Adult Blood Lead Epidemiology and Surveillance -- United States, Second Quarter, 1997

CDC's National Institute for Occupational Safety and Health (NIOSH) Adult Blood Lead Epidemiology and Surveillance (ABLES) program monitors laboratory-reported elevated blood lead levels (BLLs) among adults in the United States. During 1997, a total of 27 states reported surveillance data to ABLES. * In this report, ABLES data for the first and second quarters of 1997 are presented and compared with the first and second quarters of 1996.

During April-June 1996 and 1997, reports of BLLs greater than or equal to 25 ug/dL by the same 27 states increased by 5%, from 5867 to 6157, respectively (1). ** This quarterly increase follows an increase of 13% during the first quarter of 1997 (2). The combined increase for the first two quarters of 1997 is 9% (Table_1); in comparison, the long-term trend had been decreasing during 1993-1996 (2-4) as had the overall number of reported BLLs greater than or equal to 25 ug/dL among adults in the United States (5).

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, Div of Environmental Epidemiology and Occupational Health, Connecticut Dept of Public Health. R Gergely, Iowa Dept of Public Health. A Hawkes, MD, Occupational Health Program, Bur of Health, Maine Dept of Human Svcs. E Keyvan-Larijani, MD, Lead Poisoning Prevention Program, Maryland Dept of Health and Mental Hygiene. R Rabin, MSPH, Div of Occupational Safety, Massachusetts Dept of Labor and Workforce Development. 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 and Senior Svcs. R Prophet, PhD, New Mexico 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, Pennsylvania Dept of Health. M Stoeckel, MPH, Rhode Island 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 Dept of Health. J Tierney, Wisconsin Dept of Health and Family Svcs. T Klietz, Wyoming Dept of Health. Div of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC.

Editorial Note

Editorial Note: The increase in the number of reports of elevated BLLs for the first two quarters of 1997 suggests the possible ending of the long-term decline in the overall number of detected cases of elevated BLLs among adults reported during 1993-1996 (4). Factors related to this increase might include 1) improved efforts of the participating states and lead-using industries within them to identify lead-exposed workers; 2) improved compliance with Occupational Safety and Health Administration requirements for blood lead monitoring; 3) increased occupational exposures to lead; and/or 4) an increase in the size of the workforce in lead-using industries. However, this trend also might reflect normal variations in nationwide reporting totals that result from changes in staffing and funding in state-based surveillance programs and interstate differences in worker BLL testing by lead-using industries. Continued surveillance is required before this two-quarter increase can be confirmed as a reversal of the previous long-term decrease.

The findings in this report document the continuing hazard of lead exposures as an occupational health problem in the United States. ABLES seeks to enhance 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, second quarter, 1996. MMWR 1996;45:919-20.

2. CDC. Adult blood lead epidemiology and surveillance -- United States, first quarter 1997, and annual 1996. MMWR 1997;46:643-7.

3. CDC. Adult blood lead epidemiology and surveillance -- United States, fourth quarter, 1996. MMWR 1997;46:358-60,367.

4. CDC. Adult blood lead epidemiology and surveillance -- United States, third quarter, 1996. MMWR 1997;46:105-7.

5. CDC. Update: blood lead levels -- United States, 1991-1994. MMWR 1997;46:141-6.

* Alabama, Arizona, California, Connecticut, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Utah, Vermont, Washington, Wisconsin, and Wyoming. ** To compare the number of reports for a constant roster of 27 states in 1997 and 1996, first and second quarters 1997 data for New Mexico, Rhode Island, and Wyoming were added to the previously reported totals for the first and second quarter of 1996, and first and second quarters 1996 data for Illinois (which discontinued reporting at the end of 1996) were subtracted from the previously reported totals for the first and second quarters of 1996 (1). Adjustments were made to compare 28 states in the first quarter report for 1997 (2), but a roster of 27 states has been adopted for the remainder of 1997.

TABLE 1. Number of reports of elevated blood lead levels (BLLs) among adults, number of persons with
elevated BLLs, and percentage change in number of reports -- 27 states,* second quarter, 1997
===================================================================================================================================

                                       Second quarter, 1997                                                          % Change from
                                 -------------------------------                                   Cumulative      second quarter,
Reported BLL (ug/dL)               No. reports   No. persons +     Cumulative reports 1996&        reports 1997 &    1996 to 1997
-----------------------------------------------------------------------------------------------------------------------------------
25-39                                 4,928          3,566                8,835                        9,866             12%
40-49                                   933            652                1,947                        1,897             -3%
50-59                                   189            136                  415                          403             -3%
 >=60                                   107             76                  196                          215             10%

Total                                 6,157          4,430               11,393                       12,381              9%
-----------------------------------------------------------------------------------------------------------------------------------
* Alabama, Arizona, California, Connecticut, Iowa, Maine, Maryland, Massachusetts, Michigan,
  Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma,
  Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Utah, Vermont, Washing-ton, Wisconsin,
  and Wyoming. Data from New Hampshire were missing; 1996 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. The number of persons reported in Michigan is an estimate based on the number
  of reports received.
& To compare the number of reports for a constant roster of 27 states in 1997 and 1996, first and
  second quarter 1997 data for New Mexico, Rhode Island, and Wyoming were added to the previously
  reported totals for the first and second quarters of 1996, and first and second quarters 1996 data for
  Illinois (which discontinued reporting at the end of 1996) were subtracted from the previously reported
  totals for the first and second quarter of 1996 ( 1 ).
@ To compare a constant roster of 27 states, first quarter 1996 data for Illinois, used as an estimate,
  were subtracted from the previously reported totals for the first quarter of 1997 ( 2).
===================================================================================================================================

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