Lead exposure among lead-acid battery workers in Jamaica

To assess lead exposure in the Jamaican lead-acid battery industry, we surveyed three battery manufacturers (including 46 production workers) and 10 battery repair shops (including 23 battery repair workers). Engineering controls and respiratory protection were judged to be inadequate at battery manufacturers and battery repair shops. At manufacturers, 38 of 42 air samples for lead exceeded a work-shift time-weighted average concentration of 0.050 mg/m3 (range 0.030-5.3 mg/m3), and nine samples exceeded 0.50 mg/m3. Only one of seven air samples at repair shops exceeded 0.050 mg/m3 (range 0.003-0.066 mg/m3). Repair shop workers, however, had higher blood lead levels than manufacturing workers (65% vs. 28% with blood lead levels above 60 micrograms/dl, respectively). Manufacturing workers had a higher prevalence of safe hygienic practices and a recent interval of minimal production had occurred at one of the battery manufacturers. Workers with blood lead levels above 60 micrograms/dl tended to have higher prevalences of most symptoms of lead toxicity than did workers with lower blood lead levels, but this finding was not consistent or statistically significant. The relationship between zinc protoporphyrin concentrations and increasing blood lead concentrations was consistent with that described among workers in developed countries. The high risk of lead toxicity among Jamaican battery workers is consistent with studies of battery workers in other developing countries.     

Lead exposure in scaffolders during refurbishment construction activity--an observational study

The toxic effects of lead have been known for centuries. Occupational exposure to this chemical hazard has also been well documented in relation to various industry groups, including construction, where workers are recognized as being significantly exposed during refurbishment work, in particular through inhalation and ingestion of lead fumes and dust. It is easy to see how so-called 'burners', 'cutters' and 'blasters'--workers directly involved in removing old lead paint--may become exposed; the influence of personal hygiene, smoking, eating/drinking and nail biting has also been documented in the literature. We now report on one group, the scaffolders, not previously considered to be at risk. Although not directly involved in the paint removal, anecdotal and personal experience of the authors indicate that these workers, who erect and later dismantle access structures during the renovation of previously lead-painted surfaces, may take up significant amounts of lead, mainly by ingestion, to raise their personal blood lead levels (and body burden) in line with recognized 'lead workers'. Exposures of this magnitude would also bring the scaffolders involved in such refurbishment work under the Control of Lead at Work Regulations 1998. The authors make various recommendations on measures to minimize and control exposure of scaffolders to lead.     

Chronic lead poisoning in an adult battery worker

BACKGROUND: Lead poisoning is a common environmental health hazard in developing countries. Incidences of lead poisoning are seen in all age groups, especially in adults working in lead-based industries, where many still remain unaware of the adverse effects of exposure to unusually high levels of lead. METHODS: We report the case of an adult battery worker, who initially received symptomatic treatment because of clinical misdiagnosis. Later, he was treated with appropriate chelators, which helped to decrease blood lead levels drastically. However, being unable to change his occupation, he continues to be exposed to potentially lethal doses of lead. CONCLUSIONS: A key role for health agencies, besides providing opportunities for diagnosis and therapy, should be to increase public awareness about this widespread environmental hazard through education, documentation and communication.     

Window renovation and exposure to lead--an observational study

BACKGROUND: Renovation of windows in old houses has recently established itself as an industry. A recognizable occupational lead exposure exists, which has not been studied previously. AIM: To compare lead exposure amongst window renovators with other groups of lead-exposed workers. METHODS: Using blood lead results measured at the Health and Safety Laboratory (HSL), Sheffield, comparisons were made between three cohorts: window renovation workers, all male workers monitored by HSL during the period 1999-2001 and 63 male subjects involved in chemical paint-stripping of wood. RESULTS: Both the window renovation and the wood-stripping cohorts show significantly higher blood lead distributions than the 'all workers' cohort (P < 0.001). A similar pattern was also found for comparison of the prevalence of subjects above the UK suspension level of 60 microg/dl (2.89 microM) (window renovation, P < 0.001; wood-stripping, P < 0.0001). Blood lead results at or above the suspension level in wood-strippers were significantly higher compared to window renovators (P = 0.034). CONCLUSION: Window renovation is shown to present a potential for significant lead exposure, and suspension from work under The Control of Lead at Work Regulations 2002. Two groups of risk factors predominate: the well-documented potential for release of lead from old paint, and the peripatetic nature of the work.     

