The epidemiology and surveillance of blood lead in Taiwan (R.O.C.): A report on the PRESS-BLL project

Abstract

To monitor the lead hazards in industries and to investigate the prevalence of elevated blood lead levels (BLLs) in lead-exposed workers, a lead surveillance system (PRESS-BLLs) has been established and operated in Taiwan, Republic of China, since July 1993. A cohort of lead-exposed workers who received a periodic annual health examination at 55 accredited hospital laboratories was constructed. A total of 9807 separate BLL measurements were reported to the system in 1994. The mean BLL was 15.8 micrograms/dl in male workers and 11.6 micrograms/dl in female workers. The mean BLL of lead-exposed workers was significantly (P < 0.05, z-test) higher than that of the general Taiwanese population (8.6 micrograms/dl for males and 6.7 micrograms/dl for females). In addition, the BLLs of 983 (10.0%) workers exceeded the regulatory action level (40 micrograms/dl for males; 30 micrograms/dl for females). The workplaces and homes of 57% of the workers with elevated BLLs were thoroughly investigated to determine the sources of lead contamination. These actions identified the causes of elevated BLLs and set up strategies to reduce workers' lead exposure. The establishment of this occupational lead surveillance system represents a method for monitoring of lead hazards from occupational and environmental settings to prevent lead poisoning. The information acquired from the system can help in the setting up of a priority of prevention and the development of control measures. It is also useful for further monitoring of changes in the BLLs of the lead-exposed cohort. The Health Department of Taiwan can use this information to evaluate the effectiveness of current industrial hygiene practice. Subjects with elevated BLLs have been medically treated and placed on long-term follow-up for sequelae.

Effects of environmental lead exposure on T-helper cell-specific cytokines in children

“…The mean blood lead level in the general Taiwanese population is 8.6 µg/dl in males and 6.7 µg/dl in females (Wu et al, 1997). A subsequent report showed that the mean blood lead level in children in Kao-Hsiung City was 5.50 µg/dl (Wang et al, 2002).…”

Parental exposure to lead and small for gestational age births

“…Workers exposed to lead were identified from the occupational blood-lead notification system, the Program to Reduce Exposure by Surveillance System-Blood Lead Levels (Press-BLLS) [Wu et al, 1997]. The surveillance system overseen by the Center for Disease Control, a division of the Department of Health, was primarily designed for regular monitoring of workers exposed to lead and who, by law, should be examined annually.…”

“…The examination of PbBs was performed in the 55 accredited hospital laboratories routinely evaluated by the Department of Health. The interlaboratory coefficient of variation was about 15% for PbBs <20 mg/dl and about 10% for PbBs !20 mg/dl [Liou et al, 1995;Wu et al, 1997].…”