Lead Exposure Surveillance in the U.S.: The Adult Blood Lead Epidemiology and Surveillance (ABLES) program

Overexposure to inorganic lead continues to be an important health problem in the U.S. and worldwide, as adults continue to be exposed to lead at their workplaces and from other sources. In the U.S. the vast majority (95%) of reported elevated blood lead levels (EBLL) have been work-related. Furthermore, recent research has caused increased concerns about the toxicity of lead at low doses. These facts stress the need to maintain lead exposure surveillance systems to identify and target interventions at populations at risk.

Since 1992, the state-based ABLES program has tracked laboratory-reported EBLL in adults. A unique identifier is assigned to each person to account for multiple blood lead reports across years. Follow-up is conducted to ensure completeness of information on the exposure source for EBLL. NIOSH/CDC analysis the data and disseminates results.

An overall decreasing trend in the national prevalence rate of EBLL with a leveling off in 2006–2008 has been observed. The manufacturing, construction, and mining sectors accounts for most lead exposures. Currently, 40 states submit data to NIOSH.

To further prevent hazardous workplace lead exposures the ABLES program continues its efforts to build state capacity to initiate, expand, or improve adult blood lead surveillance programs; in 2009 has updated its case definition for EBLL to a blood lead concentration ≥ 10 µg/dL; has established the ABLES Coding Committee and the ABLES laboratory workgroup; and will continue lead exposure surveillance in adults that can be used to identify populations at risk and target public health interventions.