekly, and when visibly 

contaminated or damaged, for 

employees whose exposure levels 

exceed 20 mg/m3 of lead as an 8-hour 

TWA. 

(21) Should OSHA consider revising 

the requirements for employers to 

provide clean or new PPE to workers? 

Please provide specific 

recommendations for frequency and 

exposure triggers, and please explain 

your answers. 

(22) Washington DOSH’s stakeholder 

review draft would require that the 

training provided to all lead-exposed 

workers include information on special 

precautions for pregnant workers. 

Should OSHA consider including a 

similar requirement to include material 

on precautions for pregnant workers in 

the training provisions of its lead 

standards? 

E. Safe Harbor Compliance Protocols 

The Washington DOSH stakeholder 

review draft includes several safe harbor 

protocols which provide employers 

alternative methods of compliance, 

including some provisions that would 

relax requirements for exposure 

monitoring and for use of engineering 

and work practice controls to meet the 

proposed PEL. Employers following a 

safe harbor compliance protocol 

completely would be considered in 

compliance with the lead rule for tasks 

covered and would not be cited for 

departing from the main body of 

requirements of the lead rule for those 

tasks. However, if an employer does not 

follow the provided safe harbor protocol 

properly, the criteria and requirements 

of the main body of the Washington 

DOSH rule would be used to assess 

compliance. The Washington DOSH 

stakeholder review draft includes 

protocols that could potentially be used 

by an employer in any industry, 

including the Well Managed Blood Lead 

Levels Safe Harbor Protocol and the 

Clean Areas Safe Harbor Protocol 

described below, as well as industry- or 

task-specific protocols, including the 

Safe Harbor Protocol for Handling LeadContaining Articles in Retail Settings, 

the Safe Harbor Protocol for Office and 

Residential Settings, and the Safe 

Harbor Protocol for Incidental Lead 

Paint in Construction/Renovation, 

Repair, and Painting (RRP) Work 

described below. 

1. Well Managed Blood Lead Levels Safe 

Harbor Protocol 

The Washington DOSH stakeholder 

review draft describes a protocol that 


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15Under this protocol, the following medical 

surveillance provisions would apply: workers with 

BLLs found above 20 mg/dL would be tested 

monthly until their BLL is below 15 mg/dL for two 

monthly tests; workers would be eligible for the 

medical removal requirements included in the rule; 

and workers with a BLL greater than 10 mg/dL for 

more than 4 months must have their case reviewed 

by a physician. 

16Under the Washington DOSH stakeholder 

review draft, infrequent elevated BLLs above 20 mg/ 

dL would not disqualify an employer when: (1) the 

elevated BLL is documented as a baseline level 

prior to work with the company at this facility or 

any other facility operated by the employer, or (2) 

the employer documents the exposure incident 

responsible for the elevated BLL and takes 

corrective action to effectively prevent further 

exposures. 

17Under the Washington DOSH stakeholder 

review draft, documentation would be submitted 

annually to maintain coverage by the safe harbor, 

using forms and formats supplied by the DOSH. 

The employer would need to be responsive to 

questions from the department regarding the 

submitted documentation and must allow for onsite 

auditing of the submission by DOSH. If DOSH 

reviews the documentation and does not agree that 

it shows that the establishment qualifies for this 

safe harbor, the department would notify the 

employer in writing, including a description of how 

the documentation fails to qualify. If information in 

the submission appears to constitute a violation of 

a Washington Industrial Safety and Health Act 

(WISHA) rule, the employer would be informed and 

asked to provide proof of abatement for serious 

violations. 

18Note: Washington DOSH’s stakeholder review 

draft contemplates that maintenance and 

housekeeping staff working in a clean area may be 

doing work covered by the lead rule. 

provides an employer greater flexibility 

than would otherwise be required for 

implementing PPE, work practices, and 

other lead exposure controls, where the 

employer demonstrates that their 

program effectively controls employee 

BLLs. The compliance protocol would 

provide a safe harbor for employers who 

voluntarily submit worksite blood lead 

records demonstrating that employee 

BLLs are effectively managed. To 

demonstrate effective control of 

employee BLLs, the employer would be 

required to conduct blood lead testing 

for all workers at the facility with 

known or potential exposure to lead; 

provide ongoing documentation of 

effective blood level management to 

Washington DOSH; and, upon request, 

communicate with Washington DOSH if 

questions or concerns arise from review 

of the documentation provided. 

Employers following this protocol 

would not be subject to scheduled 

inspections for lead related issues, and 

the requirements associated with a new 

PEL of 20 mg/m3 (8-hour TWA) would 

not be enforced where airborne 

exposures are below the proposed 

Secondary Permissible Exposure Limit 

(SPEL) of 50 mg/m3 (8-hour TWA).15

In the Washington DOSH stakeholder 

review draft, effective management of 

BLLs is indicated by: blood lead testing 

for all workers at the facility with 

exposure to lead covered by the rule, 

including baseline tests for all exposed 

workers, annual tests for all exposed or 

potentially exposed workers, and more 

frequent tests for all workers meeting 

the requirements for periodic testing in 

the Washington DOSH lead rule; and a 

record of well managed BLLs, meaning 

that: (1) the average BLLs for workers 

exposed above 20 mg/m3 is below 10 mg/ 

dL and the BLLs for each worker in the 

group is kept below 20 mg/dL; and (2) 

BLLs for the group of all other workers 

(those exposed below 20 mg/m3) are kept 

below 10 mg/dL.16

To qualify for this safe harbor, the 

employer would be required to submit 

documentation annually for each 

establishment for which the safe harbor 

will be claimed.17 The required 

documentation includes the employer’s 

lead control programs for the 

establishment; the employer’s 

assessments of lead exposures for the 

establishment; names of all workers 

onsite during the previous two years 

(including workers of other employers); 

for each worker, whether they are 

known to have had exposures at any 

action level, at the PEL or at the SPEL; 

the record of all blood lead testing for 

the establishment for the past two years 

(or new testing only when resubmitting 

annually); and a report detailing actions 

taken in response to increased lead 

exposure or elevated blood BLLs found 

during the previous year. 

(23) Should OSHA consider a safe 

harbor protocol approach similar to the 

Well Managed Blood Lead Levels 

protocol described above, which is 

being considered for adoption in 

Washington State? What aspects of the 

protocol would be beneficial? Are there 

issues, concerns, or different approaches 

to a ‘‘safe harbor’’ based on wellmanaged BLLs that OSHA should 

consider? 

