The Lead-exposed Worker

The lead standard established by the federal Occupational Safety and Health Administration in 1978 requires physicians and employers to follow very specific guidelines when treating lead-exposed workers. For example, if a worker's blood lead level is 2.90 mumol/L of whole blood or greater, the worker must be removed from work, with full pay and retention of seniority, until the blood level falls below 1.95 mumol/L. Physicians play a key role in the implementation of the lead standard; the standard specifies frequency of blood lead measurements, frequency and extent of medical monitoring, and medical removal from work. This article reviews the lead standard as it applies to physicians and makes recommendations about managing the worker with lead poisoning.