成都市居民膳食中铅镉暴露水平评估

目的 了解成都市居民膳食中铅、镉暴露的基础数据,评估成都市居民膳食铅、镉暴露风险.方法 对成都市市售食品中铅、镉含量进行监测,参考2002年中国居民营养与健康状况调查中的成都市居民膳食摄入量,应用WHO推荐的食品中化学污染物膳食暴露评估方法,对成都市居民膳食中铅、镉暴露水平进行评估.结果 成都市居民平均每周膳食中铅暴露量为0.006 9 mg/kg BW,占暂定每周可耐受摄入量（PTWI）的27.6％;镉暴露量为0.005 1 mg/kg BW,占暂定每周可耐受摄入量（PTWI）的72.86％.结论成 都市居民膳食中镉暴露水平高于铅暴露水平,正常情况下均低于PTWI,但仍有进一步降低的必要.     

蓄电池制造业工人铅暴露及血铅影响因素分析

目的了解蓄电池制造行业铅污染状况,分析接铅工人血铅影响因素,为铅中毒的预防提供科学依据。方法通过对生产车间铅烟铅尘浓度检测和接铅工人职业健康检查收集数据,采用SPSS13.0统计软件对数据进行分析。血铅水平单因素分析采用t检验、方差分析,多因素分析采用有序logis-tic回归分析。结果生产车间铅尘、铅烟的短时间接触浓度均数为分别为0.191mg/m3、0.067mg/m3,超标率分别为41.67%、18.75%。单因素分析表明性别、年龄、工龄、抽烟、饮酒、工作所在部门、工种均是接铅工人血铅水平的影响因素。多因素分析表明性别、饮酒、工种是血铅水平等级提高的危险因素。结论加强对铅尘、铅烟重点超标岗位的治理。铸造/铅粉、裁减、研磨、焊接等工种的男性接铅工人为慢性铅中毒的高危人群,提倡戒酒,加强个体防护。     

Clinical and electromyographic examinations of patients with tremor after chronic occupational lead exposure

Tremor is considered to be a clinical sign of patients with chronic lead exposure. However, the type of tremor and its pathophysiological mechanisms are controversial. The aim of this study was to examine the clinical and electromyographic characteristics of tremor in patients with chronic lead exposure. Twenty-three men, 27-49 years old, participated in the study. The tremor activity was detected using surface electrodes from a pair of antagonistic hand muscles. Serum lead concentrations were measured on the day of examination. Our results revealed 12 Hz postural and kinetic tremor, with characteristics of enhanced physiological tremor. Different pathophysiological mechanisms might be responsible for the enhanced physiological tremor of patients with chronic lead exposure. In conclusion, the tremor of patients with chronic lead exposure is an enhanced physiological one. It is probable that this tremor could be influenced by beta-blockers, known to influence the enhanced physiological tremor in anxiety. This will be of benefit for patients disturbed by persistent tremor.     

Lead exposure in starter battery production: investigation of the correlation between air lead and blood lead levels

The threshold limit value (TLV) for lead (in Germany, the MAK value) is based on a certain blood lead concentration (in Germany BAT value = biological tolerance value for working materials) that is not to be exceeded; thereby a statistically significant association between air lead (PbA) and blood lead (PbB) is assumed. On the basis of a 10-year period of (1982–1991) biological and ambient monitoring of 134 battery factory staff and their workplaces, a PbA/PbB correlation with the regression equation PbB = 62.183 + 21.242 × Log 10 (PbA) (n = 1089, r = 0.274, P < 0.001) was calculated. These results are in line with those of several other investigations. The shape of the regression curve and the wide scattering of values led to the assumption that PbA values above the MAK value (0.1 mg/m³) do not necessarily result in increased PbB values. Similarly, PbA values lower than the MAK value do not guarantee PbB levels below the BAT value in every case. These observations are influenced by numerous confounders and intervening variables. It is concluded that lowering MAK values as a consequence of lowering BAT values is not mandatory.     