2. Clean Areas Safe Harbor Protocol 

The Washington DOSH stakeholder 

review draft describes a protocol that 

would relieve employers from 

implementing the requirements of the 

lead rule for workers in clean areas who 

do not have lead-related tasks. The 

clean areas protocol described by 

Washington DOSH could be used to 

designate parts of a facility, such as 

offices or work areas where leadcontaining materials are not present, as 

clean so that workers in those areas are 

not covered by the lead rule. The 

protocol could also be used for facilities 

where lead is present in building 

materials, such as lead based paint, but 

is normally undisturbed by activities of 

the employer. Where a clean area is 

designated within a work establishment, 

workers and other individuals are not 

required to use protective equipment, 

work practices, or controls to prevent 

lead exposure and will not necessarily 

be trained about lead hazards. 

The Washington DOSH stakeholder 

review draft sets out criteria for 

establishing clean areas, wherein all 

worker-accessible surfaces must be 

shown using ongoing surface sampling 

for free lead. Lead coatings and leadcontaining materials may be present 

where lead is well contained and not 

released to surface sampling. When 

sampling indicates that lead is being 

brought into the clean area or released 

from damaged materials in the area, 

non-lead workers must be kept from the 

vicinity until the hazard is abated and 

sampling in the area of the release 

indicates the area is clean. 

The following criteria would be used 

to determine if routine cleaning is 

sufficient to maintain surface lead on all 

worker accessible surfaces below 4.3 mg/ 

dm2 (equivalent to 40 mg/ft2). Single 

sample testing, conducted as specified 

in Washington DOSH’s stakeholder 

review draft, may be used to identify 

clean areas. If initial sampling indicates 

that lead on worker accessible surfaces 

is below 4.3 mg/dm2, the area 

represented by such sampling is 

considered ‘‘clean’’ and the employer 

would not be required to implement 

requirements of the lead rule (outside of 

this protocol) therein.18 When there is 

activity that could reintroduce lead into 

the area, repeat sampling would be 

required every two years. 

In an area where initial sampling 

indicates the presence of surface lead on 

worker accessible surfaces at or above 

4.3 mg/dm2, Washington DOSH’s 

proposed protocol would provide for 

representative four-sample testing to 

demonstrate that ongoing cleaning is 

sufficient to maintain minimal lead 

levels. 

(24) Should OSHA consider a safe 

harbor protocol approach similar to the 

Clean Areas protocol described above, 

which is being considered for adoption 

in Washington State? What aspects of 

the protocol would be beneficial? Are 

there issues, concerns, or different 

approaches to a ‘‘safe harbor’’ based on 

identification of clean areas using 

surface sampling that OSHA should 

consider? 

3. Safe Harbor Protocol for Handling 

Lead-Containing Articles in Retail 

Settings 

The Washington DOSH stakeholder 

review draft describes a protocol that 


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could be applied to workers handling 

lead-containing products for sale in 

retail settings where it is expected that 

lead will be generally well controlled. 

The Retail Settings protocol would not 

cover areas of a retail facility used for 

maintenance or repair work that may 

disturb lead-containing materials, and 

would not cover retail gun shops colocated with gun ranges. For areas of a 

retail establishment where lead 

products are not sold, retail employers 

could selectively apply the Clean Areas 

compliance protocol described above. 

Under the Retail Settings protocol, retail 

employers could assume that workers 

are covered by the Basic Rules set out 

in the DOSH stakeholder review draft, 

which include requirements for 

cleaning practices, hygiene, PPE, and 

provisions for hazard communication 

and training. Exposure assessments 

would not be required for workers who 

only handle lead-containing materials in 

retail activities including receiving, 

stocking, sales, and housekeeping in the 

retail activity areas. In addition, retail 

workers would not be covered under the 

Action Rules (which include ongoing 

exposure monitoring and blood lead 

testing) or the PEL and SPEL Rules 

(which include requirements covering 

routine control of airborne lead 

exposure and respirator use, as well as 

heightened requirements in the 

provisions for cleaning, hygiene, PPE, 

hazard communication and training, 

exposure monitoring and medical 

surveillance). 

The Washington DOSH stakeholder 

review draft sets out several conditions 

that must be met by the employer to 

implement the Retail Settings Protocol, 

such as requiring that lead-containing 

materials be kept segregated from other 

materials in the establishment and 

inspected when received in the 

establishment for damage to packaging 

or the product that could release lead; 

that any manufacturing, repair, 

assembly, or maintenance work 

involving lead-containing products that 

generates lead aerosols or dust must be 

performed in a separate area of the 

establishment away from the retail 

space and must follow protocols to 

prevent lead contamination of the retail 

space; and that the employer must 

implement specific housekeeping 

practices (e.g., prohibition of dry 

sweeping, use of wet wiping/mopping 

and/or HEPA filtered vacuums) around 

lead-containing products or areas where 

these products are stored. 

(25) Should OSHA consider a safe 

harbor protocol approach similar to the 

Retail Settings Protocol described above, 

which is being considered for adoption 

in Washington? What aspects of the 

Protocol would be beneficial? Are there 

issues, concerns, or different approaches 

to a ‘‘safe harbor’’ for retail settings that 

OSHA should consider? 

4. Safe Harbor Protocol for Office and 

Residential Settings 

The Washington DOSH stakeholder 

review draft describes a protocol for 

employees working within a facility that 

has lead-based paint or paint with lead 

pigments doing work that does not 

disturb painted surfaces. This protocol 

would, for example, allow the employer 

to assume that workers in office and 

residential settings are not covered by 

the lead rule unless doing maintenance, 

remodeling, or repair work. Under this 

protocol, workers occupying a facility 

for office work are not covered by the 

rule, except when there is an incident 

causing a significant release and 

exposure to lead; and except for workers 

doing housekeeping work, who would 

be covered under the Basic Rules 

requirements for cleaning practices, 

hygiene, PPE, and provisions for hazard 

communication and training. 

To implement this protocol, 

employers and building owners may 

assume that paint contains lead or 

conduct screening tests to determine 

lead content. For this protocol, it is 

expected that there may be minor 

releases due to normal wear and tear 

and light repair work in the facility. The 

building owner or employer would be 

required to make written documentation 

of the lead assessment available in the 

facility for occupants, housekeeping 

workers, and maintenance workers. 

