Table 2.1: Summary of WES and BLRL that have supporting documentation Country & Agency WESa Date Fraction BLRL (µg/dL) a, b Date Comment Reference Set Revised M & FNR FR FP & FB Set Revised EC (SCOEL) 0.1 2002 NS Lead fumes and dusts <10µm 30 (non-legislated BLRL) 2002 NS This is a recommendation from a committee, not legislated. However, it has been picked up by various member countries. Rationale not clear, however BLRL seems to be set at a level lower than that which is said to protect against a range of health effects in adult workers. Background PbB seems to have been considered. 2002 Germany (DFG) - - - - 30 c 7 c 2000 2013d Supporting documentation only located for previous recommendations. DFG 2005; 2013a, b USA (ACGIH) 0.05 1995 NA Inhalable 30 Implied BLRL for pregnant females = 10 e 1995 NA BLRL set to minimise potential for a range of non-transient effects. WES set to conform with BLRL. 2001a, b Health Organisation (WHO) 0.03 – 0.06 1980 NA NS 40 (non- BLRL) 30 (non-legislated BLRL) 1980 NA BLRL set to minimise potential for a of adverse effects. WES set to conform with BLRL using a relationship of 0.5 µg/dL increase in PbB per µg/m3 (i.e. 0.001 mg/m3) PbAir and a background PbB of 10 to 25 µg/dL. WHO 1980 Scientific members - - - - <20 (to prevent effects & chronic for 10-20 yr. exposure) 10 (to prevent chronic effects for 20-40 yr. exposure) (non-legislated BLRL) 2007 NA The scientific expert panel for the Development of Adult PbB Level Medical Management Guidelines suggested these revised BLRL aiming that their publication would have an impact on policy. They similar recommendations had been made >15 years before. Schwartz and Hu 2007
Canada – British Columbia (WorkSafe BC) 0.05 NS NS NS - - - Same as ACGIH. WorkSafe BC 2013 Canada – Ontario (MoL) 0.05 NS NS NS 70 (legislated BLRL) 40 (legislated BLRL) 1981 NA WES same as old and outdated (Ontario MoL 1981). Occupational Health Clinics for Ontario Workers (OHCOW 2013) criticised Ontario MoL for not revising BLRL although recommendations to do so were received as far back as 1992. Ontario MoL 1981, 2013 Canada – Quebec (Quebec Gov) 0.05 NS NS NS - - - - WES same as ACGIH. Quebec Gov 2013 Chile (MdS) 0.12 NS NS NS 40 NS NS MdS 2000 China (Ministry of Health) 0.05 2002 NS NS - - - Ye and Wong 2002 (not an agency reference; original agency reference could not be sourced) Denmark (DWEA) 0.05 1996 NS NS 20 NS NS DWEA 2007 Europe (EC) 0.15 1998 NA NS 70 1998 NA EC 1998 Finland (MoSAH) 0.1 1993 NA NS 50 (legislated BLRL) Objective 30 f NS NS MoSAH 2012 France (INRS) 0.1 2004 NS Inhalable 40 f 30 f 2003 NS INRS 2006, 2012; Legifrance 2003
Germany (BAuA) - g - - - 40 h 30 h 1998 Currently being revised BAuA 2013a, b Ireland (H&SA) 0.15 1998 NS NS 70 1998 NS Same as the EC (1998) regulations. H&SA 2011a, b Japan (JSOH) 0.1 1982 NS NS 40 1994 NS JSOH 2010 Luxembourg (JOGDL) 0.15 1998 NS NS 70 1998 NS Same as the EC (1998) regulations. JOGDL 2002 New Zealand (DoL) 0.1 NS NS Inhalable 50 BLRL) objective <30 i 30 (or lower) i 2010 NA NZ DoL 2011 South Africa (SA DoL) 0.15 NS NS NS 60 BLRL) 40 (legislated BLRL) j 2002 NS SA DoL 2002 Spain 