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Lead in the Workplace
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 Lead in the Workplace
 About
																							Symptoms
																							Risk Factors
																							Prevention
																							Workplace Lead Exposure Trends
																							Blood Lead Level Guidance
																							Resources
																							About ABLES
																						View All
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						Lead in the Workplace


About Symptoms Risk Factors Prevention Workplace Lead Exposure Trends Blood Lead Level Guidance Resources About ABLES View All




Lead in the Workplace
 Blood Lead Level Guidance


Key points
 Blood lead tests are used to check a person's blood lead level to ensure workers are protected from lead exposure.
Any amount of lead in the blood means a person was exposed to lead.
There are several regulations/recommendations related to blood lead testing, blood lead levels, and lead exposure in the workplace.
 Healthcare providers decide on the best treatment based on the level of lead in the blood.
 About blood lead levels (BLLs) Workplace safety and health professionals use BLLs to ensure workers are protected from lead exposure. Healthcare providers can measure your BLL by taking a blood sample. A lab tests the sample for lead. Any amount of lead in the blood means a person was exposed to lead. Healthcare providers will decide on the best treatment based on the level of lead in the blood.
 Regulations and recommendations The Occupational Safety and Health Administration (OSHA) and a few state agencies **regulate**BLLs in workers. Other government agencies and non-government groups offer **recommended**lead exposure limits. The following table presents a range of BLLs along with related information and documented regulatory and recommended actions associated with each level. BLLs are in units of micrograms per deciliter (μg/dL). 0.855 μg/dL
 In 2017-2018, this was the typical BLL among adults in the United States.1
 3.5 μg/dL
 The Council of State and Territorial Epidemiologists’ (CSTE) blood lead reference value is 3.5 μg/dL. This value is used to identify adults and children whose blood lead levels are higher than the 97.5th percentile of adults and children nationwide.23The California Department of Public Health (CDPH) recommends that, if the BLL is between 3.5 to 9 μg/dL, the BLL test be repeated every 3 months for adults until their BLL is less than 3.5 μg/dL. 45The American College of Occupational and Environmental Medicine (ACOEM) states it is advisable for women who are or may become pregnant to avoid occupational lead exposure that would elevate the BLL greater than or equal to 3.5 μg/dL.6
 5 μg/dL
 The ABLES programuses 5 μg/dL to indicate an elevated BLL for surveillance purposes.If pregnant, you should not exceed 5 μg/dL. The National Toxicology Program (NTP) concluded that people who are pregnant with BLLs even lower than 5 μg/dL can result in reduced fetal growth.7
 10 μg/dL
 Below 10μg/dL, the NTP concluded lead increases blood pressure, the risk of hypertension, and the incidence of essential tremor.7ACOEM and CDPH recommend repeat BLL tests every two months if a person’s BLL results are between 10 to 19 μg/dL.56
 15 μg/dL
 Michigan Occupational Safety and Health Administration (MIOSHA) requires BLL testing every 2 months for employees found to have a BLL of 15 μg/dL or higher8. Employees can return to work when they have 2 consecutive BLL tests below 15 μg/dL.ACOEM believes workers should not return to work until the BLL is below 15 μg/dL and after a physician assessment of the worker’s health and work status.6
 20 μg/dL
 ACOEM and CDPH recommend medical removal if a worker has two consecutive BLLs between 20-29 μg/dL.56The American Conference of Governmental Industrial Hygienists (ACGIH®) guideline states that the typical worker can experience a BLL of 20 μg/dL without adverse health effect.9 This guideline is intended for use in the practice of industrial hygiene, but others may wish to use these guidelines as supplements to occupational safety and health programs.
 25 μg/dL
 ACOEM and CDPH recommend medical removal if a worker has two consecutive BLLs between 20-29 μg/dL.56The Occupational Safety and Health Administration (OSHA) considers a BLL of 25 μg/dL as serious and must be handled by inspection. This determination was based on OSHA’s National Emphasis Program (NEP) for Lead, which was released to protect the health and safety of workers in industries determined to pose a higher risk to people and the environment.
 30 μg/dL
 MIOSHA requires medical removal at 30 μg/dL.8The Association of Occupational and Environmental Clinics (AOEC), ACOEM, and CDPH recommend that workers be medically removed from work with lead exposure if one BLL exceeds 30 μg/dL. 7610ACOEM, CDPH, and MIOSHA  have issued more stringent and health protective limits than other federal and state-based regulatory groups.
 40 μg/dL
 If an employee has been medically removed from work based on a previously high BLL, OSHA permits the employee to return to work once 2 consecutive BLLs are measured below 40 μg/dL.11
 50-60 μg/dL
 At a BLL of 50-60 μg/dL, OSHA requires medical removal.11The employer must remove any employees exposed to lead in the workplace if their BLL is 50 μg/dL or more for workers in construction, or 60 μg/dL or more for workers in general industry.
  April 11, 2024 Sources Print Share
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 National Institute for Occupational Safety and Health
 References Centers for Disease Control and Prevention (CDC) [2019] Fourth national report on human exposure to environmental chemicals, updated tables, January 2019. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention
CDC [2023] National Notifiable Diseases Surveillance System (NNDSS), Lead, elevated blood lead level.Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
Council of State and Territorial Epidemiologists (CSTE) [2022], Public health reporting and national notification for elevated blood lead levels. Atlanta, GA.
Adopted CSTE Occupational Subcommittee [2021]. Management Guidelines for Blood Lead Levels in Adults.
California Department of Public Health [2021]. Health-based guidelines for blood lead levels in adults.
Kosnett MJ, Berenji M, Burton AD, et al. [2023]. American College of Occupational and Environmental Medicine (ACOEM) Position Statement: Workplace Health and Safety Necessitates an Update to Occupational Lead Standard Provisions for Medical Removal Protection, Medical Surveillance Triggers, and the Action Level and Permissible Exposure Level for Lead in Workplace Air: ACOEM Response to OSHA. JOEM Mar 1; 65(3): e170-e176
National Institute for Environmental Health Services (NIEHS) [2012] National Toxicology Program NTP Monograph: Health effects of low-level lead. Research Triangle Park, NC: U.S. Department of Health and Human Services, National Institutes of Health.
Michigan Occupational Safety and Health Administration, Occupational Health Guide for Lead
American Conference of Governmental Industrial Hygienists (ACGIH®) [Last revised April 2012] Biological Exposure Indices (BEI®) Introduction Cincinnati, OH. Page visited 2/1/2021.
Association of Occupational and Environmental Clinics (AOEC) [2007] Medical management guidelines for lead-exposed adults, revised 4/24/2007external icon. Washington, D.C.
OSHA Lead Standards. Washington, DC: U.S. Department of Labor, Occupational Safety and Health Administration.


National Institute for Occupational Safety and Health (NIOSH) The Occupational Safety and Health Act of 1970 established NIOSH as a research agency focused on the study of worker safety and health, and empowering employers and workers to create safe and healthy workplaces. View All
 Lead in the Workplace About
													Symptoms
													Risk Factors
													Prevention
 Workplace Lead Exposure Trends
													Blood Lead Level Guidance
													Resources
													About ABLES
																			View All
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Contact Us Contact Us  Call 800-232-4636
						Contact CDC
 About CDC Mission & Organization
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						About CDC
 Policies Accessibility
						External Links
						Privacy
						Web Policies FOIA
						OIG
						No Fear Act
						Nondiscrimination
						Vulnerability Disclosure Policy
 Languages Languages Español
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