Adult Blood Lead Epidemiology and Surveillance -- United States, Third Quarter, 1996

CDC's National Institute for Occupational Safety and Health Adult Blood Lead Epidemiology and Surveillance program (ABLES) monitors laboratory-reported elevated blood lead levels (BLLs) among adults in 25 states. * This report presents ABLES data through the third quarter of 1996 and compares these data with the third quarter of 1995.

During July 1-September 30, 1996, the 4990 reports of BLLs greater than or equal to 25 ug/dL represented a 15% decrease from the 5888 reports for the third quarter of 1995 (1), which now include previously unpublished data for Minnesota and an estimate for Ohio. For the first 3 quarters of 1996, the number of reports of BLLs greater than or equal to 25 ug/dL decreased by 11% compared with the number reported for the first 3 quarters of 1995 (1), which also include previously unpublished data for Minnesota and an estimate for Ohio (Table_1). The cumulative number of reports in 1996 decreased at each reporting level compared with data for 1995. This overall trend of decreasing reports is consistent with the second quarter report for 1996 (2).

Of the 25 states currently participating in ABLES, 17 reported each year during 1993-1995. Among these 17, the overall number of reports of BLLs greater than or equal to 25 ug/dL decreased by 3%; the largest decreases were reported in Oregon (-44%), New York (-40%), and Texas (-38%). However, the number of reports of BLLs greater than or equal to 25 ug/dL increased in six of the 17 states; the largest increases were reported in Iowa (215%), Arizona (205%), and Washington (76%).

During 1993-1995, the number of persons with reported elevated BLLs decreased by 18% overall in the 17 states. Decreases occurred in nine of the 17 states; the largest decreases were in Texas (-66%), Illinois (-61%), and California (-42%). However, the number of persons increased in eight of the 17 states; the largest increases were in Wisconsin (216%), Arizona (174%), and Iowa (41%). The number of persons with new cases decreased in each of the 17 states except Arizona (41%) and decreased by 42% overall; the largest decreases were in Illinois (-84%), Iowa (-76%), and Connecticut (-60%).

Reported by: JP Lofgren, MD, Alabama Dept of Public Health. K Schaller, Arizona Dept of Health Svcs. S Payne, MA, Occupational Lead Poisoning Prevention Program, California Dept of Health Svcs. BC Jung, MPH, Connecticut Dept of Public Health. M Lehnherr, Occupational Disease Registry, Div of Epidemiologic Studies, Illinois Dept of Public Health. R Gergely, Iowa Dept of Public Health. A Hawkes, MD, Occupational Health Program, Maine Bur of Health. E Keyvan-Larijani, MD, Lead Poisoning Prevention Program, Maryland Dept of the Environment. R Rabin, MSPH, Div of Occupational Hygiene, Massachusetts Dept of Labor and Industries. M Scoblic, MN, Michigan Dept of Public Health. M Falken, PhD, Minnesota Dept of Health. L Thistle-Elliott, MEd, Div of Public Health Svcs, New Hampshire State Dept of Health and Human Svcs. B Gerwel, MD, Occupational Disease Prevention Project, New Jersey State Dept of Health. R Stone, PhD, New York State Dept of Health. S Randolph, MSN, North Carolina Dept of Environment, Health, and Natural Resources. A Migliozzi, MSN, Bur of Health Risk Reduction, Ohio Dept of Health. E Rhoades, MD, Oklahoma State Dept of Health. A Sandoval, MS, State Health Div, Oregon Dept of Human Resources. J Gostin, MS, Occupational Health Program, Div of Environmental Health, K Ramaswamy, MSc, Bur of Epidemiology, Pennsylvania Dept of Health. A Gardner-Hillian, Div of Health Hazard Evaluations, South Carolina Dept of Health and Environmental Control. P Schnitzer, PhD, Bur of Epidemiology, Texas Dept of Health. W Ball, PhD, Bur of Epidemiology, Utah Dept of Health. L Toof, Div of Epidemiology and Health Promotion, Vermont Dept of Health. J Kaufman, MD, Washington State Dept of Labor and Industries. J Tierney, Wisconsin Dept of Health and Social Svcs. Div of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC.

Editorial Note

Editorial Note: The findings in this report suggest a continued decline in the overall number of detected cases of elevated BLLs, possibly reflecting decreased occupational exposures to lead, diminished compliance with Occupational Safety and Health Administration requirements regarding blood lead monitoring, and/or a reduction in the size of the workforce in lead-using industries. Although this overall decrease in reports is consistent with the overall decline reported during 1993-1995 (3), increases occurred in some of the states participating in ABLES during that period. Variation in nationwide quarterly reporting totals may result from

1. changes in the roster of participating states, 2) changes in staffing and funding in state-based surveillance programs, and 3) interstate differences in worker BLL testing by lead-using industries.

The findings in this report document the continuing hazard of work-related lead exposures as an occupational health problem in the United States. ABLES enhances surveillance for this preventable condition by expanding the number of participating states, reducing variability in reporting, and distinguishing between new and recurring elevated BLLs in adults.

References

1. CDC. Adult blood lead epidemiology and surveillance -- United States, third quarter, 1995. MMWR 1996;45:170-1.

2. CDC. Adult blood lead epidemiology and surveillance -- United States, second quarter, 1996. MMWR 1996;45:919-20.

3. CDC. Adult blood lead epidemiology and surveillance -- United States, first quarter, 1996, and annual 1995. MMWR 1996;45:628-31.

*

Alabama, Arizona, California, Connecticut, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Texas, Utah, Vermont, Washington, and Wisconsin.

TABLE 1. Number of reports of elevated blood lead levels (BLLs) among adults, number of adults with elevated BLLs, and percentage change
in number of reports -- 25 states, * third quarter, 1996
===========================================================================================================================================
                                  Third quarter, 1996
                             ------------------------------
Reported BLL (ug/dL)          No. reports +  No. persons &  Cumulative reports, 1995 @  Cumulative reports, 1996   % Change 1995 to 1996
-------------------------------------------------------------------------------------------------------------------------------------------
25-39                                3,974          2,972             15,039                    13,952                    - 7%
40-49                                  780            554              3,713                     2,891                    -22%
50-59                                  162            137                791                       593                    -25%
 >=60                                  74             65                 359                       274                    -24%

Total                                4,990          3,728             19,902                    17,710                    -11%
-------------------------------------------------------------------------------------------------------------------------------------------
* Alabama, Arizona, California, Connecticut, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire,
  New Jersey, New York, North Carolina, Ohio, Okla-homa, Oregon, Pennsylvania, South Carolina, Texas, Utah, Vermont, Washington, and
  Wisconsin.
+ Data for Alabama were missing; first quarter 1995 data were used as an estimate.
& Individual reports for persons are categorized according to the highest reported BLL for the person during the given quarter.
  Pennsylvania and Michigan provide the number of reports but no information on persons. The data on persons for Pennsylvania and Michigan
  included in this table are estimates based on the proportions from the other 23 states combined and the number of reports received.
  Data for Alabama were missing; first quarter 1995 data were used as an estimate.
@ Data for Minnesota and Ohio are included for the first time in addition to previously published 1995 totals ( 1 ). For Minnesota, first
  through third quarter data for 1995 were used; for Ohio, first through third quarter data for 1996 were used as an estimate.
===========================================================================================================================================

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