Lead Poisoning On the Job

It wasn't that long ago that a California man in his mid-30s walked into a doctor's office with such astronomical levels of lead in his blood that he was barred from returning to work. Alarmed, health officials began looking into his workplace, the Alco Iron and Scrap Metal Co. in San Leandro, California. What they found at Alco was shocking: So much lead dust permeated the plant's atmosphere that employees were breathing it, bringing it home on their clothes, even eating it with their lunch.

Further testing showed that others in the plant also had unacceptably high lead levels. The investigation resulted in one of the biggest fines ever levied against a Northern California company. According to the state, Alco ignored orders dating back to 1991 to reduce levels of airborne lead and cadmium in its scrap yard.

Alco appealed, and the fine was later reduced to a fraction of the original $282,000. But it's no wonder the state stepped in. Workers who went home with lead on their clothes may have unwittingly exposed their spouses and children as well.

A case in point was reported recently by USA Today. At the age of 6, Shawn Trotter was a clumsy and fidgety child. Now 13, the Vallejo, California, teenager still struggles with school and forgets simple tasks. The parents say the child was poisoned by lead dust his father brought home from his job repairing and building batteries -- from years of father and son playing together while Shawn's father was still dressed in his lead-contaminated work clothes. When the boy was tested at 6, he had blood-lead levels nearly four times the acceptable numbers for children, according to the family's lawsuit. His parents have been told that the brain damage he suffered is permanent.

Low level of awareness

"Lead affects nearly every system of the body," says Barbara Materna, chief of the Occupational Health Branch of the California Department of Public Health. Because it can cause so much damage, lead is the only environmental toxin for which children are routinely screened. Toxic lead levels in children can produce learning disabilities as well as hearing loss. Lead in the bloodstream can also lead to nerve damage and kidney failure and, in adults, infertility, miscarriages, and an inability to produce red blood cells.

It's no longer mixed into household paint, but lead is still ubiquitous in industry and is used even on some of the country's national treasures. "All that golden color you see on the Golden Gate Bridge -- that's red lead primer," says David Harrington, coordinator of outreach, education and training for the Occupational Lead Poisoning Prevention Program. Workers on the Golden Gate and other bridges routinely strip and replace the paint, putting them at risk for exposure.

"People don't realize (that) everyday they drive over the Golden Gate Bridge or the Oakland Bay Bridge there's somebody hanging underneath or above doing this work," Harrington says.

Although the Alco case was extreme, small exposures are happening in hundreds of businesses every day, lead experts say. Small businesses, like mom-and-pop radiator repair shops, generally don't go out of their way to learn about lead regulations, Materna says. "There's a pretty low level of awareness out there in terms of any kind of occupational health and safety regulations," she says. "In some of these industries they kind of know the regulations are there, and they do something, but they may not do enough."

Because it's soft, easy to shape and relatively resistant to corrosion, lead is often added to other materials to make them more durable or easier to work with.

Lead can still be found in automobile batteries and radiators, glazes on ceramics and pottery, stained glass, bullets and fishing weights, solder (used on copper pipes), scrap metal, brass keys and faucets, old plumbing pipes, and old paint. Although lead was banned from household paint in 1978, any furniture, toys, or houses painted before then may still contain it. Concern has arisen in the U.S. over lead contamination in toys produced in China. And lead is still legal in some paint used for non-household applications, such as preventing corrosion on bridges and other metal surfaces

Which workers need to watch out for lead?

According to the California Department of Public Health, workers in over 120 occupations are exposed to lead. Some of the jobs that commonly involve lead exposure are battery manufacture or repair; construction (welding or cutting lead-painted metal); radiator manufacture or repair; wire cable cutting and manufacture, and cable, battery, or scrap metal salvage.

Some jobs come with more obvious potential exposure, such as lead smelting; foundry operations (melting, casting, or grinding lead, brass, or bronze); plating operations; manufacturing or using leaded paints, inks, dyes, glazes, or pigments, or lead soldering, prevalent in the electronics industry.

You should be wary of lead if you're involved in auto-body repair, sandblasting or stripping old paint from houses or furniture, or tearing down or remodeling houses, buildings, plumbing, or bridges. You may also be exposed to lead if you're involved in ship and aircraft building; rubber and plastics manufacture; roofing and gutter installation or repair; manufacturing radiation shielding; working at a gun-firing range, or making stained glass, pottery, tile, or other ceramics.

How does lead enter the body?

Lead is either swallowed or inhaled. Lead fumes and lead dust are created when lead is heated, for instance, from foundry work, paint stripping, or cutting scrap metal. Any sort of dry scraping or cutting can produce lead dust, which can be inhaled or swallowed if the dust is transferred to your mouth, either by your hands, on food, or from facial hair.

How do I know if I've been exposed?

Lead exposure is sneaky. It's possible to have significant amounts in your system and not show any symptoms. And mild symptoms of lead poisoning, such as fatigue and headaches, are so common they can be mistaken for any number of other ailments. Instead of causing damage from a single, major dose, lead can accumulate in your body, eroding your health over the long term from consistent exposures.