Influence of the delta-aminolevulinic acid dehydratase (ALAD) polymorphism on biomarkers of lead exposure in Turkish storage battery manufacturing workers

BACKGROUND: The relationship between delta-aminolevulinic acid dehydratase polymorphism (ALAD) and biomarkers of exposure was investigated in Turkish lead workers in this study. METHODS: Seventy two male lead battery manufacturing workers were selected for the study. Blood lead (BPb) and urinary lead (UPb) concentrations were determined by atomic absorption spectrometry. Erythrocyte ALAD activity and urinary 5-aminolevulinic acid (UALA) were measured spectrophotometrically. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to determine the genotype of the ALAD gene. RESULTS: In total, 51 workers (70.8%) had the ALAD 1-1 genotype, whereas 21 workers (29.2%) had the ALAD 1-2 genotype. No significant relationships were found between the two genotypes and BPb, UPb, and ALAD activity. ALAD1 homozygotes showed significantly higher levels of UALA in comparison with those ALAD2 carriers. CONCLUSIONS: ALAD 1-1 individuals might be an increased risk compared to ALAD2 carriers to disturbance in heme biosynthetic pathway in high lead exposure.     

Comparability of different methods of retrospective exposure assessment of metals in manufacturing industries

Many occupational case-control studies have relied on either self-report or exposure assessment based on job titles linked to a job exposure matrix (JEM) as opposed to the generally considered more accurate, but labor intensive, method of expert review of job histories. Our study examined the comparability of these different methods in assessing occupational exposure to the metals copper (Cu), lead (Pb), and iron (Fe) in manufacturing industries. Subjects were older people from a case-control study of a neurologic disease, and consisted of 188 individuals (72% male, 85% white) who had worked an average of 22.4 years in the manufacturing industry. An industrial hygienist review (IHR) of occupational history data from a comprehensive questionnaire was used as the reference method. The percent agreement (%A), sensitivity (SE), and specificity (SP) for direct self-report of metal exposures were: Cu, %A = 94.6, SE = 83.6, SP = 96.1; Pb, %A = 91.9, SE = 72.5, SP = 93.5; and Fe, %A = 82.7, SE = 64.5, SP = 88.1. Using the National Institute for Occupational Safety and Health (NIOSH) JEM, we analyzed the jobs of 115 of the 188 study subjects who had all their jobs listed in the JEM. Exposure assessment based on the NIOSH JEM compared with the IHR resulted in greater misclassification relative to direct self-report: Cu, %A = 81.5, SE = 21.2, SP = 89.2; Pb, %A = 86.0, SE = 0.0, SP = 92.6; and Fe, %A = 69.2, SE = 15.5, SP = 86.4. For all three study metals, combining the information from both direct self-report and the JEM did not improve upon the results compared with direct self-report alone. Due to the complex nature of metal exposure assessment, we suggest using an expert review of job histories whenever possible to minimize potential misclassification. Am. J. Ind. Med. 31:36–43 © 1997 Wiley-Liss, Inc.     

某蓄电池厂244例尿铅测定结果分析

目的:了解某蓄电池厂工人的尿铅水平,从而采取有效的防护措施。方法:采用石墨炉原子吸收法测定尿铅含量并进行统计分析。结果:在244份尿样检测结果中尿铅超标者共22人,超标率9.02%;男性超标率高于女性,但差异无显著性(P>0.05);不同工种间和不同工龄间工人超标率差异均具有统计学意义(P<0.05)。结论:统计结果表明该公司职工尿铅超标率仍处于较高水平,因此应加强工人的职业健康监测工作,并改善车间环境、完善规章制度,同时提高工作人员在生产中自我防护意识,保护职工身体健康。     

Lifestyle and work predictors of fatigue in Japanese manufacturing workers

BACKGROUND: Fatigue is one of the most common symptoms encountered in medical practice. However, little is known about the causal relationship between change in lifestyle and fatigue. AIM: To help prevent fatigue-related disorders, we investigated the association between changes in lifestyle and fatigue among employees. METHODS: We studied data sets from the High-risk and Population Strategy for Occupational Health Promotion study for employees at 10 workplaces in Japan. The baseline survey was done in 1999 and the follow-up survey in 2003 via a questionnaire which examined lifestyle and fatigue variables using the vitality domain scale of the SF-36 Health Survey. The lifestyle factors focused on were diet, smoking and alcohol habits and working conditions. Four-year changes in lifestyle that predicted the vitality domain score in the follow-up survey were examined by analysis of covariance RESULTS: Of the 6284 participants in the baseline survey, 4507 replied to the follow-up survey, of whom 3498, with a mean age of 37 (SD 18) years, returned valid responses. A low vitality score at follow-up was predicted by a change in lifestyle factors such as an increase in overtime work, change to non-sedentary work and increased frequency of eating between meals (P < 0.01, P < 0.01 and P = 0.02, respectively). CONCLUSION: Fatigue in salaried workers as measured by the vitality domain of the SF-36 is predicted by an increase in overtime work, change to non-sedentary work and an increase in the frequency of eating between meals.     