Maintenance or housekeeping staff 

would be required to make at least 

quarterly visual inspections of the 

facility for damage to lead paint surfaces 

in occupied areas. Whenever damage is 

discovered, by inspection, occupant 

report, or other observations, the 

building owner or employer would be 

required to assess the damage and 

ensure any repair and clean-up is done 

in a timely manner using methods that 

limit the spread of lead-containing 

materials (e.g., wet wiping, use of HEPA 

filtered vacuums). 

(26) Should OSHA consider a safe 

harbor protocol approach similar to the 

Office and Residential Settings protocol 

described above, which is being 

considered for adoption in Washington? 

What aspects of the protocol would be 

beneficial? Are there issues, concerns, 

or different approaches to a ‘‘safe 

harbor’’ that OSHA should consider for 

work in office and residential settings 

that does not involve maintenance, 

remodeling, or repair work? 

5. Safe Harbor Protocol for Incidental 

Lead Paint in Construction/Renovation, 

Repair, and Painting (RRP) Work 

The Washington DOSH stakeholder 

review draft describes a protocol for use 

by contractors and maintenance 

operations handling lead-containing 

paint. This protocol would apply to 

employers conducting incidental lead 

paint work covered by the EPA 

renovation, repair and painting work 

rules, or doing similar work. It is not 

intended for lead abatement work as 

defined by the U.S. Department of 

Commerce and EPA, which would be 

expected to involve greater levels of 

exposure than is contemplated by this 

protocol. 

This protocol assumes that: (1) work 

will be done with hand tools or power 

tools with HEPA filtered dust collection 

systems; (2) the work occurs in 

residential or similar construction 

where the primary lead-containing 

material is finish paint on wood or 

wallboard substrates, rather than 

structural steel; (3) contractors 

conducting this work are in compliance 

with the Department of Commerce and 

EPA programs and have certification 

from them when required; and (4) 

training required for environmental 

certification will be supplemented with 

additional information on Washington 

DOSH rules, including for personal 

protective equipment, respiratory 

protection, hygiene practices, and work 

practices. 

This protocol would require workers 

disturbing painted surfaces to wear halfface respirators with P100 filters or 

more protective respirators and would 

allow for workers to request Powered 

Air Purifying Respirators (PAPRs) with 

HEPA cartridges. The employer must 

implement a respiratory protection 

program (including identification of a 

respirator program administrator; 

identification of the respirator models 

and configuration the employer will 

require for each task performed; and the 

process for medical clearance and fit 

testing of workers) and must provide 

personal protective equipment 

including either safety glasses/goggles 

or full face respirators; disposable 

overalls or overalls that are laundered 

per Washington DOSH rule 

requirements; work boots; disposable 

shoe covers or dedicated work boots 

that are not worn off the worksite for 

workers scraping or sanding paint; 

gloves or a glove combination sufficient 

to prevent lead accumulation on the 

hands and provide necessary protection 

from cuts or other hand hazards; and 

other personal protective equipment 


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19Employers could choose to conduct exposure 

assessments to determine actual lead exposure 

levels and tailor their program under this protocol 

as indicated by those results. However, direct 

monitoring of exposure would not be required 

when not feasible in the timeframe of the project. 

Employers would assume paint in structures built 

before 1978 contains lead in quantities that will 

require controls and PPE as specified in this 

protocol. Paint could be tested by collecting 

samples for laboratory analysis, use of X-ray 

fluorescence, or following EPA/Department of 

Commerce rules for colorimetric testing kits. The 

protocol would require any paint found to 

potentially contain 5000 ppm lead or more than 1 

mg/cm2 of lead on the surface to be treated as a 

lead-containing material. 

20 ‘‘Lead-containing coatings’’ refers to coatings 

that are known or presumed to contain lead. 

necessary based on other hazards at the 

worksite. 

Employers using this protocol would 

provide workers with workplacespecific training (see DOSH Stakeholder 

Review Draft—Action Rules). Work 

covered under the EPA/Department of 

Commerce rules must be conducted by 

workers meeting the minimum training 

and certification standards of that 

program, with additional training on 

worker safety issues including health 

effects of lead, respiratory protection, 

PPE, work practices specific to the 

worksite, and limits of work practices. 

An on-site competent person must be 

able to recognize lead-related hazards 

and have authority to take action to 

correct lead issues at the worksite. 

Under this protocol, direct monitoring 

of employee exposure would not be 

required. The employer could presume 

that employee exposure to airborne lead 

is no greater than 10 times the proposed 

PEL of 20 mg/m3 as an eight-hour 

TWA.19 While this presumption is used, 

the employer must meet all 

requirements of the rule consistent with 

this level of exposure, including: 

baseline blood lead testing for all 

workers contacting lead-containing 

coatings 20 or in the vicinity of any work 

disturbing these materials, follow-up 

blood lead testing every two months for 

the first six months and every six 

months thereafter, and blood lead 

testing at the conclusion of work; lead 

control areas around any work 

disturbing lead-containing coatings; 

respirator use for all workers disturbing 

lead-containing coatings; and provision 

of appropriate PPE, a clean change area, 

and hygiene facilities including 

dedicated handwashing, boot cleaning, 

and showers as necessary. 

(27) Should OSHA adopt a safe harbor 

protocol approach similar to the 

protocol described above for incidental 

lead paint in RRP work that is being 

considered for adoption in Washington? 

What aspects of the protocol would be 

beneficial? Are there issues, concerns, 

or different approaches to a protocol for 

RRP work that OSHA should consider? 

F. Environmental Effects 

The National Environmental Policy 

Act (NEPA) of 1969 (42 U.S.C. 4321, et 

seq.), the Council on Environmental 

Quality (CEQ) regulations (40 CFR part 

1500), and the Department of Labor 

(DOL) NEPA Compliance Procedures 

(29 CFR part 11) require that OSHA give 

appropriate consideration to 

environmental issues and the impacts of 

proposed actions significantly affecting 

the quality of the human environment. 

OSHA intends to collect written 

information and data on possible 

environmental impacts that could occur 

outside of the workplace (e.g., exposure 

to the community through contaminated 

air/water, contaminated waste sites, 

etc.) if the agency were to revise the 

existing standard for occupational 

exposure to lead. Such information 

should include both negative and 

positive environmental effects that 

could be expected to result from 

guidance or a revised standard. 