Once absorbed, lead is found in all the tissues of the body, but eventually most of it accumulates in the soft tissues and bones. Although your body will slowly rid itself of lead once you're no longer exposed, this can take years, and some of the damage associated with lead poisoning can be permanent. If you're worried, see a doctor and have your blood lead level (BLL) checked.

What are the symptoms of lead poisoning?

Symptoms vary with the individual and the severity of the poisoning. Children with high levels of lead in their blood may not exhibit symptoms, so they should be tested if lead exposure is suspected.

For mild poisoning, symptoms can include:

• mild fatigue or exhaustion
• emotional instability, difficulty concentrating
• sleep disturbances
• high blood pressure
• decreased learning and memory
• impairment of speech and hearing

Moderate lead poisoning can also cause:

• headache
• anemia
• general fatigue or sleepiness
• muscular exhaustion or pain
• pain in one or more joints
• tremor
• nausea, weight loss
• diffuse abdominal pain, constipation or diarrhea
• decreased libido
• irritability

Severe lead poisoning can include any of the above symptoms, plus:

• intermittent, severe abdominal cramps
• vomiting
• alteration of brain structure
• nerve degeneration
• convulsions and seizures
• delirium
• coma
• death

How do I protect myself?

The good news about lead poisoning is that it's completely preventable, even if your job involves working with materials that contain the metal. To start, your employer is required by law to follow special regulations to protect you. If you're manufacturing or building something and using a material that contains lead, your employer may be able to switch to one of the lead-free substitutes. Some solders and glazes now come in lead-free versions.

But even if you can't avoid contact with lead, in most circumstances there are simple precautions and clean-up measures that can keep your exposure to a minimum.

The most important thing is to avoid eating lead dust or breathing dust and fumes. If you work with lead, your employer should have a safety program in place and should provide you with proper safety equipment, including a respirator, gloves, and special work clothes. Adequate ventilation is also important. While at work, you should always wash your hands thoroughly before eating, and don't eat, drink, or smoke in the work area.

Before leaving your workplace for the day, change your clothes and shoes, and wash your face and hands with soap and warm water. If you can take a shower and wash your hair at work, that's even better, but otherwise, bathe as soon as you get home. Stash your work clothes directly into a plastic bag, and wash them separately from other laundry. It's a good idea to run the empty washing machine through another cycle right after washing your work clothes, just to make sure the next load doesn't pick up any leftover lead dust.

Another precaution is to simply maintain a healthy diet, with ample iron and calcium, which will make your body less vulnerable. If you are concerned that your workplace may not be safe, you should talk to your shop steward, if you have one. Otherwise, bring your concerns to your employer. If that doesn't help, contact the federal Occupational Safety and Health Administration (OSHA).

How is lead poisoning treated?

If you think you've been exposed to lead in your workplace, you should see a doctor and get your blood lead level (BLL) checked. In most cases, the only treatment needed is to remove the source of lead. Once it stops entering your system, your body will begin ridding itself of the lead you've already absorbed.

If your BLL is really high, your doctor may decide to restrict you from working -- like the Alco employee -- until your lead level is lowered and the hazard at your job is reduced. In severe cases, your doctor may use a treatment called chelation therapy. This involves giving you a chemical that binds to the lead in your blood and helps you pass it more quickly. If you're sure you've been exposed to lead at work, tell your shop steward, employer, or OSHA.

Experts say that protecting oneself against lead exposure requires vigilance, and despite strides in household lead reduction it's clearly not a thing of the past in the workplace. The San Francisco Chronicle reported that nine painters who spent hours grinding away old lead paint on Bay Area bridges had been lead poisoned. One of them had the highest blood-lead level ever seen by state officials.

Further Resources

National Lead Information Center
800-532-3394
For more in-depth information call the center's clearinghouse at 800-424-5323

The Association of Occupational and Environmental Clinics
202-347-4976

Occupational Safety and Health Administration (OSHA) http://www.osha.gov
800-321-6742

National Institute for Occupational Safety and Health http://www.cdc.gov/niosh
800-356-4674

The American Ceramic Society Ceramic Information Center
614-794-5810

The Society of Glass and Ceramic Decorators http://www.sgcd.org
A trade association for manufacturers, decorators and suppliers.
202-728-4132

References

Lead poisoning disease, National Library of Medicine, Medline http://www.nlm.nih.gov/medlineplus/ency/article/001653.htm

Occupational lead poisoning, Kevin C. Staudinger, MD, MPH, Victor S. Roth, MD, MPH, American Family Physician,.

American Academy of Pediatrics. Lead Screening. . http://www.aap.org/publiced/BR_Lead.htm

Agency for Toxic Substances and Disease Registry. Lead Toxicity: How should patients exposed to lead be evaluated? August 2007. http://www.atsdr.cdc.gov/csem/lead/pbpatient_evaluation2.html

California Environmental Protection Agency. Occupational Health Hazard Risk Assessment Project for California: Identification of Chemicals of Concern, Possible Risk Assessment Methods, and Examples of Health Protective Occupational Air Concentrations. December 2007. http://www.dhs.ca.gov/OHB/HESIS/risksummary.pdf