0.15 NS NS NS 70 NS NS Same as the EC (1998) regulations. INSHT 2013 Sweden (SWEA) 0.1 1993 NS Total dust 40 BLRL) k 25 Not to work k NS NS Lead-related work is completely forbidden for pregnant or workers. SWEA 2005a, b, NIWL 2005 0.05 Respirable dust Switzerland (SUVA) 0.1 NS NS NS 40 l 10 l NS NS Same as the German DFG (2005) values (see Section 2.1.2) SUVA 2013 UK (HSE) 0.15 NS NS Inhalable 60 BLRL) m 30 Not to work m NS NS UK HSE 2002, 2012 USA (OSHA) 0.05 1978 NA NS 60 or 50 (legislated BLRL) n 1978 1983 OSHA 1991 USA (NIOSH) 0.05 1978 NS NS 60 NS NS 2010, 2011, FR 1997
Table 4.1: PbB response in adults from occupational epidemiology studies a PbB (μg/dL) Nervous System ^ ^ Blood? Kidneys? Endocrine system? Immune system? Female reproduction? Male reproduction ^ Mutagenicity? Cancer? k Gastrointestinal Liver? <5 5-10 Auditory function decrements? k ↓haemoglobin, activity? l ↑ hormone in response to stress? m 10-15 15-20 20-30 Increased blood pressure & heart rate variability c ↓ haemoglobin, activity d Subtle changes in immune markers g Endocrine function, reduced sperm quality h ↑ chrom aberration, micronuclei, & SCE i 30-40 Slight neurobehavioral symptoms (cognitive deficits, peripheral neuropathy) b Kidney dysfunction e adrenal axes f Changes in levels of Hormones q ? n 40-50 Changes in thyroid hormone levels p g 50-60 Kidney lung? j 60-80 Anaemia d >80 Encephalopathy, neuropathy o Nephropathy cramps vascular
Table 4.2: PbB response in adults from non-occupational epidemiology studies a PbB (μg/dL) Nervous System ^ ^ Kidneys? Endocrine system? Immune system? Female reproduction? Male reproduction? Mutagenicity? Cancer? Gastrointestinal <5 Slight cognitive deficits? b Auditory function decrements? k Changes in levels of reproductive hormones? j 5-10 effects (e.g. depression, anxiety)? c ↑ blood pressure e ↑ risk of death from coronary heart disease d ↓ haemoglobin, activity h Kidney dysfunction (e.g. creatinine clearance)? f Spontaneous abortion, postnatal development delay, ↑ risk of preterm birth, ↓ birth weight? g Reduced sperm quality? i ? l 10-15 15-20 20-30 30-40 40-50 50-60 60-80 Anaemia >80 Encephalopathy
C.1: Summary of background PbB levels in Australian and overseas adults Study date Location Study Group (n) PbB (μg/dL) Reference AM GM % > 10μg/dL 2000 – current a Australia 2011 Victoria Male & female adults (3,622) - 1.4 0.7 Vic DoH 2012 2008 Broken Hill b Ante-natal women (120) - 1.3 - GWAHS 2009 2007 Port Esperance, WA 20-<40yrs, (565) 1.9 - 0.7 WA DoH 2007 Australia Pregnant females 19-32yrs (9) 2.3 c 2.1 c 0 Gulson et al. 2006 Overseas 2005 Korea >20 yrs (1997) - 2.61 - Kim & Lee 2009 USA >20 yrs (4,525) - 1.52 - CDC 2009 2002 Suwannee County, FL Adults (5) Range: 2.5 - <5 ATSDR 2004 2001 Czech Republic 18-58 yrs (1188) - 3.3 - Batariova et al. 2006 2000? Italy 18-64 yrs (1164) 4.5(M) 3.1(F) - - Apostoli et al. 2002 2000 Egypt Adults 28-40 yrs (93) 12.4 - - Mortada et al. 2002 1960 – 1999 d Australia Australia Pregnant & females (30) 2.6 c 2.7 c - Gulson et al. 2006 South Australia e Pregnant females (185) 7.6 - - McMichael et al. 1986 Overseas 1998 Germany 18-69 yrs (4,800) - 3.1 - Becker et al. 2002 1989 Adults (959) 15.8 - - Minoia et al. 1990 1989 Germany Adults (unknown) 5.9(M) 5.3(F)f - - Müller 1992 1988 Belgium Adults >20 yrs (5,837) 7.8 - - Ducoffre et al. 1990 1988 Germany Adults (unknown) 6.8(M) 5.3(F)f - - Müller 1992
