LEAD ON THE JOB

PHYSICIAN RESPONSIBILITIES

Pursuant to Wyoming Statute 35-1-240(a)(vii), to assist the physicians within the State of Wyoming in identifying and preventing lead poisoning, all human blood lead level (BLL) test results of Wyoming residents shall be reported to the Wyoming Department of Health effective January 1, 1995. All BLL >45µg/dL shall be reported within 24 hours of laboratory confirmation; all BLL<45µg/dL shall be reported bi-weekly.

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Who is Covered Under The Law?

The law covers all workers exposed to metallic lead, inorganic lead compounds or organic lead soaps. The Wyoming Department of Health provides surveillance of all adults with blood lead levels > 25mg/dL.

What Are Lead Poisoning Symptoms?

  • Hypertension, fatigue, hemolytic anemia
  • Abdominal pain, nausea, constipation, weight loss
  • Peripheral neuropathy, cognitive dysfunction
  • Arthralgias, headache, weakness, irritability
  • Impotence, loss of libido, depression
  • Depression of thyroid and adrenal function
  • Chronic renal failure, gout

A patient with lead poisoning may have a combination of symptoms - or no symptoms at all until the condition has progressed.

What Jobs Pose Lead Poisoning Risks?

  • Producing or smelting lead
  • Manufacturing/recycling batteries, metal or ammunition
  • Melting, soldering and/or casting brass, copper or lead
  • Repairing radiators
  • Handling scrap metals
  • Indoor firing ranges
  • Burning or welding old, painted metals; foundry work
  • Mixing ceramic glazes, making stained glass or jewelry
  • Machining and grinding lead alloys
  • Demolishing, renovating or welding old structures
  • Bridge works
  • Making cables and cable splicers
  • Working as a plumber, roofer or painter

Is Occupational Lead Poisoning a Problem in Wyoming?

Yes. Although little screening has been done, we know of cases, some requiring hospitalization and chelation, involving lead smelting, radiator repair, firing ranges, painting and manufacture of lead anodes.

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Other Identified Sources of Lead in Wyoming

  • Paint from homes built before 1978.
  • Drinking water from pipes with lead solder or lead service connections to city water supplies.
  • Food and beverages stored, heated or served in pottery and ceramics.

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Medical Surveillance

Employers must have a medical surveillance program, which includes biological monitoring and medical evaluation. This is required by law.

Biological monitoring consists of blood sampling and analysis for blood lead level (BLL) and zinc protoporphyrin (ZPP) levels. It should be performed on the following schedule:

  • Before assignment to work in areas where airborne concentrations of lead are at or above the action level of 30mg/m; averaged over an 8 hour period.
  • At least every two months during the first six months for an employee who is or may be exposed at or above the action level; every six months after that.
  • At least every 2 months for any employee whose last BLL was >40mg/dL until two consecutive tests show a BLL <40mg/dL.
  • At least monthly during the removal period.
  • At the end of employment.

NOTE: Employer should not be notified of any medical findings, laboratory results or diagnoses which are unrelated to occupational lead exposure. Physician should advise the employee of an occupationally or non-occupationally related medical condition requiring further treatment or reevaluation.

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Medical Evaluation for a Lead Occupational Surveillance Program Should Include:

  • Occupational history with attention to previous lead exposure
  • Medical history of past and present medical conditions involving specific organ systems
  • Personal history of hygienic habits, smoking, alcohol consumption, hobbies
  • Blood pressure
  • Physical examination with special attention to neurological, gastrointestinal, cardiovascular and renal systems
  • Laboratory testing for BLL, hemoglobin, hematocrit, red blood cell indices and examination of peripheral smear morphology, ZPP level, BUN and serum creatine, routine urinalysis

All Exposed Employees With BLL >40mg/dL Should Receive an Annual Medical Evaluation

>>> Employees Should be Medically Evaluated if They:

  • Develop symptoms and signs of lead poisoning
  • Ask for medical advice on the effect of lead exposure on their ability to have a health child
  • Are pregnant
  • Have difficulty breathing when wearing a respirator

Employees should receive appropriate medical evaluation if removed from exposure due to health problems, or if placed on limited duty pending medical evaluation.

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When Should an Employee be Medically Removed ?

The employee should be transferred to a non-lead exposed job without loss of pay, benefits or seniority if he or she has a BLL >50mg/dL (>60mg/dL for General Industry) or on being found to have a condition placing him or her at increased risk from lead. The employee may return when two consecutive blood sampling tests indicate that the blood lead level is <40mg/dL.

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Wyoming Department of Health Lead Project
6101 Yellowstone Road, Ste #510
Cheyenne, WY 82002
1-307-777-6015