Lead exposure and blood lead level of workers in a battery manufacturing plant in Thailand

This study was conducted in a battery manufacturing plant where lead was used in the processes of production, to survey the working conditions and safety behaviors, and to measure the airborne lead level contaminated in the workplace and the blood lead level of workers. The survey of working conditions showed that the workers were directly exposed to lead in sections e.g. grid casting, spreading, forming and polishing, assembly and special battery production sections. Some workers in these sections used a cotton mask to protect dust exposure, but most workers did not use any masks. High airborne lead level more than 0.2 mg/m3 was frequently measured in these sections. Geometric average of blood lead level slightly increased from 17.9 microg/dl to 22.3 microg/dl during 1998 and 2001. However, the geometric average of blood lead level dropped to 17.4 microg/dl in 2002. No workers had blood lead level above 60 microg/dl. Workers with different age groups had no significantly different average blood lead level. Workers whose duration of work was between 20-29 years had average blood lead level of 21.5 microg/dl. This group of workers had slightly higher blood lead level than those whose duration of work was 19 years or less, but with no significant difference. 21 subjects underwent annual health examination and exposure monitoring in 2002. There was no significant relation between airborne lead level and blood lead level.     

Blood pressure, left ventricular mass, and lead exposure in battery manufacturing workers.

BACKGROUND: Although debate about the relationship between lead and blood pressure has focused on low environmental lead levels, industrial exposure remains a concern. METHODS: We measured blood pressure and left ventricular mass (LVM) in 108 battery manufacturing workers, and calculated cumulative and historic average measures of blood lead. RESULTS: Diastolic pressure increased with increasing lead levels, with a significant (P = 0.04) 5 mmHg difference in mean pressure between the highest and lowest cumulative exposure levels. Diastolic pressure increased with the log of cumulative lead (P = 0.06). Both hypertension (defined as currently medicated or systolic > 160 mmHg or diastolic > 95 mmHg) and LVM increased nonsignificantly with increasing lead exposure (P-values > or = 0.17 for hypertension and > or = 0.20 for LVM). CONCLUSIONS: We found a small effect of blood lead on diastolic blood pressure, particularly for a cumulative measure of exposure, but no convincing evidence of associations between lead and other blood-pressure-related outcomes. Published 2001 Wiley-Liss, Inc.     

重金属污染区人群镉暴露水平的估算

目的了解环境镉污染状况和人群镉暴露水平。方法采集当地自产粮食和蔬菜样品进行镉含量检测,同时开展人群膳食调查。结果采集污染区样品833份,对照区样品124份,共完成546人的三日膳食调查。污染区农作物镉含量整体高于对照区。玉米、青菜、土豆和红芸豆是当地居民主要消费食物,青菜是膳食摄入镉的主要来源,污染区高年龄组居民日均摄镉量和累积镉摄入量均已超过WHO建议的允许最大限值,对照区居民未超过限值要求。结论污染区居民镉暴露的主要介质是当地产蔬菜,男性55岁以上(女性65岁以上)人群累积镉暴露已达到WHO建议的健康危害阈值2000mg水平。     

An evaluation of the significance of mouth and hand contamination for lead absorption in lead-acid battery workers

Summary The present study was conducted to evaluate the role of ingestion through hand and mouth contamination in the absorption of lead in 25 lead-acid battery workers. Levels of personal exposure to airborne lead ranged from 0.004 to 2.58 mg/m³ [geometric mean 0.098, with 25% of samples exceeding threshold limit values (ACGIH) of 0.15 mg/m³]; the mean (SD) blood lead level was 48.9 (10.8) g/dl. Mean hand lead contents increased 33-fold from preshift levels on Monday mornings (33.5 g/500 ml) to midshift levels on Thursday afternoons (1121 g/500 ml). Mouth lead contents increased 16-fold from 0.021 g/50 ml on Mondays to 0.345 g/50 ml on Thursdays. The typical Malay racial habit of feeding with bare hands and fingers without utensils (closely associated with mouth and hand lead levels on Mondays) explained the bulk of the variance in blood lead levels (40%), with mouth lead on Thursdays (closely associated with poor personal hygiene) explaining a further 10%. Air lead was not a significant explanatory variable. The implementation of a programme of reinforcing handwashing and mouth-rinsing practices resulted in a reduction of the blood lead level by 11.5% 6 months later. These results indicate that parenteral intake from hand and mouth contamination is an important cause of lead absorption in lead-exposed workers.     

