Targeting of workplace inspections for lead.

The prevention of occupational lead poisoning requires identification of worksites with ongoing excessive lead exposures. The utility of different sources of surveillance data in identifying worksites was evaluated by comparing a list of companies inspected by the Occupational Safety and Health Administration (OSHA) for lead with 1) Ohio Bureau of Workers' Compensation (BWC) claims for lead poisoning, and 2) the New York Health Department's Heavy Metal Registry (NYHMR) reports of individuals with elevated blood lead levels. For the period 1981 through 1985, the NYHMR identified 179 companies with at least one employee having an elevated blood lead level. Of the 134 OSHA inspections conducted in New York during the same time period, 23 (17%) companies were identified by the NYHMR. In Ohio from 1979 through 1985, 50 companies had workers' compensation claims filed against them involving documented elevated blood lead levels. OSHA inspected 306 companies; 23 (7.5%) were identified by the BWC. In both states, companies inspected by OSHA were concentrated in larger industries with traditional, well-recognized lead hazards (e.g., primary metal and fabricated metals). Companies identified by compensation claims and laboratory reports tended to be in industries dominated by smaller establishments where lead is not a primary part of the industrial process (e.g., automotive repair and construction). Sources of surveillance data, such as workers' compensation claims and laboratory reports, identify worksites that tend not to be routinely inspected by OSHA and which need intervention to prevent excessive lead exposure. To maximize the impact of public health resources devoted to the elimination of occupational lead poisoning, follow-up efforts at companies identified by state health departments and workers' compensation systems offer an important opportunity to complement OSHA's inspection efforts.