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Doom and Gloom on Blood Lead Levels (Really?)


By Robert Ikenberry

As one gets older, it’s interesting how people’s perspectives differ.

I recently read an article in the Cal/OSHA Reporter®, which reported that California’s Department of Health Services (DHS) had said: “Up to 10% of workers tested have elevated blood lead levels.”

“That sounds like an awful lot,” I thought.

From the headline, one might think that 10 percent of California's workers had elevated blood levels. So I tracked down the original report, actually published by the DHS’s Occupational Lead Poisoning Prevention Program.

By the Numbers

Now, DHS gets blood lead level (BLL) lab reports on about 50,000 individuals each year. Of those, the agency can identify about 17,000 as work-related, or occupational, BLL tests.

Here’s the DHS chart:

BLL Distribution in Workers
Source: California DHS

Based on these results, the Occupational Lead Poisoning Prevention Program concludes in its report: “Overexposure to lead continues to be a serious occupational health problem in California.”


The lead program is charged with monitoring, tracking and evaluating Blood Lead Level (BLL) reports from labs in California. I believe it used to be that levels over 25 (µg/dl) were reported to the program, but now it gets all of the reports.

From 2008 to 2011, the program received an average of about 17,500 lab reports from occupational tests annually.

I think there are probably a lot more than 17,500 workers in California.

In fact, according to the federal Bureau of Labor Statistics,  there were 17,053,000 civilian workers in California as of June 2013.  So the tests received by the lead program covered only 0.1 percent of total workers. That means that the 10 percent with “elevated” levels is actually only 0.01 percent of total California workers.

How High is High?

Looking deeper, I considered the term Elevated. Historically, in the 1970s and 1980s, “elevated Blood Lead Levels” might have referred to workers with BLLs over 50 (µg/dl).  When the OSHA construction lead regulations went into effect in the early 1990s, only those workers had to be medically removed from lead exposure.

Lead paint in housing

When the OSHA construction lead regulations went into effect in the early 1990s, only workers with BLLs over 50 (µg/dl) had to be medically removed from lead exposure.

But OSHA also indicated in the appendix to the original regulations that workers who were actively trying to have children should keep their blood levels under 30. So, maybe 30 µg/dl could also be considered Elevated.

During the 1990s and 2000s, the consensus of the painting contractors I dealt with was that workers should be able to keep their BLLs below 25 on all projects—even when the paint being removed had high lead levels—and that would help ensure that no one approached 50.

As you can see from the table above, however, the Occupational Lead Poisoning Prevention Program now considers any test at or above 10 to be elevated.


How Low is Low?

While some recent studies indicate that some adverse health effects show up at lower levels than we used to think, and that some of those effects start to show up in some people as low as 10 µg/dl, it’s not yet clear what constitutes a scientifically justified regulatory limit.

The long-held opinion that lower levels are better than higher ones, and that lead should be completely avoided to the extent practical, still holds. Unlike iron or zinc, humans have no need for lead.

Note that in this chart (from the Journal of Clinical Investigation) in 1976, the year lead in gasoline started to be phased out, the average BLLs in the U.S. were over 15 µg/dl.

JCI lead poisoning chart (Vol 116, Issue 4)
Journal of Clinical Investigation

Amazing how things change with the perspective of almost 50 years.

Take 2

So my analysis of the numbers on the lead program's chart would go something like this:

Between 2008 and 2011, the number of workers with the highest range of BLLs (those over 30 µg/dl) declined to 95 from 191.  That's a reduction of 50 percent, to a total of 0.00056 percent of the workforce.

The number of BLL tests in the medium elevated category (20 to 29 µg/dl) dropped to 285 from 380—a reduction of about 25 percent.

The number of total BLL tests at or above 10 (what the occupational lead program now considers elevated) ranged during the study period from 1,866 in 2008 to 1,475 in 2011—a reduction of about 20 percent, encompassing a total of 0.0086 percent of the workforce.

Which Means...

So, rather than the lead program's doom-and-gloom conclusion that overexposure to lead is a serious occupational health problem, it looks to me like we continue to make rapid and steady progress to eliminate all vestiges of lead as a common worker health risk.

Elevated lead levels are now rare, and only one worker in 12,000 shows even the slightly elevated levels that would have been considered about average when lead was common in gasoline.

It’s a question of perspective. I certainly admit that one’s view may be impacted by who writes their paycheck, but I see real positive progress in this report.

Maybe we can now spend some of our limited government funds on more pressing problems.

