Protecting workers from lead exposure

For as long as people have worked, the threat of occupational lead exposure has existed.

Egyptians used the metal as far back as 4000 B.C., according to the London-based International Lead Association. Romans followed suit by using lead to create water pipes, aqueducts, tank linings and cooking pots. Eventually, scientists determined ways to use lead in paints and pigments, as well as in ancient cosmetics and glazes.

Back then, no one knew about the neurological and reproductive harm – as well as other health problems – that could result from prolonged exposure to lead. As late as the 20th century, dangerous levels of lead existed in new residential paints and gasoline.

Fast forward to today: Lead remains a valuable – albeit hazardous – metal in construction, manufacturing and other industries. And although the potential health consequences are well-established, many workers are not protected as well as they should be.

“I think lead exposure has sort of gone in the background because people think, ‘Well, they have eliminated it from gasoline, they have eliminated it from paint, so everything must be pretty good now,’” said Victor S. Roth, M.D., M.P.H., who is board certified in occupational medicine by the American Board of Preventive Medicine and has authored several articles about lead. “But the fact is if you work in a certain confined area where they are not taking safety very seriously, it’s a problem. As a medical occupational professional, I just can’t imagine a safety professional not taking it seriously nowadays.”

Problems remain

According to a January report from the California Department of Public Health, from 2012 to 2014 more than 6,000 workers in the state had elevated levels of lead in their blood, defined by the Centers for Disease Control and Prevention as at least 5 micrograms per deciliter. Extrapolating those results means that hundreds of thousands of workers across the nation could be affected.

“This is an issue that we’ve known about for millennia, so the fact that there are more than 6,000 known workers exposed to lead on the job in California is far too many,” said Nina Townsend, CDPH Occupational Lead Poisoning Prevention Program chief.

The numbers align with OSHA’s estimate that 804,000 workers in general industry and an additional 838,000 workers in construction are potentially exposed to lead. OSHA requires employers to protect their workers under standards covering general industry (1910.1025), shipyards (1915.1025) and construction (1926.62). The standards establish a permissible exposure limit of 50 µg/m³ of lead over an 8-hour, time-weighted average for all employees covered. In addition, OSHA established an action level of 30 µg/m³, which marks the level at which employers must initiate certain compliance actions.

Employers also must follow several other requirements from OSHA if their workers are exposed to lead. The requirements are intended to protect workers during their shifts, as well as prevent them from tracking lead home and potentially putting family members at risk. These requirements are:

• Test workplace air for lead and test blood-lead levels in workers.
• Inform workers if their job involves exposure to lead, and provide proper training if that is the case.
• Establish controls for lead dust and fumes in the workplace.
• Provide protective clothing and equipment for workers in exposed areas.
• Give workers a place to wash their hands and shower after a shift.
• Provide workers with a place to change into clean clothes, and ensure work clothes are kept away from street clothes.

Jobs associated with lead exposure include painting, building renovation, radiator repair, bridge work, demolition, battery manufacturing, metal production, metal scrap cutting and recycling, plumbing, soldering, and ceramic work, according to OSHA.

“Safety professionals should know if there is a possibility of lead exposure,” Roth said. “That’s part of being a work professional, whether it’s knowing about asbestos or lead or any other type of exposure that would be toxic to an employee. If there is a possibility of lead exposure, they need to do monitoring for air levels of lead. And, no matter what, they should minimize any exposure – even if it’s below the action level or the permissible exposure limit. You should try to get way below even that.”

Create a plan

At Michigan State University, Zach Hansmann knew it was critical to protect staff employees and contract workers from lead. Hansmann oversees the school’s lead management plan as contractor safety manager, environmental health and safety. Like many universities across the country, MSU’s campus features massive buildings from the early-to-mid 1900s.

“We had a challenge working with contractors and getting contractors to commit to complying with the rules,” Hansmann said. “There is a lot of front-end work that goes into it that a lot of times scares contractors off. We tell them that we have millions of square feet of buildings, and if you want to work on anything that contains any amount of paint, you have to go through a written respirator program, a fit test, an initial exposure assessment and all these other steps.”