Specifically, OSHA requests comments 

and information on the following: 

(28) What is the potential direct or 

indirect environmental impact (for 

example, the effect on air and water 

quality, energy usage, solid waste 

disposal, and land use) from a reduction 

in BLL triggers or other changes to the 

OSHA lead standards? 

(29) Are there any situations in which 

reducing lead exposures to employees 

would be inconsistent with meeting 

environmental regulations? 

G. Duplicative, Overlapping, or 

Conflicting Rules 

This section examines whether there 

are any duplicative, overlapping, or 

conflicting regulations concerning lead 

that OSHA should be aware of. In your 

explanation, please explain in detail if 

there are any such concerns of which 

the agency should be aware. 

(30) Are there any federal regulations 

that might duplicate, overlap, or conflict 

with modifications to the current lead 

standards? If yes, please identify and 

explain how they would duplicate, 

overlap, or conflict. 

(31) Are there any federal programs in 

areas such as defense or energy that 

might be impacted by modifications to 

the current lead standards? If yes, please 

identify and explain how they would be 

impacted. 

H. Questions for Employers on Current 

Practices 

OSHA requests that commenters, 

when answering questions regarding 

economic impact, be as specific as 

possible. For example, if an employer is 

using a modified medical surveillance 

program, then helpful information 

would include the following: the 

medical testing necessary; the exposure 

status or types of employees who would 

receive medical testing; the frequency of 

the testing; and the medical surveillance 

costs. The agency invites comment on 

the labor time and level of labor 

expertise required to implement 

proposed methods, even if dollar-cost 

estimates are not available. For 

discussion of equipment-related costs, 

OSHA requests that commenters 

estimate relevant factors such as 

purchase price, cost of installation, cost 

of equipment maintenance, cost of 

training, and expected life of the 

equipment. Also, please discuss the 

quantitative benefits (e.g., reductions in 

BLLs) and the associated costs (e.g., cost 

of an exposure control method). Because 

there are some differences between 

OSHA’s lead standards for general 

industry and construction, please 

specify which standard is applicable to 

your work. 

(32) If you use criteria more stringent 

than OSHA’s requirements for 

conducting blood lead testing on your 

employees, how do your criteria differ 

from OSHA’s requirements? 

(33) If you use criteria more stringent 

than OSHA’s requirements for notifying 

employees of their BLL and ZPP results, 

how do your criteria differ from OSHA’s 

requirements? 

(34) If you use criteria more stringent 

than OSHA’s requirements for medical 

removal protection in your work 

environment or industry, how do your 

criteria differ from OSHA’s 

requirements? Please include the 

criteria, such as the BLL, for both 

medical removal and return to work 

status. 

(35) What are your current costs of 

medical removal per employee (where 

possible, please monetize in terms of 

dollars per time unit (e.g., per month, 

per year))? Would your company be able 

to reassign the medically removed 

worker to a job at least at the clerical 

level that the employee would find 

acceptable? Please include specific 

examples of hourly wages (per job 

category) for the employee’s regular 

occupation and the hourly wages for the 

medically assigned clerical job, if 

available. 

(36) How many of your employees, 

over the past 10 years, have been 

removed from lead-exposed work due to 

elevated BLLs? If possible, please 

submit anonymized examples of 

employees who were brought into the 

medical removal program, their BLL 

level at the time of removal, and the 


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time required to bring the BLL level 

below 40 mg/dL (or an alternative 

specified level). 

(37) Over the past ten years, how 

many, or what percentage, of your 

employees were removed from leadexposed work due to elevated BLLs 

exceeding the maximum 18-month time 

period and were unable to return to 

work? 

(38) OSHA’s lead standards set a BLL 

of below 40 mg/dL (two consecutive 

tests) for return to lead-exposed work 

for medically removed workers. As 

discussed earlier in this ANPRM, in 

Section I.A. Background; Events 

Leading to this Action, OSHA is 

considering lowering the BLL for 

medical removal. If possible, please 

submit estimated increases in the 

number of affected employees and in 

costs if the BLL for allowing return to 

work were reduced to a level lower than 

OSHA’s current BLL of 40 mg/dL. Please 

specify the BLL for return to work you 

assume in your estimation. 

(39) How many and what percentage 

of your employees are currently in your 

medical surveillance program? How 

many of these employees receive BLL 

testing? How many receive ZPP 

monitoring? 

(40) What are your current costs of 

medical surveillance per employee? 

Please include specific examples of 

resource requirements in terms of 

additional staffing or time commitments 

(per job category), costs for purchase of 

testing materials (dollar cost per unit), 

expected life of equipment, and costs for 

energy usage and any other additional 

expenses. 

(41) The OSHA lead standard for 

general industry requires the employer 

to institute a medical surveillance 

program for all employees who are or 

may be exposed at or above the AL (30 

mg/m3) for more than 30 days per year. 

There are three requirements for 

biological monitoring that are triggered 

by the current AL (30 mg/m3): 

• At least every 6 months for each 

employee; 

• At least every two months for each 

employee whose last blood lead test 

indicated a BLL at or above 40 mg/dL. 

This frequency shall continue until two 

consecutive blood lead tests indicate a 

BLL below 40 mg/dL; and 

• At least monthly during the 

removal period of each employee 

removed from exposure to lead due to 

an elevated BLL. 

If possible, please discuss and/or 

submit quantitative estimates of the 

increases in the number of affected 

employees and in medical surveillance 

costs or other pertinent costs if the AL 

(30 mg/m3) were decreased. Please 

specify the AL you assume in your 

estimation. 

(42) Have you upgraded engineering 

controls to reduce airborne 

concentrations of lead in your facility? 

If yes, please describe the controls and 

whether you observed a subsequent 

reduction in BLLs. If so, did you 

monitor to what extent workers’ BLLs 

were reduced following implementation 

of upgraded controls? Please provide 

data, if available, on airborne lead 

concentrations in your facility and on 

workers’ BLLs prior to and following the 

upgrades. Also provide related initial 

and annual engineering control costs of 

upgraded controls, as well as the 

expected life of the equipment. 