1987 United Kingdom Adults living away from highway (unknown) 9.1(M) 6.9(F)f - - Atherton 1992 1987 United Kingdom Adults living near highway (unknown) 9.8(M) 7.6(F)f - - Atherton 1992 1987 Germany Adults (unknown) 7.7(M) 6.2(F)f - - Müller 1992 1986 United Kingdom Adults living near highway (unknown) 10.9 (M) 7.9(F)f - - Atherton 1992 1986 United Kingdom Adults living away from highway (unknown) 9.9(M) 7.2(F)f - - Atherton 1992 1986 Germany Adults (unknown) 9.1(M) 7.7(F)f - - Müller 1992 1985 United Kingdom Adults living near highway (unknown) 12(M) 8.7(F)f - - Atherton 1992 1985 United Kingdom Adults living away from highway (unknown) 10.2 (M) 7.4(F)f - - Atherton 1992 1985 Germany Adults (unknown) 10.3 (M) 7.4(F)f - - Müller 1992 1984 United Kingdom Adults living near highway (unknown) 12.6 (M) 9.8(F)f - - Atherton 1992 1984 United Kingdom Adults living away from highway (unknown) 10.7 (M) 7.9(F)f - - Atherton 1992 1984 Stockholm, Sweden General population (unknown) 5.2f - - KEMI 1992 1984 Halkyn, Wales, UK Adults, mean age 52 yrs 13.7 - - Elwood and Toothill 1986 1984 Y Fan, UK Adults, mean age 58 yrs 10.2 - - Elwood and Toothill 1986 1984 Ruthin, Wales, UK Adults, mean age 58 yrs 12.6 - - Elwood and Toothill 1986 1984 Greenfield, Wales, UK Adults, mean age 46 yrs 11.2 - - Elwood and Toothill 1986
1973 Southern California, USA Adults (unknown) 11.7 - - Goldsmith 1974 1972 USA Adults (unknown) 19.2 - - McLaughlin and Stopps 1972 1971 Port Washington, New York, USA Adults 20-79 yrs (198) - 15.3 - Tepper and Levin 1972 1971 Greenwich Village, New York, USA Adults 20-79 yrs (140) - 16.6 - Tepper and Levin 1972 1971 Bridgeport, Illinois, USA Adults 20-79 yrs (147) - 17.6 - Tepper and Levin 1972 1971 Lombard, Illinois, USA Adults 20-79 yrs (208) - 13.9 - Tepper and 1972 1971 Houston, Texas, USA Adults 20-79 yrs (191) - 12.5 - Tepper and Levin 1972 1971 Washington D.C., USA Adults 20-79 yrs (219) - 19.2 - Tepper and Levin 1972 1970 USA Adults (unknown) 18.3 - - McLaughlin et al. 1973 1969 Okeana, Ohio, USA Adults 20-79 yrs (162) - 15.7 - Tepper and 1972 1969 Los Alamos, USA Adults 20-79 yrs (271) - 17.2 (M) 14.9 (F) - Tepper and Levin 1972 1969 Philadelphia, Pennsylvania, USA Adults 20-79 yrs (136) - 20.5 - Tepper and 1972 1969 Ardmore, USA Adults 20-79 yrs (150) - 18 - Tepper and Levin 1972 1969 Pasadena, USA Adults 20-79 yrs (193) - 17.5 - Tepper and Levin 1972 1968 USA Adults (unknown) 19.8 - - McLaughlin et al. 1973 1967 USA Adults (unknown) 20.1 - - McLaughlin et al. 1973 1963 Ohio, USA Adults (unknown) 16 - - Goldwater and Hoover 1967 1963 New York, USA Adults (unknown) 21 - - Goldwater and Hoover 1967 1963 California, USA Adults (unknown) 17 - - Goldwater and Hoover 1967 1963 Pasadena, California, USA Adults (unknown) 17.7 - - Butt et al. 1964 1963 Cincinnati, Ohio, USA Adults (unknown) 24 - - Ludwig et al. 1965