Some prospective contractors have balked at the rules, which may seem daunting at first. Hansmann provided more clarity in 2011 by writing a standard specifying that all coated surfaces should be assumed to contain lead. Contractors’ bids would need to include the appropriate contingency plan to accommodate the provisions of the lead rules.

“That helped us get the conversation started with contractors about, ‘What do I have to do to work here?’” Hansmann said. “We’ve really been trying to work with them and get them up to a level of comfort with what a negative exposure assessment really means, and how you do one, and how you justify what your operations are when I come to ask or OSHA comes to ask.”

Under the state program in Michigan, the university is able to pool all of its contractors on large projects and use a single abatement contract for the entirety of the work. That way, every individual contractor does not need to launch its own respirator program or lead management program. Abatement workers who already are under contract may conduct assessments and manage protective actions for other participants in the project.

Hansmann offered advice for other safety professionals that work with contractors in areas where lead could be an issue.

“I’d say you have to be very clear upfront with what your expectations are,” Hansmann said. “In the contracts that you sign, you have to be explicit. Because there comes a point where OSHA will show up and ask what you’re doing, and the contractor says, ‘We have no knowledge of this being lead.’ Then OSHA says, ‘This building was built in 1940. What do you mean you have no knowledge of this being lead?’ And you have this conflict.”

Every exposure is serious

Some hazards are easier to detect than others. Take electrical shock, for example. If a worker puts his or her finger in an outlet, the consequence is immediate and severe.

Lead exposure typically manifests itself in a very different fashion. Low-level exposure accumulates over time, and health risks quietly increase for the person exposed. Lead poisoning often has no symptoms, according to CDC. Lower-level exposures can damage a person’s kidneys, nervous system and cognitive abilities. Workers should tell their doctor if they are exposed to lead at work, OSHA states.

To reduce the risk of take-home lead exposure, workers should frequently wash their hands and shower at the end of every shift. The agency also advises workers to change out of their work clothes and shoes before returning home. Preferably, exposed work clothes should not go home with the worker. However, if a worker brings the garments home, he or she should keep them in a plastic bag and wash them separately from other clothing.

Meanwhile, Roth said, be aware that any level of exposure can be dangerous over time.

“It builds up,” Roth said. “It’s not like you have a low-level exposure and you go home and it’s back to zero the next day. It stays at the same level – it doesn’t go back to zero. It can build up with low-level exposure day after day. So even if the exposure is not of a high level, you can end up experiencing levels that are higher than they should be.

“The other thing is that [elevated blood-lead levels] last for a while. It’s not like you can say, ‘Here’s a pill, you’ll get better.’ Once it’s there and it has reached a certain level, it stays there. It can be eliminated, but it takes a long time.”

Workers can advocate for themselves by taking an active role in their health and safety on the job.

“The best thing to do is to communicate with your safety professional and find out is there a possibility of getting exposed to lead?” Roth said. “Then you know that if there is, you want to make sure it’s below the action level.

“You don’t want to wait to experience signs and symptoms, there’s no question about that. If you are having signs or symptoms, I’m not saying it’s too late, but it means you should have asked a long time ago.”

The CDPH study found that the majority of workers with elevated blood-lead levels were male, Hispanic, and between the ages of 20 and 59. Sixty percent worked in manufacturing and 14 percent worked in construction. In light of the results, the department’s Occupational Lead Poisoning Prevention Program stated it will increase blood-lead level testing and establish targeted prevention efforts for vulnerable workers.

“The damage from lead can be permanent,” Townsend said. “Just because we’ve known about an issue for a long time doesn’t mean it has gone away. I think that is one of the primary takeaways from the report.”

Because older buildings require renovation or demolition, lead exposure is likely to remain a serious concern for workers.

“So very few employers actually do blood-lead testing of their workers,” said Susan Payne, CDPH research scientist supervisor and epidemiologist. “We believe there are actually a lot more workers out there exposed to lead on the job who are never getting a blood-lead test. We would like to get the message out there for more employers to be doing blood-lead testing of their employees.”