Medical Management of Lead-Exposed Adults
Medical Guidelines for Lead-Exposed Workers
OLPPP considers a level of 3.5 µg/dL in adults to be elevated.
OLPPP recommends workers be removed from lead exposure if they have two BLLs of 20 µg/dL or higher or one BLL of 30 µg/dL.
If worker is pregnant, OLPPP recommends worker be removed from lead exposure at 3.5 µg/dL.
Depending on a worker's other health-related conditions, medical removal may be needed at lower BLLs.
Frequently Asked Questions
What are the health effects of lead?
See page 9 of Medical Guidelines for the Lead-Exposed Worker (PDF).
For health effects information written for lead-exposed workers, see Lead and Your Health.
What is an “average” blood lead level?
The average blood lead level for adults in the United States is currently less than 1 microgram per deciliter (µg/dL) based on data from 2005–2014. This is significantly lower than in the 1970s, when the average BLL for adults was 13 µg/dL. The decrease is due in large part to the removal of lead from gasoline, residential paint, and canned food.
How has our understanding about the health effects of lead changed?
Recent research shows that lead is harmful to the body at levels as low as 5 μg/dL. While having a single BLL ≥5 µg/dL may not necessarily cause health damage, chronic exposure at this level puts adults at an increased risk for effects such as hypertension and reduced kidney and cognitive function.
What are the laws about sharing patient BLL information with employers and with CDPH OLPPP? How does HIPAA apply?
HIPAA allows the health care provider to report the results of a BLL test to an employer under the following conditions:
The blood lead test was performed at the request of the employer as part of an employer-sponsored employee blood lead testing program, AND
Before the test was performed, the health care provider notified the employee in writing that the results of the test would be released to the employer.
HIPAA also allows health care providers to disclose, without individual authorization, protected health information to public health authorities authorized by law to receive such information for the purposes of preventing or controlling disease, injury, or disability. CDPH is legally mandated to maintain the California Occupational Blood Lead Registry and to investigate cases of occupational lead poisoning or cases of children poisoned as a result of lead brought home from the workplace. CDPH collects blood test results for the purpose of fulfilling these mandates.
Health Care Provider letter: HIPAA and Sharing of BLL Results (PDF) – guidance on Health Insurance Portability and Accountability Act and sharing of employee blood lead test results
Are there similar guidelines for medical management of lead-poisoned children?
Yes, CDPH’s Childhood Lead Poisoning Prevention Branch provides guidelines for the medical management of lead-poisoned children.
The Centers for Disease Control and Prevention also developed guidelines for health professionals that care for lead-exposed children.
For more information regarding medical management of lead-exposed workers, see the following OLPPP resources: