Workplace Medical Mystery Solved: An Unknown Exposure Leaves a Child with High Amounts of Lead in her Blood

The local health department conducted a lead risk assessment of Michelle and Ted’s house that turned up some interesting findings. While their home was built before 1978—when lead-containing paint was banned by the U.S. Consumer Products Safety Commission—no lead-based paint was found in the house. The homes that were demolished to make way for the construction of the family’s home and the proximity to the freeway and vehicle exhaust could have contaminated the soil in the yard, however, no lead was found there either. Lead dust was found on the floor in the family’s laundry room. So where did the lead dust on the floor come from?

Upon further testing of the family, Ted was found to have a BLL of 25 micrograms per deciliter (µg/dL). The National Institute for Occupational Safety and Health (NIOSH) defines an elevated BLL for those over age 16 to be 10 µg/dL or more.

Ted told the lead risk assessor that he typically came home from work at the e-scrap recycling facility with dust in his hair and on his clothes. He routinely picked up and played with his two-year-old daughter Sarah when he arrived home, then would take a shower and throw his clothes in the laundry before sitting down for dinner.

The type of work Ted performed at the e-scrap recycling facility, crushing cathode ray tubes from discarded TVs and computer monitors, exposed him and his coworkers to lead.

Without access to showers at work or uniforms that could be left at work for laundering, employees of the e-scrap recycling facility risked contaminating their personal clothes, vehicles, and homes with lead. This is known as “take-home” exposure and how Ted’s daughter Sarah came to have an elevated BLL.

The Occupational Safety and Health Administration estimates that approximately 804,000 workers in general industry and an additional 838,000 workers in construction are potentially exposed to lead as a result of the production, use, maintenance, recycling, and disposal of lead material and products.

NIOSH has studied take-home contamination from workplace chemicals, including lead, since 1992 when Congress passed the Workers’ Family Protection Act. Since then, NIOSH has found that take-home exposure is a widespread problem.

Workplace measures effective in preventing take-home exposures include:

• Reducing exposure in the workplace
• Changing clothes before going home and leaving soiled clothing at work for laundering
• Storing street clothes in areas separate from work clothes
• Showering before leaving work
• Prohibiting removal of toxic substances or contaminated items from the workplace

Preventing take-home exposure is critical because decontaminating homes and vehicles is not always effective. Normal house cleaning and laundry methods are inadequate, and decontamination can expose the people doing the cleaning and laundry.

Shortly after lead was found in their home, Ted decided to quit his job at the e-scrap recycling facility. Three months following his job change, Ted’s daughter’s BLL decreased to 8 µg/dL.

Read more about NIOSH’s work studying occupational exposures at electronic scrap recycling facilities in the recent NIOSH Science Blog.

Stephanie Stevens, MA, is a Health Communication Specialist in the NIOSH Office of the Director.

This is the second installment in the NIOSH Workplace Medical Mystery Series. This “mystery” is loosely based on Health Hazard Evaluation (HHE) reports conducted by NIOSH and other sources, and any recommendations made herein were for the specific facility evaluated and may not be universally applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.  HHEs are publicly available at www.cdc.gov/niosh/hhe/reports/, but the names of individuals and facilities mentioned in the HHE reports and in this series have been changed to protect their identities. For more information on the NIOSH HHE program, visit www.cdc.gov/niosh/hhe/.

Sources:

Centers for Disease Control and Prevention. (2014). Lead. Retrieved from http://www.cdc.gov/nceh/lead/

Environmental Protection Agency. (2014). Understanding Inspection, Risk Assessment, and Abatement. Retrieved from http://www2.epa.gov/lead/understanding-inspection-risk-assessment-and-abatement

National Institute for Occupational Safety and Health. (2013). Adult Blood Lead Epidemiology & Surveillance (ABLES). Retrieved from http://www.cdc.gov/niosh/topics/ables/description.html

Occupational Safety & Health Administration. (2014). Lead. Retrieved from https://www.osha.gov/SLTC/lead/

National Institute for Occupational Safety and Health. (2014) Protect Your Family: Reduce Contamination at Home. Retrieved from http://www.cdc.gov/niosh/docs/97-125/

Ceballos D., Chen L., Page E., Echt A., Oza A., Ramsey J. (2014) Evaluation of Occupational Exposures at an Electronic Scrap Recycling Facility Report No. 2012-0100-3217. Retrieved from http://www.cdc.gov/niosh/hhe/reports/pdfs/2012-0100-3217.pdf

Consumer Products Safety Commission. (1977) CPSC Announces Final Ban On Lead-Containing Paint. Retrieved from http://www.cpsc.gov/en/Recalls/1977/CPSC-Announces-Final-Ban-On-Lead-Containing-Paint/