Lead Related Health Surveillance Medicals

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Health Monitoring for Inorganic Lead under WHS Regulations

We prioritise the wellbeing of workers exposed to inorganic lead. Under the Work Health and Safety (WHS) Regulations, stringent measures are in place to ensure the safety and health of individuals engaged in lead risk work. Here, we outline the essential components of health monitoring for those involved in lead processes.

Collection of Demographic, Medical, and Occupational History

Before commencing work in an inorganic lead process, it’s crucial to gather comprehensive information regarding the worker’s medical history, including reproductive, neuropsychological, hematological, and renal aspects. Additionally, details about prior non-work-related lead exposure, medication history, and smoking habits are recorded.

Physical Examination

A thorough physical examination, focusing on various systems such as gastrointestinal, hematopoietic, renal, cardiovascular, reproductive, and neurological, may be necessary, especially when respiratory protective equipment is required.

Biological Monitoring

Biological monitoring involves regular assessments of blood lead levels, full blood examination, serum creatinine, routine urinalysis, and pulmonary function testing if exposure occurs via airborne lead fumes or dust.

Health Monitoring Before Starting Work in Inorganic Lead Process

Baseline health monitoring is mandatory before a worker starts lead risk work, with blood lead levels repeated one month after commencing the work. If lead risk work is identified after the worker starts, health monitoring must be initiated promptly, with subsequent blood lead level checks.

Health Counseling and Personal Hygiene Advice

Monitoring Exposure to Inorganic Lead

Regular blood lead level testing is scheduled based on specific criteria, with increased frequency if the nature or duration of lead exposure changes significantly.

Removal from Lead Risk Work

Workers exhibiting adverse symptoms or surpassing specified blood lead levels must be promptly removed from lead risk work until their levels decrease to safe thresholds. Pregnant or breastfeeding workers may have additional requirements for removal.

Return to Work and Final Medical Examination

Workers are permitted to return to lead risk work only after meeting established criteria and undergoing medical clearance. A final medical examination assesses any lingering health effects from lead exposure.

Potential Health Effects and Carcinogenicity

Inorganic lead exposure can lead to various health issues, including neurological, hematological, cardiovascular, and reproductive effects. Certain lead compounds are classified as carcinogens, necessitating careful handling and monitoring.

Protocol for Health Surveillance of Workers in Lead Risk Jobs

1. INTRODUCTION AND INITIAL MEDICAL ASSESSMENT PHASE OF NEW WORKERS IN LEAD RISK JOBS
Monitoring Frequency	Action Required	Blood Lead Results (all workers except females of reproductive capacity)			Blood Lead Results (females of reproductive capacity)
Within 1/12	New worker to receive basic information on health hazards of lead and specific training in safe work practices. Initial biological monitoring to be undertaken to determine baseline blood lead level. If baseline unexpectedly high, repeat. Initial medical examination to be performed and information given on health effects of lead specific to individual worker.	Baseline Baseline			Baseline Baseline
At 3/12	Second medical examination If blood lead results –> THEN arrange next biological monitoring and medical examination in 3/12 OTHERWISE arrange next biological and medical examination in 6/52	<1.4µmol/L	<30 µg/100mL		<0.5µmol/L	<10µg/100mL
At 6/12 Or 4 ½ / 12	Third medical examination Next biological monitoring according to blood lead results
This initial induction and assessment of new workers is undertaken over a period of approximately six months. After this period the frequency of routine biological monitoring and medical examination is determined by the blood lead results.
2. ROUTINE BIOLOGICAL MONITORING PHASE
Every 6/12		<1.4µmol/L		<30µg/100mL
Every 3/12		1.4-≥1.9 µmol/L		30-≥40 µg/100mL	<0.5µmol/L		<10µgmol/L
Every 6/52	Review lead process control measures	≥1.9µmol/L		≥40µg/100mL	≥0.5µmol/L		≥10µgmol/L
3. REMOVAL PHASE
	Remove from lead process	≥2.4µmol/L* *Confirmed		≥50µg/100mL* *Confirmed	≥1.0µmol/L* *Confirmed		≥20µg/100mL* *Confirmed
	If also pregnant or breast feeding and blood lead results –>				≥0.7µmol/L* *Confirmed		≥15µg/100mL* *Confirmed
As specified by authorised medical practitioner	Medical examination at which information given on health effects of lead specific to individual worker
4. RETURN PHASE
	Medical examination. If satisfactory, return worker to lead process and resume routine biological monitoring	>1.9µmol/L* *Confirmed		<40µg/100mL* *Confirmed	<0.5µmol/L* *Confirmed		<10µg/100mL* *Confirmed

Contact Us for Assistance

Our commitment to ensuring the health and safety of workers exposed to inorganic lead remains unwavering. Through rigorous health monitoring, counseling, and adherence to WHS regulations, we strive to mitigate the risks associated with lead exposure and safeguard the well-being of all individuals involved in lead processes.

For further information or assistance, please contact our Occupational Health team.

Sources

Association of Occupational and Environmental Clinics (AOEC) (2007) Medical Management Guidelines for Lead-Exposed Adults.
Australian Institute of Occupational Hygienists Position Paper (2009) Inorganic Lead and Occupational Health Issues.
Chemical analysis branch handbook, 9th Edition, Workplace and biological monitoring exposure analysis, WorkCover NSW
Cherrie, J.W., Semple, S., Christopher, Y., Saleem, A., Hughson, G.W. and Phillips, A. (2006) How Important is Inadvertent Ingestion of Hazardous Substances at Work?, Ann. Occ. Hyg. 50(7): 693-704.
Lauwerys, R.R. and Hoet, P. (2001) Industrial Chemical Exposure Guidelines for Biological Monitoring, 3rd Ed, Lewis Publishers, Boca Raton.
Lead Development Association International (LDAI), Voluntary Risk Assessment Report on Lead and Some Lead Compounds, Human Health Section, Interim Revised Draft, March 2008, prepared by the ILZRO and EBRC consulting under contract to the LDAI Lead Risk Assessment Working Group.
Lundströrom, N-G., Nordberg, G., Englyst, V., Gerhardsson, L., Hagmar, L., Jin, T., Rylander, L. and Wall, S. (1997) Cumulative Lead Exposure In Relation to Mortality and Lung Cancer Morbidity in a Cohort of Primary Smelter Workers. Scand. J. Work Environ. Health 23(1): 24-30.
Kosnett, M.J., Wedeen, R.P., Rothenberg, S.J., Hipkins, K.L., Materna, B.L., Schwartz, B.S., Hu, H. and Woolf, A. (2007) Recommendations for medical management of adult lead exposure. Environ. Health Perspectives 115(3): 463-471.
Safe Work Australia and ToxConsult. (2014) Review of Hazards and Health Effects of Inorganic Lead – Implications for WHS Regulatory Policy
Safe Work Australia (2013) Workplace Exposure Standards for Airborne Contaminants.
Safe Work Australia; Hazardous Chemicals Information System.
Sourced AOEC – http://www.aoec.org/principles.htm.
Skerfving, S. (2005) Criteria Document for Swedish Occupational Standards: Inorganic Lead – an update 1991–2004, The Swedish Group for Occupational Standards, Department of Occupational and Environmental Medicine, Lund, Sweden
Wooller, K.K. (2003) Occupational Medicine Handbook (Eleventh Edition), Information for
WorkCover Authority of NSW Authorised Medical Practitioners.

EMPLOYEES HEALTH