LEAD HEALTH SURVEILLANCE

Lead is a well known poison. Health surveillance organised by the employer is required by law where there is a risk of significant lead exposure. As a general rule, lead health surveillance is advisable:

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• If workers are required to wear respiratory personal protective equipment (PPE) to control lead exposure

• If workers are at risk of returning blood lead levels of 5 ug/dL or higher due to an occupational source

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Ability OPN's occupational physicians are AMPs (appointed medical practitioners). We offer:

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• Assessment on whether health surveillance is required

• Lead health surveillance including biological monitoring and medical examinations

• On-site medical examinations

• Facilitating electronic linkage of results with your preferred pathology provider

• Online submission of Worksafe health surveillance forms during biological monitoring

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Code of practice

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National code of practice for the control and safe use inorganic lead at work NOHSC: 2015 (1994)

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The code of practice outlines the employers' duties in providing a safe lead workplace with a focus on risk assessment, induction and training, control measures, PPE and health surveillance. 

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Information for workers

This Worksafe bulletin provides effective understandable information including a FAQ. Also see Common Questions about Lead.

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Download the Worksafe Prevention of Lead Poisoning information bulletin

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Health surveillance guidelines for Appointed Medical Practitioners contains a useful summary of the health effects of lead and the rationale behind health surveillance.

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Health effects of lead

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Lead enters the body through breathing it in (lead dust and fume) and ingestion (typically through hands contaminated with lead touching food, the mouth and cigarettes).

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Once lead is absorbed, it is stored in blood and body tissues, particularly bone where it is only very slowly removed from the body. Lead can damage various body organs and in many cases the damage is irreversible or only partially reversible. 

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Therefore, it is very important to minimise any lead absorption in the first place through good workplace controls and safe work practices. 

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Lead exerts toxicity on the nervous system, cardiovascular system, gastrointestinal system, kidneys and blood making organs. 

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Problems associated with lead include:

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• Peripheral nerve damage - weak wrist or foot extension (levels over 80 ug/dL)

• Raised blood pressure (levels above 10 ug/dL)

• Anaemia (levels over 50 ug/dL)

• Increased cancer risk - lung, stomach and bladder cancer

• Kidney damage (levels over 50 ug/dL)

• Reproductive problems - infertility, miscarriage, stillbirths

• Effects on the developing brain of the fetus and children leading to behavioural problems and reduction in IQ

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Symptoms associated with higher lead levels (more than 40-60 ug/dL) include:

• Fatigue

• Feeling generally unwell

• Headaches

• Memory problems

• Generalised aches & pains

• Loss of appetite, abdominal pain, diarrhoea, constipation

• Depression

• Sexual dysfunction

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At lower levels, symptoms are often absent but if present are typically minor and non-specific:

• Not feeling right

• Low in energy

• Mood changes

• Irritability

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The developing fetus and children are particularly sensitive to the effects of lead. 

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Acute symptomatic lead poisoning (abdominal pain, weakness, constipation) very rarely occurs when blood lead levels are kept below 80 ug/dL. 

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As more scientific evidence has accumulated about the health effects of lead, the regulatory blood lead level threshold for removal from lead work for males has progressively lowered from 80ug/dL to the current 30 ug/dL. The reasoning behind the lower thresholds is to protect against 'subclinical' health effects ie. adverse health effects which may not have obvious symptoms.