(43) Please describe your control 

strategies to reduce lead surface 

contamination and the potential for 

dermal exposure to lead in your facility, 

such as housekeeping procedures, 

hygiene areas and practices, and 

personal protective clothing and 

equipment (PPE). Please describe such 

controls, their costs, and explain how 

well they work and why. To what extent 

were you able to lower the surface levels 

of lead? Did you see a subsequent 

reduction in employee BLLs? Please 

provide supporting data, if available. 

Personal Protective Clothing and 

Equipment (PPE) 

Employers are required to provide 

work clothing and equipment if an 

employee is exposed to lead above the 

PEL or where the possibility of skin or 

eye irritation exists. 

(44) Do you provide PPE in your 

workplace, including equipment 

providing respiratory protection? If yes, 

has it reduced BLLs in your workers? 

Please describe the type of PPE that you 

provide. 

(45) Does your company have triggers 

for PPE that are different from 

requirements under OSHA’s lead 

standards? Please describe the triggers 

used for providing PPE. 

(46) If your firm purchases clothing 

and equipment to protect employees 

from lead exposure, please estimate the 

PPE costs necessary to comply with the 

current OSHA lead standard. Please give 

costs on a per employee basis and at an 

aggregated level, if available. 

(47) Have you upgraded PPE to reduce 

worker exposure to lead? If yes, please 

describe the controls and whether you 

observed a subsequent reduction in 

BLLs. If so, to what extent were workers’ 

BLLs reduced following implementation 

of upgraded PPE, if applicable? Please 

provide data, if available. 

Housekeeping 

OSHA’s lead standards contain a 

housekeeping provision that requires 

employers to keep surfaces as free as 

practicable from lead, encourages the 

use of vacuuming to clean surfaces, 

limits the use of dry sweeping and 

shoveling, and prohibits using 

compressed air to clean surfaces. Some 

variation exists between the 

housekeeping provisions for general 

industry and construction. 

(48) Do you have housekeeping 

procedures? If yes, please describe. 

(49) Does your company have 

cleaning criteria specific to surfaces? 

This may include a schedule for 

cleaning and periodic surface 

cleanliness measurements, specific 

types of cleaning practices and 

activities, or other activities associated 

with surface decontamination. 

(50) What are your current 

housekeeping costs to comply with the 

OSHA lead standard? Please provide the 

amount of time allocated for 

housekeeping costs calculated on an 

hourly basis. 

Hygiene Facilities and Practices 

OSHA’s lead standards contain 

hygiene facilities and practices 

provisions that require employers to 

provide showers, change rooms, and 

lunchrooms when workers are exposed 

to lead above the PEL without regard to 

the use of respirators. The employer 

must also ensure that food or beverage 

is not present or consumed, tobacco 

products are not present or used, and 

cosmetics are not applied in areas where 

workers are exposed above the PEL. 

Some variation exists between the 

hygiene facilities and practices 

provisions for general industry and 

construction. 

(51) Have you provided hygiene 

facilities or used hygiene practices 

beyond the requirements of OSHA’s 

lead standards? This may include more 

frequent hand washing breaks or 

providing access and time for showers 

at exposures below the PEL. Please 

describe how your practices differ from 

requirements in OSHA’s lead standards. 

(52) What are your current costs to 

comply with the hygiene provisions of 

OSHA’s lead standards? Please provide 

the amount of time allocated for hygiene 

costs calculated on an hourly basis. 

BLLs and Lead Dust Contamination 

Some federal agencies, such as the 

U.S. Department of Housing and Urban 

Development (HUD) and the EPA, have 

established lead dust hazard action 

levels for surfaces (HUD, 2012; EPA 

2001). OSHA is interested in 


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information on using lead dust hazard 

surface measurements and any observed 

correlation between surface lead dust 

levels and elevated BLLs. 

(53) Have you taken lead dust surface 

measurements in your work 

environment? If so, what are your 

procedures and current costs for this 

testing? Please specify the labor and 

equipment costs for the testing. Have 

you experienced any impediments or 

limitations when using wipe sampling 

to identify surface contamination with 

lead? What can be done to overcome 

these barriers? 

(54) If you have taken lead dust 

surface measurements, are they 

qualitative (presence of lead only) or 

quantitative? If quantitative, do you use 

lead dust hazard levels established by 

HUD and EPA? Please provide any data 

you have on quantitative surface 

contamination measurements in your 

work environment. 

(55) Have you evaluated lead surface 

contamination to investigate elevated 

employee BLLs in areas where airborne 

lead exposure was below the PEL? If 

yes, what were your findings? 

(56) Have you taken wipe samples of 

skin or clothing to identify lead 

contamination? If yes, what were your 

findings? 

(57) Have you found any correlation 

between BLLs and lead surface 

contamination, particularly when 

airborne exposures are below the PEL? 

Impact on Small Business Entities 

Under the Regulatory Flexibility Act 

(5 U.S.C. 601 et seq.), OSHA is required 

to assess the impact of proposed and 

final rules on small entities. OSHA 

requests that members of the small 

business community, or other parties 

familiar with regulation of small 

business, address any special 

circumstances facing small firms in 

controlling occupational exposure to 

lead. 

(58) How many and what kinds of 

small businesses or other small entities 

in your industry could be affected by 

lower protective BLL triggers in the 

OSHA lead standard for general 

industry? Describe any such effects. 

(59) How many and what kinds of 

small businesses or other small entities 

in your industry could be affected by 

lower BLL triggers in the OSHA lead 

standard for construction? Describe any 

such effects. 

(60) Are there special issues or 

reasons that lower BLL triggers are more 

difficult or costlier to implement in 

small firms? Please describe. 

(61) Are there any reasons why 

benefits from reducing worker BLLs 

would be different in small firms than 

in larger firms? With regard to potential 

impacts on small firms, please describe 

specific concerns that OSHA should 

address and any alternatives that might 

serve to minimize these impacts while 

meeting the requirements of the OSH 

Act. 

Authority and Signature 

Douglas Parker, Assistant Secretary of 

Labor for Occupational Safety and 

Health, U.S. Department of Labor, 200 

Constitution Avenue NW, Washington, 

DC, 20210, authorized the preparation 

of this document pursuant to the 

following authorities: sections 4, 6, and 

8 of the Occupational Safety and Health 

Act of 1970 (29 U.S.C. 653, 655, 657), 

Secretary’s Order 8–2020 (Sept. 18, 

2020), and 29 CFR part 1911. 

