Chart Book (6th edition): Hazards and Exposures – Lead Exposure in the Construction Industry
Lead is found in many construction materials, including but not limited to paint, welding wire, and electrical conduit.1,2 Construction workers can be exposed to lead during the handling and demolition of lead-containing products, as well as during tasks that generate fumes and respirable dusts, such as welding, smelting, refining, and soldering.1,2 In addition, construction workers may expose their children and other family members to lead via take-home exposure (such as lead dust on clothing, skin, hair, and tools).3 Lead exposure can result in adverse health effects, such as anemia, hypertension, central nervous system effects, peripheral neuropathy, nephropathy, infertility, and miscarriages.1-5 Lead exposure can be measured by micrograms of lead per deciliter of blood (μg/dL) through a blood test.
Over the past 30 years, the National Institute for Occupational Safety and Health (NIOSH)’s Adult Blood Lead Epidemiology and Surveillance (ABLES) program has worked with states to study lead exposure of adults (≥16 years old) in the U.S. ABLES contributes to the Healthy People 2020 goal of reducing the rate of blood lead levels (BLLs) ≥10 µg/dL among adults.4 When the source can be identified, about 95% of those with BLLs ≥25 µg/dL were exposed at work.4 In 2016, ABLES identified 6,160 cases of BLLs ≥10 μg/dL in 18 states submitting industry data to the program. Of the reported 6,160 cases, the construction industry alone accounted for 20% of the total (chart 36a),6 which is disproportionately high given that construction employment accounts for just 6.4% of the overall workforce.7 Even so, the number of construction-related cases is likely underreported due to several factors:
- Workers employed in lead abatement are classified under remediation services (North American Industry Classification System [NAICS] 562910) instead of construction (NAICS 23), resulting in 79 uncounted cases in 2016.6
- Employers working in construction may not comply with the Occupational Safety and Health Administration (OSHA)-mandated employee BLL testing and not all construction workers exposed to lead are tested.
- Laboratories may not report all tests to state health departments.
- BLL reports may not have employer or industry information.
Based on available ABLES data from 2011 to 2016, the prevalence rate of workers with BLLs ≥10 μg/dL in the construction industry has been declining, with a slight increase in 2016 (chart 36b). Highway, Street, and Bridge (NAICS 2373) and Building Finishing (NAICS 2383) were the two construction subsectors with the largest number of reported cases with BLLs ≥10 μg/dL (chart 36c).
Prevalence rates of BLLs ≥10 μg/dL among construction workers vary by state. Among the 12 states that reported five or more occupational cases in the construction industry in 2016, New York, Vermont, Louisiana, Maryland, and Connecticut reported rates above the national prevalence rate (chart 36d).
Regulations on lead have gradually been tightened over time. Lead was banned from commercial paint in 1978 and phased out of gasoline in the 1980s.1 Additionally, workers who disturb lead-based paint in facilities built before 1978 are required to be trained and certified.8 Responding to increasing evidence of adverse health outcomes at low BLLs, the NIOSH ABLES program, the Centers for Disease Control and Prevention, and the Council of State and Territorial Epidemiologists lowered the case definition for elevated BLLs to BLLs ≥5 μg/dL in 2015.4,9,10 However, the OSHA requirement to institute protections for workers exposed to lead in the construction industry has not been updated since 1993.11 Given that a substantial number of construction workers continue to have BLLs ≥10 μg/dL, enhanced efforts are needed to further protect these workers. Currently, three OSHA state plan states (California, Michigan, and Washington) where OSHA is administered by the states and not the federal government, have begun rule-making procedures to reduce the allowable exposure levels of lead for construction and other workers.
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1. Polh H, Ingber S, Abadin H. 2017. Historical view on lead: Guidelines and regulations. Metal Ions in Life Sciences, 17: 435-470.
2. Michigan Occupational Safety and Health Administration. 2015. MIOSHA Fact Sheet, Lead exposure in construction, http://www.michigan.gov/documents/lara/lara_miosha_constfact_lead_exposure_in_construction_413873_7.pdf (Accessed December 2017).
3. Bennet K, et al. 2015. Lead poisoning: What’s new about an old problem? Contemporary Pediatrics, http://contemporarypediatrics.modernmedicine.com/contemporary-pediatrics/news/lead-poisoning-what-s-new-about-old-problem-1? (Accessed December 2017).
4. National Institute for Occupational Safety and Health. Adult Blood Lead Epidemiology and Surveillance (ABLES), https://www.cdc.gov/niosh/topics/ables/description.html (Accessed December 2017).
5. Agency for Toxic Substances and Disease Registry. 2017. Lead toxicity: What are possible health effects from lead exposure? https://www.atsdr.cdc.gov/csem/csem.asp?csem=34&po=10 (Accessed December 2017).
6. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health. Adult Blood Lead Epidemiology & Surveillance program [unpublished]. Contact: Rebecca Tsai, NIOSH ABLES program officer (firstname.lastname@example.org)
7. The percentage of construction employment was estimated using data from the 2016 American Community Survey.
8. U.S. Environmental Protection Agency. 2010. Lead; Amendment to the opt-out and recordkeeping provisions in the renovation, repair, and painting program. Federal Register, 75(87): 24,802-24,819 [40 CFR Part 745].
9. Council of State and Territorial Epidemiologists. 2015. Public health reporting and national notification for elevated blood lead levels, http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/2015PS/2015PSFinal/15-EH-01.pdf (Accessed December 2017).
10. Centers for Disease Control and Prevention. 2016. National Notifiable Diseases Surveillance System (NNDSS). Lead, elevated blood levels, 2016 case definition, http://wwwn.cdc.gov/nndss/conditions/lead-elevated-blood-levels/case-definition/2016/ (Accessed December 2017).
11. U.S. Department of Labor. Occupational Safety and Health Administration. 1993. Lead, Safety and health regulations for construction [29 CFR 1926.62], https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10641 (Accessed December 2017).
All charts – For workers with more than one blood lead test in a given year, only the highest BLL for that year was included. Disclaimer: The findings and conclusions on this page are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health.
Chart 36a – Total may not add to 100% due to rounding. Other includes cases without industry information. Industries are based on NIOSH’s NORA sectors. See information on the NORA sectors at https://www.cdc.gov/niosh/nora/sectorapproach.html (Accessed January 2018).
Chart 36b – When a worker had BLLs ≥10 μg/dL reported in multiple years, this worker was counted as a case each year. Rate = (number of construction workers with BLLs ≥10 μg/dL / number of full-time workers employed in the construction industry) * 100,000.
Chart 36d – Twelve states reporting five or more occupational cases with BLLs ≥10 μg/dL in construction were included in the rate calculations. N/A represents states not participating in the ABLES program, states with fewer than five occupational cases in construction, or states not submitting industry data to NIOSH.
All charts – U.S. NIOSH ABLES program. Denominator data for rates (2011–2016) were from the American Community Survey and consisted of all workers employed in the construction industry (NAICS 23) and not just construction workers exposed to lead. Contact: Rebecca Tsai, NIOSH ABLES program project officer (email@example.com).