Levin S M, Goldberg M, Doucette J T
Department of Community Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA.
Am J Ind Med. 1997 Mar;31(3):303-9. doi: 10.1002/(sici)1097-0274(199703)31:3<303::aid-ajim6>3.0.co;2-y.
Over 50,000 workers are at risk of occupational exposure to lead in the course of renovating the nation's deteriorating infrastructure. In mid-1993, to control exposure to lead in the construction setting OSHA promulgated a Lead in Construction Standard. In this study, we assessed the effect of the mandated changes in exposure conditions which followed the introduction of this new standard. We analyzed changes in baseline and maximum blood lead concentrations and in maximum increments in blood lead levels before and after introduction of the standard among iron workers employed in the renovation of a large, lead-painted, steel bridge in New York City. Results indicated that baseline and maximum blood lead levels fell significantly after the implementation of the provisions of the standard, as did maximum increments in blood lead concentrations. Seventy-six percent of the workers maintained blood lead concentrations below 20 micrograms/dl after the OSHA standard, as compared with 66% prior to its implementation. Increments of 20 micrograms/dl or more occurred considerably more frequently before introduction of the standard (13% before vs. 4% after; p = 0.01). Evidence of decreased exposure to lead was observed among iron workers who were present both before and after the introduction of the OSHA standard, as well as among iron workers newly hired after the OSHA provisions were put in place. These findings document the effectiveness of the OSHA construction lead standard in controlling exposure to lead in this complex and variable environment. The data indicate the utility of blood lead determinations in assessing the outcome of industrial hygiene interventions to reduce exposures to lead in the construction setting.
在翻新美国日益破败的基础设施过程中,超过5万名工人面临职业性铅暴露风险。1993年年中,为控制建筑环境中的铅暴露,职业安全与健康管理局(OSHA)颁布了《建筑铅标准》。在本研究中,我们评估了引入这一新标准后强制改变暴露条件所产生的效果。我们分析了纽约市一座大型铅漆钢桥翻新工程中,钢铁工人在标准引入前后的基线血铅浓度、最高血铅浓度以及血铅水平的最大增幅变化。结果表明,在实施该标准规定后,基线血铅水平和最高血铅水平均显著下降,血铅浓度的最大增幅也同样下降。职业安全与健康管理局标准实施后,76%的工人血铅浓度维持在20微克/分升以下,而在该标准实施前这一比例为66%。在标准引入前,血铅水平增加20微克/分升或更多的情况更为频繁(之前为13%,之后为4%;p = 0.01)。在职业安全与健康管理局标准引入前后都在岗的钢铁工人以及在该标准实施后新雇佣的钢铁工人中,均观察到铅暴露减少的证据。这些发现证明了职业安全与健康管理局建筑铅标准在这种复杂多变环境中控制铅暴露的有效性。数据表明血铅测定在评估建筑环境中减少铅暴露的工业卫生干预效果方面的作用。