Occupational exposure to HIV and the use of post-exposure prophylaxis

The use of antiretroviral therapy as post-exposure prophylaxis against human immunodeficiency virus (HIV) is now routine following high-risk exposure to the HIV virus. This article summarizes the management of health care workers and others exposed to HIV in an occupational setting, and the evidence behind it.     

Health surveillance in milling, baking and other food manufacturing operations--five years' experience.

The objective of this study was to describe the incidence of allergic respiratory disease and its outcome in terms of symptoms and jobs, across different flour-using industries. It uses the findings of a health surveillance programme in a large food organization over a five-year period. The population under surveillance consisted of 3,450 employees with exposure to ingredient dusts, of whom 400 were in flour milling, 1,650 in bread baking, 550 in cake baking and 850 in other flour-using operations. A total of 66 employees with either asthma or rhinitis symptoms attributable to sensitization to allergens in the workplace were identified. The majority of these (48/66) had become symptomatic prior to the commencement of the health surveillance programme in 1993. The incidence rates (per million employees per year) for those who developed symptoms between 1993 and 1997 were 550 for flour milling, 1,940 for bread baking, 0 for cake baking and 235 for other flour-using operations. The agent believed to be responsible for symptoms was most commonly grain dust in flour millers and fungal amylase in bread bakers. Wheat flour appeared to have a weaker sensitizing potential than these other two substances. In terms of outcome, at follow-up 18% of symptomatically sensitized employees had left the company. Two of the ex-employees retired through ill health due to occupational asthma. Of those still in employment, 63% described an improvement in symptoms, 32% were unchanged and 4% were worse than when first diagnosed. Over half the cases still in employment were continuing to work in the same job as at the time of diagnosis.     

儿童食物铅摄入与血铅水平关系的研究

目的探讨南京市小学生食物铅摄入与血铅水平的关系。方法整群抽取南京市两所小学9~12岁学生404名为研究对象,采指端末梢血,用原子吸收石墨炉法测定血铅;采用原子吸收石墨炉法测定各种食物中的含铅量、连续3 d询问法进行膳食调查,了解铅摄取量。结果南京市小学生血铅平均水平为81.2μg/L,血铅达到和超过100μg/L人数占22.8%。以血铅水平100μg/L为判定标准,将被调查对象分为高血铅组(≥100μg/L)和低血铅组(<100μg/L),高血铅组儿童铅摄入量显著高于低血铅组,高血铅组儿童摄入铅污染较高的水产类、糕点类明显高于低血铅组。结论铅摄入量高可导致血铅升高,血铅水平高的儿童摄入铅污染较高的水产类、糕点类明显较多。     

The decay of blood lead levels in workers suspended under the control of lead at work regulations

AIMS: To study the rate of decline in blood lead levels post-suspension under Control of Lead at Work Regulations (CLAW) and thereby suggest sampling frequencies for follow-up blood lead measurements. METHODS: A retrospective cohort of lead workers with blood lead levels over the current suspension level were identified from blood lead records. Data on their suspension and follow-up blood lead measurements were obtained. RESULTS: Sixteen per cent of the identified cohort did not appear to return to lead work under CLAW. Twenty-seven suspension cases with an initial mean blood lead of 79 microg/dl (3.82 micromol/l) formed the dataset for analysis of decline in blood lead levels. The mean length of time between the blood sample indicating suspension and the first follow-up blood sample was 32 days. The mean length of suspension under CLAW was 61 days. The mean initial rate of blood lead decay was 0.659 microg/dl per day (0.032 micromol/l per day), although with a wide range. The rate of decline in blood lead after suspension was increased by the blood lead level at suspension, but was decreased by increasing past cumulative exposure. CONCLUSIONS: A follow-up blood lead sample 1 month after suspension should show a mean decrease between 13 and 26 microg/dl (0.63-1.25 micromol/l), which is substantially greater than that due to analytical 'noise' associated with two sequential measurements (approximately 5 microg/dl). Therefore, a follow-up blood sample taken around 3-4 weeks after suspension would seem practical. A decrease in blood lead of 7-8 mug/dl (0.36 micromol/l) or less in the month after suspension may suggest continuing lead exposure.