Signed at Washington, DC, on June 21, 

2022. 

Douglas L. Parker, 

Assistant Secretary of Labor for Occupational 

Safety and Health. 

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Profile (Subcategory) OSHA Information 

System (OIS) Personal Sampling Data for 

Lead (2014–2018). Salt Lake Technical 

Center. Retrieved from: https://

www.osha.gov/lead/industry-groupprofile. Accessed on November 10, 2020. 

Occupational Safety and Health 

Administration (OSHA). (2020b). OSHA 

Enforcement Data, Inspection. Retrieved 

from: https://enforcedata.dol.gov/views/ 

data_summary.php. Accessed on April 

3, 2020. 

Occupational Safety and Health 

Administration (OSHA). (2020c). OSHA 

Enforcement Data, Violation. Retrieved 

from: https://enforcedata.dol.gov/views/ 

data_summary.php. Accessed on April 

3, 2020. 

Office of Environmental Health Hazard 

Assessment (OEHHA). (2014). California 

Environmental Protection Agency; 

(2014). Estimating Workplace Air and 

Worker Blood Lead Concentration using 

an Updated Physiologically-based 

Pharmacokinetic (PBPK) Model. 

Retrieved from: https://oehha.ca.gov/air/ 

document/oehha-presentation-pbpkmodel-blood-lead-and-worker-exposure. 

Accessed on July 12, 2021. 

Payne S, et al. (2017). Blood Lead Levels in 

California Workers: Data Reported to the 

Occupational Blood Lead Registry, 2012– 

2014. Richmond, CA, California 

Department of Public Health, 

Occupational Health Branch. 

Schwartz BS, Hu H. (2007). Adult lead 

exposure: time for change. Environ 

Health Perspect. 115(3): 451–454. 

Shih RA, Hu H, Weisskopf MG, Schwartz BS. 

(2007). Environ Health Perspect. 115(3): 

483–492. 

U.S. Census Bureau, 2017, Statistics of US 

Businesses, Program Glossary. Available 

at: https://www.census.gov/programssurveys/susb/about/glossary.html. 

U.S. Department of Defense (DOD). (2018.) 

DoD 6055.05–M. Occupational Medical 

Examinations and Surveillance Manual, 

Incorporating Change 3, August 31, 2018. 

U.S. Department of Health and Human 

Services (HHS). (2022). Fourth national 

report on human exposure to 

environmental chemicals, updated 

tables, March 2022, volume one. 

Retrieved from: https://www.cdc.gov/ 

exposurereport/data_tables.html. 

Accessed April 25, 2022. 

U.S. Department of Housing and Urban 

Development (HUD). (2012). Guidelines 

for the Evaluation and Control of LeadBased Paint Hazards in Housing (2012 

Edition). Retrieved from: https://

www.hud.gov/program_offices/healthy_

homes/lbp/hudguidelines. Accessed on 

November 10, 2020. 

Appendix A 

TABLE 1—SUMMARY OF ANNUAL NUMBER OF FIRMS WITH BLL TESTS AND CASES 1

NAICS NAICS description 

Estimated 

number of 

firms where 

employees 

receive 

BLL tests 

Estimated number of firms with BLL cases 

BLL ≥5 BLL ≥10 BLL ≥25 BLL ≥ medical 

removal BLL 2

1151 .... Support Activities for Crop Production ............... 2 1 0 0 0 

2122 .... Metal Ore Mining ................................................ 466 78 36 11 0 

2123 .... Nonmetallic Mineral Mining and Quarrying ........ 17 2 0 0 0 

2131 .... Support Activities for Mining .............................. 35 5 0 0 0 

2211 .... Electric Power Generation, Transmission and 

Distribution.

25 22 22 10 0 

2212 .... Natural Gas Distribution ..................................... 138 19 11 2 0 


khammond on DSKJM1Z7X2PROD with PROPOSALS
38360 Federal Register / Vol. 87, No. 123 / Tuesday, June 28, 2022 / Proposed Rules 

TABLE 1—SUMMARY OF ANNUAL NUMBER OF FIRMS WITH BLL TESTS AND CASES 1—Continued 

NAICS NAICS description 

Estimated 

number of 

firms where 

employees 

receive 

BLL tests 

Estimated number of firms with BLL cases 

BLL ≥5 BLL ≥10 BLL ≥25 BLL ≥ medical 

removal BLL 2

2213 .... Water, Sewage and Other Systems .................. 9 9 0 0 0 

2361 .... Residential Building Construction ...................... 769 145 83 37 2 

2362 .... Nonresidential Building Construction ................. 864 323 204 67 9 

2371 .... Utility System Construction ................................ 87 50 36 10 1 

2373 .... Highway, Street, and Bridge Construction ......... 386 136 91 43 4 

2379 .... Other Heavy and Civil Engineering Construction.51 10 10 8 1 

2381 .... Foundation, Structure, and Building Exterior 

Contractors.

251 171 95 11 1 

2382 .... Building Equipment Contractors ........................ 488 132 58 31 4 

2383 .... Building Finishing Contractors ........................... 2,746 655 452 199 34 

2389 .... Other Specialty Trade Contractors .................... 1,305 354 227 47 9 

2399 .... Construction (Specific industry unknown) .......... 516 86 25 25 0 

3231 .... Printing and Related Support Activities ............. 146 20 11 2 0 

3241 .... Petroleum and Coal Products Manufacturing .... 11 11 0 0 0 

3251 .... Basic Chemical Manufacturing .......................... 42 20 11 2 0 

3252 .... Resin, Synthetic Rubber, and Artificial and Synthetic Fibers and Filaments Manufacturing.175 25 13 3 0 

3255 .... Paint, Coating, and Adhesive Manufacturing .... 38 21 12 2 0 

3259 .... Other Chemical Product and Preparation Manufacturing.158 22 12 2 0 

3271 .... Clay Product and Refractory Manufacturing ...... 99 50 27 5 0 

3272 .... Glass and Glass Product Manufacturing ........... 5,156 715 398 113 2 

3279 .... Other Nonmetallic Mineral Product Manufacturing.12 2 0 0 0 

3311 .... Iron and Steel Mills and Ferroalloy Manufacturing.99 13 13 13 1 

3312 .... Steel Product Manufacturing from Purchased 

Steel.

