Seligman P J, Halperin W E
Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH 45226.
Am J Ind Med. 1991;20(3):381-90. doi: 10.1002/ajim.4700200310.
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.
预防职业性铅中毒需要识别存在持续过度铅暴露的工作场所。通过将职业安全与健康管理局（OSHA）检查过的铅相关公司名单与以下两项进行比较，评估了不同监测数据来源在识别工作场所方面的效用：1）俄亥俄州工人赔偿局（BWC）的铅中毒索赔记录；2）纽约州卫生部重金属登记处（NYHMR）关于血铅水平升高个体的报告。在1981年至1985年期间，NYHMR识别出179家公司，这些公司中至少有一名员工血铅水平升高。在同一时期纽约进行的134次OSHA检查中，NYHMR识别出了23家（17%）公司。在俄亥俄州，1979年至1985年期间，有50家公司面临涉及血铅水平记录升高的工人赔偿索赔。OSHA检查了306家公司；BWC识别出了23家（7.5%）。在这两个州，接受OSHA检查的公司都集中在存在传统且公认的铅危害的较大行业（如原生金属和金属制品业）。通过赔偿索赔和实验室报告识别出的公司往往处于以小型企业为主的行业，在这些行业中铅并非工业生产过程的主要部分（如汽车修理和建筑业）。监测数据来源，如工人赔偿索赔和实验室报告，能够识别出那些往往未被OSHA常规检查且需要采取干预措施以防止过度铅暴露的工作场所。为了最大限度地发挥用于消除职业性铅中毒的公共卫生资源的影响，对由州卫生部门和工人赔偿系统识别出的公司进行后续跟进，为补充OSHA的检查工作提供了一个重要机会。
