What is lead?
The Centers for Disease Control and Prevention summarizes: "Lead is a soft, heavy, blue-gray metal. It occurs naturally in the earth's crust, and human activities such as burning fossil fuels, mining, and manufacturing have spread it throughout the environment, including our homes and workplaces. Exposure to lead should be avoided. Lead is highly toxic to humans, especially young children. It has no known physiologic value to the human body." (http://www.cdc.gov/nceh/lead/)
Great effort has been undertaken in the United States over the last two decades to remove lead from gasoline, paints, and many other products. However, lead is still found in some types of ammunition, batteries, medical and scientific equipment and other products. Because lead does not break down or decompose, lead from past products remains in the environment.
Click here for more detailed information on lead.
How do people get exposed to lead?
People who work in certain industries can be exposed by breathing in air that contains lead particles or fumes. In Alaska, such industries include:
Families of workers may be exposed to lead when workers bring lead dust home on their work clothes. This can be avoided if employers and employees follow the federal Occupational Safety & Health Administration (OSHA) regulations and use protective clothing that is cleaned properly. See 1910.1025 (g) (1) and (2).
The U.S. Environmental Protection Agency has guidance for homeowners, tenants, childcare providers and parents on lead safety during renovation, repair, and painting: http://www2.epa.gov/lead/renovation-repair-and-painting-program.
Non-occupational Exposures in Adults
People who enjoy certain hobbies can be exposed to lead by breathing in air that contains lead particles or fumes. In Alaska, such hobbies include:
- Shooting and reloading firearms
- Shooting at an indoor firing range
- Casting lead bullets or fishing weights
- Metal recycling
- Stained glass
People can also be exposed to lead in the home through various sources such as:
Exposures in Children
Fetuses and children under the age of 6 are the most vulnerable to the negative health effects of lead. If exposure levels are high enough during critical growth stages, children can sustain permanent damage. Lead can delay or impair brain development in children and adversely affect IQ, and can cause anemia and impaired metabolism of vitamin D. Absorption of lead appears to be higher in children who have low dietary iron or calcium intakes, so a healthy diet is important. Adequate intake of zinc is also important to help protect against health effects from lead exposure.
Exposure routes for children include:
Older children's brains continue to develop, so they are also vulnerable to the toxic effects of lead. In Alaska, we have identified additional sources of lead exposures in older children including:
- Shooting and reloading firearms
- Shooting at an indoor firing range
To learn about past lead exposures in Alaska, click here to access the Section of Epidemiology Bulletins on lead.
The decision to test a child's blood lead level is best made by the child's parents and health care provider, taking into consideration the child's exposure risk factors. Interested parents should discuss blood lead testing during their child's physical exam.
The Environmental Public Health Program has free lead testing materials available to health care providers interested in providing lead screening to Medicaid-eligible children. The test uses a finger stick to collect a capillary blood sample. Multivette tubes, lancets, and supporting paperwork will be provided. To order lead screening kits, please contact the Environmental Public Health Program at firstname.lastname@example.org or call (907) 269-8000.
What are the health effects of lead exposure?
Lead poisoning occurs when blood lead levels (BLLs) are elevated. Exposures occur primarily through breathing or ingesting lead. BLLs are currently the best indicators of personal lead exposure. People can minimize the risk of adverse health effects by preventing lead exposures.
The effects of lead are the same whether lead enters the body through breathing or ingestion. Lead can affect almost every organ and system in your body. The main target for lead toxicity is the nervous system, both in adults and children.
Alaska Blood Lead Epidemiology and Surveillance Program
Alaska has a comprehensive statewide blood lead surveillance program and targeted screening program to identify and control sources of lead exposure and assist in the medical management of patients with elevated blood lead levels (BLLs).
In Alaska, elevated lead levels are found mostly in adults, usually as a result of mining occupations, casting of lead bullets or fishing weights, or exposure in shooting ranges. Present efforts are being directed towards targeted screening of populations potentially at risk for elevated lead exposures. These include occupational and non-occupational exposures.
In Alaska, follow-up investigations are conducted for children under age 18 when the initial BLL is 5 µg/dL or higher and for adults when the initial BLL is 25 µg/dL or higher. For occupational exposures, OSHA (Occupational Safety and Health Administration) requires follow-ups when BLLs exceed 40 µg/dL.
Alaska Public Health Reporting Law
Health care providers and laboratories are required to report all blood lead levels to the Section of Epidemiology and include the patient's date of birth, sex, race, and community of residence, as well as the provider's name. Reporting of levels 5 µg/dL or higher in children aged <18 years and levels 10 µg/dL or higher for adults ≥18 years of age is required within 1 week of receiving the result. All other levels are required within 4 weeks of receiving the result. Reports may be made may be made by mail, FAX, or by calling the RTR System. The report form is available at: www.epi.alaska.gov/pubs/conditions
Title 7. Alaska Administrative Code. 27.014. Reporting of blood lead test results:
- Not later than one week after receiving the results of a blood lead test of a person described in (b) of this section, a health care provider shall report to the department
- the name and address of the health care provider that requested the test; and
- the person's
- date of birth;
- community of residence; and
- test results in micrograms per deciliter, including the date of the test.
- The blood lead test report described in (a) of this section is required for a person
- younger than 18 years of age if the reported blood lead test result is greater than or equal to five micrograms per deciliter; and
- 18 years of age or older if the reported blood lead test result is greater than or equal to 10 micrograms per deciliter.
- A public, private, military, hospital, or other laboratory performing blood lead analyses in this state or on samples obtained in this state shall report, not later than four weeks after performing the test,
- the name, date of birth, sex, race, ethnicity, and community of residence of the person tested;
- the test result in micrograms per deciliter, including the date of the test; and
- the name and address of the health care provider that ordered the test.
Providers and Laboratories - How to report Blood Lead Levels to the Alaska Division of Public Health:
- Use the Blood Lead Level Reporting form. Send the form to: Section of Epidemiology, 3601 C Street, Suite 540, Anchorage, AK 99503
- Call the State of Alaska Infectious Disease Report Line toll-free: (800) 478-1700
To find out more about the lead surveillance program, contact the Environmental Public Health Program either by phone (907-269-8000) or e-mail (email@example.com).
Most common lead exposures in Alaska (and associated literature):
Indoor firing range
Hand reloading ammunition
Fishing weight melting/casting
Other hobbies, stained glass, soldering
Lead in Toys, Jewelry and Other Consumer Products
Proceedings from conference, "Ingestion of Lead from Spent Ammunition: Implications for Wildlife and Humans"
The Environmental Public Health Program recently participated in a conference convened by The Peregrine Fund discussing the available research on the effects and risks of lead exposure from spent bullet fragments. The Peregrine Fund, a conservation group for birds of prey, convened the conference after a decade of research on wild California Condors in the Grand Canyon region of Arizona revealed that lead exposure from spent ammunition is the most important factor impeding the full recovery of the species in the area. The research also suggested that lead from spent ammunition could be a concern to people who eat game harvested with lead bullets or shot shells.