Under UK legislation, employers must test for blood lead levels in workers exposed to lead at work if

• the lead levels in the air are at a significant level (air tests show levels of 0.075mg/m3) or
• employees may take lead in by mouth – for example via their hands, or
• skin absorption is a possibility.

The employer should contract an appointed doctor, from the list kept by the local HSE office, to do this.

In practice, employees either at their own initiative or at the request of their employer may come to see their GP for a test.

Advisers or clinicians who encounter workers with lead exposure who have not had blood leads should institute them straight away.

Practice nurses may need to be advised that the blood sample should be a Lithium-heparin or EDTA sample, sent to the local Clinical Chemistry department in the normal way. The report received will state the level and give guidance on normal values.

Blood levels are evidence of intensity of current lead exposure and body burden. How long it takes to reduce the level after reducing exposure depends on the accumulated amount in the body (e.g. in bone) and any medical interventions used to reduce it.

If the level exceeds 60 microgram/dl for all employees, 50 for young people and 30 for women of reproductive capacity, the employer is legally obliged to medically suspend the employee; meaning in practice, finding a job in which there is minimal lead exposure and remaining there till the lead level has reduced to below the suspension level.

However all levels above 15 micrograms are evidence of abnormal exposure, and because lead’s effects start at low levels and are initially hard to distinguish, action should be taken to identify and control the source of exposure.

Medical surveillance measurements should be reported to the Health and Safety Executive.

In cases of severe poisoning, active clinical interventions to reduce lead levels should be taken and additional monitoring methods adopted.

Contact SOHAS library for further information.