184 26 14 3 0 

3314 .... Nonferrous Metal (except Aluminum) Production and Processing.1,431 224 189 187 13 

3315 .... Foundries ........................................................... 1,103 152 102 28 1 

3323 .... Architectural and Structural Metals Manufacturing.994 142 91 44 2 

3324 .... Boiler, Tank, and Shipping Container Manufacturing.261 38 23 7 0 

3325 .... Hardware Manufacturing .................................... 166 23 13 2 0 

3327 .... Machine Shops; Turned Product; and Screw, 

Nut, and Bolt Manufacturing.

53 15 15 14 0 

3328 .... Coating, Engraving, Heat Treating, and Allied 

Activities.

256 39 22 10 0 

3329 .... Other Fabricated Metal Product Manufacturing 1,100 187 154 46 1 

3333 .... Commercial and Service Industry Machinery 

Manufacturing.

133 19 10 2 0 

3336 .... Engine, Turbine, and Power Transmission 

Equipment Manufacturing.

17 17 0 0 0 

3339 .... Other General Purpose Machinery Manufacturing.65 9 9 2 0 

3341 .... Computer and Peripheral Equipment Manufacturing.6 1 0 0 0 

3342 .... Communications Equipment Manufacturing ...... 146 31 17 3 0 

3343 .... Audio and Video Equipment Manufacturing ...... 4 0 0 0 0 

3344 .... Semiconductor and Other Electronic Component Manufacturing.323 37 25 9 1 

3345 .... Navigational, Measuring, Electromedical, and 

Control Instruments Manufacturing.

394 72 37 11 0 

3359 .... Other Electrical Equipment and Component 

Manufacturing.

851 165 136 136 24 

3363 .... Motor Vehicle Parts Manufacturing .................... 994 142 89 33 2 

3364 .... Aerospace Product and Parts Manufacturing .... 427 96 40 21 1 

3366 .... Ship and Boat Building ...................................... 23 23 13 13 0 

3369 .... Other Transportation Equipment Manufacturing 9 8 0 0 0 

3399 .... Other Miscellaneous Manufacturing .................. 296 53 53 12 0 

4231 .... Motor Vehicle and Motor Vehicle Parts and 

Supplies Merchant Wholesalers.

305 57 31 6 0 

4236 .... Household Appliances and Electrical and Electronic Goods Merchant Wholesalers.330 46 25 6 0 


khammond on DSKJM1Z7X2PROD with PROPOSALS
Federal Register / Vol. 87, No. 123 / Tuesday, June 28, 2022 / Proposed Rules 38361 

TABLE 1—SUMMARY OF ANNUAL NUMBER OF FIRMS WITH BLL TESTS AND CASES 1—Continued 

NAICS NAICS description 

Estimated 

number of 

firms where 

employees 

receive 

BLL tests 

Estimated number of firms with BLL cases 

BLL ≥5 BLL ≥10 BLL ≥25 BLL ≥ medical 

removal BLL 2

4237 .... Hardware, and Plumbing and Heating Equipment and Supplies Merchant Wholesalers.130 18 10 2 0 

4238 .... Machinery, Equipment, and Supplies Merchant 

Wholesalers.

12 2 0 0 0 

4239 .... Miscellaneous Durable Goods Merchant 

Wholesalers.

629 141 141 130 3 

4244 .... Grocery and Related Product Merchant Wholesalers.7 1 0 0 0 

4247 .... Petroleum and Petroleum Products Merchant 

Wholesalers.

14 2 0 0 0 

4413 .... Automotive Parts, Accessories, and Tire Stores 136 19 10 2 0 

4441 .... Building Material and Supplies Dealers ............. 134 19 10 2 0 

4451 .... Grocery Stores ................................................... 8 1 0 0 0 

4483 .... Jewelry, Luggage, and Leather Goods Stores .. 125 18 10 2 0 

4511 .... Sporting Goods, Hobby, and Musical Instrument Stores.780 109 60 11 0 

4821 .... Rail Transportation ............................................. 8 8 8 2 0 

4841 .... General Freight Trucking ................................... 13 13 0 0 0 

4842 .... Specialized Freight Trucking .............................. 12 3 0 0 0 

4851 .... Urban Transit Systems ...................................... 3 3 3 2 0 

4881 .... Support Activities for Air Transportation ............ 21 21 21 12 0 

4883 .... Support Activities for Water Transportation ....... 306 45 25 6 0 

4884 .... Support Activities for Road Transportation ........ 183 11 10 3 0 

4911 .... Postal Service .................................................... 0 0 0 0 0 

4921 .... Couriers and Express Delivery Services ........... 8 1 0 0 0 

5111 .... Newspaper, Periodical, Book, and Directory 

Publishers.

131 18 10 2 0 

5173 .... Wired and Wireless Telecommunications Carriers.10 1 0 0 0 

5182 .... Data Processing, Hosting, and Related Services.0 0 0 0 0 

5211 .... Monetary Authorities-Central Bank .................... 131 18 10 2 0 

5242 .... Agencies, Brokerages, and Other Insurance 

Related Activities.

10 3 0 0 0 

5311 .... Lessors of Real Estate ....................................... 7 4 0 0 0 

5313 .... Activities Related to Real Estate ....................... 231 32 18 3 0 

5323 .... General Rental Centers ..................................... 53 19 10 4 0 

5324 .... Commercial and Industrial Machinery and 

Equipment Rental and Leasing.

113 16 9 2 0 

5413 .... Architectural, Engineering, and Related Services.218 88 65 12 0 

5415 .... Computer Systems Design and Related Services.121 17 9 2 0 

5416 .... Management, Scientific, and Technical Consulting Services.153 53 19 7 0 

5417 .... Scientific Research and Development Services 12 12 8 2 0 

5419 .... Other Professional, Scientific, and Technical 

Services.

125 18 10 2 0 

5611 .... Office Administrative Services ........................... 118 17 9 2 0 

5613 .... Employment Services ........................................ 119 45 34 10 0 

5614 .... Business Support Services ................................ 12 2 0 0 0 

5616 .... Investigation and Security Services ................... 395 66 36 7 0 

5617 .... Services to Buildings and Dwellings .................. 127 18 10 2 0 

5621 .... Waste Collection ................................................ 102 35 19 4 0 

5622 .... Waste Treatment and Disposal ......................... 39 28 22 6 0 

5629 .... Remediation and Other Waste Management 

Services.

1,663 739 494 190 4 

6111 .... Elementary and Secondary Schools .................. 4 3 3 2 0 

6112 .... Junior Colleges .................................................. 146 20 11 2 0 

6113 .... Colleges, Universities, and Professional 

Schools.

11 8 0 0 0 

6115 .... Technical and Trade Schools ............................ 714 100 46 10 0 

6116 .... Other Schools and Instruction ........................... 745 111 61 19 0 

6211 .... Offices of Physicians .......................................... 9 9 0 0 0 

6214 .... Outpatient Care Centers .................................... 9 5 0 0 0 

6215 .... Medical and Diagnostic Laboratories ................. 9 9 0 0 0 

6219 .... Other Ambulatory Health Care Services ........... 9 4 4 4 0 

6221 .... General Medical and Surgical Hospitals ............ 10 4 0 0 0 


khammond on DSKJM1Z7X2PROD with PROPOSALS
38362 Federal Register / Vol. 87, No. 123 / Tuesday, June 28, 2022 / Proposed Rules 

TABLE 1—SUMMARY OF ANNUAL NUMBER OF FIRMS WITH BLL TESTS AND CASES 1—Continued 

NAICS NAICS description 

Estimated 

number of 

firms where 

employees 

receive 

BLL tests 

Estimated number of firms with BLL cases 

BLL ≥5 BLL ≥10 BLL ≥25 BLL ≥ medical 

removal BLL 2

6222 .... Psychiatric and Substance Abuse Hospitals ..... 12 12 0 0 0 

6232 .... Residential Intellectual and Developmental Disability, Mental Health, and Substance Abuse 

Facilities.

15 15 0 0 0 

6241 .... Individual and Family Services .......................... 51 18 10 2 0 

6243 .... Vocational Rehabilitation Services ..................... 10 1 0 0 0 

7115 .... Independent Artists, Writers, and Performers ... 3 1 0 0 0 

7121 .... Museums, Historical Sites, and Similar Institutions.309 50 30 21 0 

7131 .... Amusement Parks and Arcades ........................ 3 3 0 0 0 

7139 .... Other Amusement and Recreation Industries ... 6,656 1024 619 205 9 

8111 .... Automotive Repair and Maintenance ................. 3,333 553 310 72 1 

8112 .... Electronic and Precision Equipment Repair and 

Maintenance.

29 17 17 11 0 

8113 .... Commercial and Industrial Machinery and 

Equipment (except Automotive and Electronic) Repair and Maintenance.

79 14 10 6 0 

8114 .... Personal and Household Goods Repair and 

Maintenance.

953 133 71 34 1 

8122 .... Death Care Services .......................................... 145 20 11 2 0 

8131 .... Religious Organizations ..................................... 12 3 0 0 0 

8139 .... Business, Professional, Labor, Political, and 

Similar Organizations.

488 72 50 28 1 

9211 .... Executive, Legislative, and Other General Government Support.0 0 0 0 0 

9221 .... Justice, Public Order, and Safety Activities ....... 0 0 0 0 0 

9231 .... Administration of Human Resource Programs .. 0 0 0 0 0 

9241 .... Administration of Environmental Quality Programs.0 0 0 0 0 

9251 .... Administration of Housing Programs, Urban 

Planning, and Community Development.

0 0 0 0 0 

9261 .... Administration of Economic Programs ............... 0 0 0 0 0 

9281 .... National Security and International Affairs ........ 0 0 0 0 0 

Total 44,144 8,611 5,302 2,087 137 

1The Census Bureau defines an establishment as a single physical location at which business is conducted or services or industrial operations 

are performed. The Census Bureau defines a business firm or entity as a business organization consisting of one or more domestic establishments in the same state and industry that are specified under common ownership or control. The firm and the establishment are the same for 

single-establishment firms. For each multi-establishment firm, establishments in the same industry within a state will be counted as one firm; the 

firm employment and annual payroll are summed from the associated establishments. 2 Medical removal levels are BLL ≥50 μg/dL in Construction (NAICS 23) and BLL ≥60 μg/dL in General Industry. 

[FR Doc. 2022–13696 Filed 6–27–22; 8:45 am] 

BILLING CODE 4510–26–P 

ENVIRONMENTAL PROTECTION 

AGENCY 

40 CFR Part 52 

[EPA–R06–OAR–2021–0772; FRL–9889–01– 

R6] 

Air Plan Approval; New Mexico; 

Interstate Transport Requirements for 

2010 Nitrogen Dioxide National 

Ambient Air Quality Standards 

AGENCY: Environmental Protection 

Agency (EPA). 

ACTION: Proposed rule. 

SUMMARY: The Environmental Protection 

Agency (EPA) is proposing to approve 

the State Implementation Plan (SIP) 

revision submitted by the State of New 

Mexico, through New Mexico 

Environment Department (NMED) dated 

June 25, 2021, for the purpose of 

addressing the Clean Air Act (CAA or 

‘‘Act’’) ‘‘good neighbor’’ interstate 

transport (prongs 1 and 2) infrastructure 

SIP requirements for the 2010 1-hour 

Nitrogen Dioxide (NO2) National 

Ambient Air Quality Standard 

(NAAQS). The CAA requires that each 

state adopt and submit a SIP for the 

implementation, maintenance, and 

enforcement of each NAAQS 

promulgated by the EPA, commonly 

referred to as an ‘‘infrastructure SIP.’’ 

Specifically, the EPA is proposing to 

approve New Mexico’s June 25, 2021, 

SIP revision addressing prongs 1 and 2 

to ensure that air emissions in the State 

do not significantly contribute to 

nonattainment or interfere with 

maintenance of the 2010 1-hour NO2

NAAQS in any other state. The EPA is 

proposing to approve this action 

pursuant to section 110 and part D of 

the CAA and the EPA’s regulations. 

DATES: Written comments must be 

received on or before July 28, 2022. 

ADDRESSES: Submit your comments, 

identified by Docket No. EPA–R06– 

OAR–2021–0772, at https://

www.regulations.gov. Follow the online 

instructions for submitting comments. 

Once submitted, comments cannot be 

edited or removed from Regulations.gov. 

The EPA may publish any comment 

received to its public docket. Do not 

submit electronically any information 

you consider to be Confidential 

Business Information (CBI) or other 


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