Or maybe this really is a continuing serious occupational health problem.

What’s your take?

The author wishes to thank Cal/OSHA Reporter for allowing the free use of its article to PaintSquare News readers.

Editor's Note: Updated on Aug. 21, 2013.


Robert Ikenberry

Robert Ikenberry, PCS, has been in industrial painting and construction since 1975. Now semi-retired as the Safety Director and Project Manager for California Engineering Contractors, Robert stays busy rehabbing, retrofitting and painting bridges. His documentary on the 1927 Carquinez Bridge was the pilot for National Geographic’s Break it Down and an episode of MegaStructures.



Tagged categories: Bridges; Program/Project Management; Health & Safety; Health and safety; Lead; Workers

Comment from Stephen Dobrosielski, (8/21/2013, 8:48 AM)

Outstanding analysis by Mr. Ikenberry. It is amazing how our mainstream media and government media (the technical writers who claimed the 10% of workers have elevated BLLs) consistently get it wrong - or maybe not “totally correct”. Lies, damn lies and statistics.

Comment from Burt Olhiser, (8/21/2013, 11:52 AM)

Robert, a great article and excellent commentary my friend. You draw attention to a very frustrating aspect of our work which is the little recognition our industry gets for how far we’ve come in improving work environments and so the health of our work force. Again, great job that is well stated.

Comment from Tom Schwerdt, (8/21/2013, 12:09 PM)

Really good analysis. Does DHS have data for a wider range of years? One nitpick: I’d call the 10-19 category “average” or “about average” for the leaded gasoline years, not “below average” - the data is not granular enough to call it “below average” in my opinion. Again, this is a small nitpick on a really good writeup.

Comment from Robert Ikenberry, (8/21/2013, 1:20 PM)

Tom - Good point! What I should have said was “considered about average when lead was common in gasoline” I'll get the editors to make a correction if I can.

Comment from John Fauth, (8/22/2013, 9:07 AM)

Interpreting the data to reach conclusions unsupported by environmentalists and mainstream media makes all of you lead deniers who must be in favor of poisoning the American worker, air and water. Tongue firmly implanted in cheek.

Comment from Alison Kaelin, (8/22/2013, 9:35 AM)

Robert - As always, nice analysis and I agree the average BLL continues to drop. However as noted in my May 2013 JPCL article, there is a lot of recent scientific data that indicates significant health effects in adults at levels as low as 5-10 ug/dl. The ABLES program droppped their level from 25 to 10 in 2009, in response to this same data, as did CDC when they dropped the level for children from 10 to 5. While I don't know the magic number, I do think the current OSHA threshold for BLL is obsolete and should be reduced.

Comment from Robert Ikenberry, (8/22/2013, 9:41 AM)

Alison - Agreed that the current regs are based on obsolete data, and I mentioned the new studies briefly. My main point is the industry should get some credit for strong progress. Moving forward, we are refining the detals on a successful program, not in the midst of a crisis.

Comment from Simon Hope, (8/30/2013, 4:17 AM)

Great analysis and very robust reasoning!

Comment from Tom Schwerdt, (9/3/2013, 12:27 PM)

Interestingly (and a bit disturbingly) leaded gasoline is still in widespread use across the USA decades after the phaseout of lead in automotive gasoline. Aviation gasoline still uses quit a bit of tetraethyl lead.

Comment from Kathy Lauckner, (10/15/2013, 10:11 AM)

If the painting industry would have taken responsibility for their own worker protection when it came to working with lead paint, no government funds would have been spent to educate and certify rehabilitation crews. In other western states, the 1900-1950 housing is extremely desirable by the "up and coming" generation and the thoughts of using any lead safe work practices is simply not comprehending! Please stop saying that the issue of lead poisoning is not an issue any more. The issue is so few workers are tested that the statistics can not prove anything at this stage. The EPA is working on the development of a new rule to guide lead safe work practices for commercial properties. Is the painting industry involved in the development of this rule? I have taught thousands of workers on the concerns regarding lead poisoning. Only those working on a government project get a blood test. So, please encourage your work crews to test and then prove lead poisoning is not an issue anymore. Thank you.

Comment from WAN MOHAMAD NOR WAN ABDUL RAHMAN, (10/16/2013, 9:58 AM)

We have to accept the fact that in order for mankind to progress in this world we cannot evade problems like this. What we can do is to minimize the effect.

Comment from Randy Gordon, (12/6/2013, 7:05 PM)

Good Job Rob! I happen to know just a little bit about the topic and agree with...progress. =)

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