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Trends in Occupational and Adult Lead Exposure in Wisconsin 1988 - 2005. By Henry Anderson, MD Monirul Islam, MD, PhD Wisconsin Division of Public Health Bureau of Environmental and Occupational Health.
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Trends in Occupational and Adult Lead Exposure in Wisconsin 1988 - 2005 By Henry Anderson, MD Monirul Islam, MD, PhD Wisconsin Division of Public Health Bureau of Environmental and Occupational Health
ObjectivesWisconsin Adult Blood Lead Epidemiology and Surveillance (ABLES) Program: 1988-2005 • Reduce Wisconsin’s burden of adult lead poisoning • Track the screened individuals and their BLL over time • Early identification of emerging industries and exposures needing technical assistance and education
Wisconsin ABLES Programs Activities: • The program receives statutorily required laboratory reports of blood lead testing of adult Wisconsin residents aged 16 and older. 1. Maintains a database of reported laboratory lead results which is used by all states participating in ABLES; 2. Through employer questionnaires and employee interviews Investigates the circumstances associated with adult blood lead levels greater than 40g/dL including employer awareness of lead hazards and regulatory requirements;
Wisconsin ABLES Programs Activities (cont.): 3. Provides education about the health effects of lead and regulatory requirements to employers, employees, and the general public and; 4. Refers employers needing technical assistance to the Wisconsin OSHA Consultation Program.
Wisconsin ABLES Program: Partnerships Wisconsin ABLES Program has the following Partnership Programs: • Wisconsin OSHA Consultation Program • WI State Laboratory of Hygiene • Participating Employers throughout Wisconsin • WI Childhood Lead Poisoning Surveillance • WI Environmental Public Health Tracking Program • WI Occupational Health and Surveillance Program
Wisconsin Blood Lead Test Reports: 1988-2005
Adult Blood Lead Level by Age WI Residents:1988-2005
Percent of Adult Blood Lead by Employer Standard Industrial Code Classification WI Residents: 1988-2005
Change in Blood Lead Level (BLL) Subsequent to Identified Elevated BLL WI Residents:1988-2005
Wisconsin Blood Lead Reports >39 µg/dl: 1988-2005
Wisconsin ABLES Program: Strengths • Can passively track the time trend for individuals in a medical monitoring program and indirectly assess the success of employer efforts to reduce individual lead exposures • Provides a means to evaluate the efforts to control and reduce occupational lead exposure • Identify emerging hazardous circumstances and provide information to employees, employers and health care providers
Wisconsin ABLES Program: Limitations • We should recognize several limitations of this surveillance system. The most important one is due to the passive data collection process, which makes longer gap between the actual data and the reporting. • It also requires being cautious when interpreting the results due to the following facts: • Underreporting of adult lead poisoning by employees, physicians, and employers • Inadequate health care provider recognition of adult lead poisoning • Possible exclusion of at-risk populations from surveillance (e.g. self-employed)