Lead-Safe Weatherization for Crews and Managers
Health Effects of Lead
WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – September 2012
1 | WEATHERIZATION
ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Learning Objectives
HEALTH EFFECTS OF LEAD
• Describe lead poisoning and understand how much lead is
dangerous to the body.
• Explain methods through which lead can enter the body.
• List the different effects of lead on children and adults.
• Describe how blood lead levels are measured.
• Summarize OSHA worker protection standards related to
lead.
2 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Possible Sources of Lead
HEALTH EFFECTS OF LEAD
Photo courtesy of the Centers for Disease Control
•
•
•
•
•
•
•
Imported pottery
Water pipes
Mini-blinds
Painted toys
Painted furniture
Craft products
Others
Image courtesy of Mike Vogel
Photo courtesy of CPSC
Photo courtesy of the
Cincinnati Children's Hospital
Image courtesy of Mike Vogel
Photo courtesy of the Centers for Disease Control
3 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
What is Lead Poisoning?
HEALTH EFFECTS OF LEAD
• Lead poisoning refers to the health effects associated with an
abnormally high level of lead in the blood stream.
• Symptoms of lead poisoning may develop quickly but are often not
recognized until severe damage is done.
• These symptoms of lead poisoning are often mistaken for the flu.
• In cases of chronic lead poisoning, the symptoms may come and
go for months.
• A child can seem healthy because the symptoms do not develop
until the condition is serious and significant irreversible damage is
already done.
Photo courtesy of the U.S. EPA
4 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
How Long Can Lead Remain in
the Body?
HEALTH EFFECTS OF LEAD
• Once lead gets into the body, it stays in the blood for
several weeks and can be stored in the bones for 30
years or more.
• The more lead a person is exposed to, the greater
the chance for lead poisoning.
• Many small doses of lead over a long period of time
can cause lead poisoning.
• One large dose of lead in less than a day can cause
lead poisoning.
5 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
How is Lead in the Body
Measured?
HEALTH EFFECTS OF LEAD
• Blood tests are the only way to measure lead
exposure.
• The amount of lead in the body is the Blood
Lead Level (BLL).
• BLL is measured in micrograms (µg) of lead
per deciliter (dL) of blood.
– A microgram is equal to one single grain of
sugar cut into 1,000 pieces.
– A deciliter, a volume measure, is equal to a
little less than half a cup. A person weighing
165 pounds has about 60dL of blood.
Photos courtesy of Mike Vogel
6 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
How Much Lead is Dangerous?
HEALTH EFFECTS OF LEAD
How much lead is dangerous?
•According to the Centers for Disease Control and Prevention
(CDC) 5 µg/dL is the “blood lead level of concern”.
•The Occupational Safety and Health Administration (OSHA)
requires the medical removal of workers whose blood lead
level reaches 50μg/dl or greater.
•The typical level for U.S. adults is less than 10 µg/dL
(mean = 3 µg/dL).
7 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Adult Reactions to Lead
HEALTH EFFECTS OF LEAD
Blood Level Reactions to Lead
10 µg/dL
25 µg/dL
Increased blood pressure, harmful effects on a fetus, and
joint and muscle aches.
Reproductive problems.
40 µg/dL
Kidney damage and damage to blood formation.
60 µg/dL
Anemia, nerve damage, constipation, stomach pain,
irritability, fatigue, memory and concentration problems,
clumsiness, drowsiness, and sleep problems.
>80 µg/dL
Blue line on gums, uncontrollable shaking of hands, wrist
and foot drop, hallucinations, brain damage, coma, and
death (STDR 1989).
8 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Child Reactions to Lead
HEALTH EFFECTS OF LEAD
Blood Level Reactions to Lead
10 µg/dL
CDC - 5 µg/dL is the “blood lead level of concern”.
Loss in IQ, hearing problems, and growth problems.
20 µg/dL
Hyperactivity, poor attention span, difficulty learning,
language and speech problems, and slower reflexes.
40 µg/dL
Poor bone and muscle development, clumsiness, lack of
coordination, early anemia, tiredness, and drowsiness.
>50 µg/dL
Stomach aches and cramps, anemia, and brain damage.
150 µg/dL
Swelling of the brain, seizures, coma, death.
9 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
How Does Lead Get into the
Body?
HEALTH EFFECTS OF LEAD
• The chemical properties of lead are similar to the
properties of calcium, a necessary nutrient, and are
therefore readily absorbed by the human body.
• Those who lack calcium and iron in their diets absorb more
lead.
• Children and pregnant women absorb up to 50% of the
lead they ingest or inhale.
• The rest of the population absorbs 10-15% of ingested or
inhaled lead.
10 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Lead Enters the Body in Two
Ways:
HEALTH EFFECTS OF LEAD
• Inhalation (breathed in): Tiny lead particles in dust or
fume form can be breathed into the lungs and absorbed
into the blood stream.
• Ingestion (swallowed): Lead can be swallowed if it is
airborne or if it is on food, fingers, cigarettes, toys, or
anything that is placed in the mouth. Lead that is inhaled
but does not reach the lungs, can be trapped in the upper
respiratory tract and is eventually swallowed.
11 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Lead and Children
HEALTH EFFECTS OF LEAD
• Lead is the foremost environmental health threat to children.
Since children have a much smaller body mass, similar
exposures between a child and an adult, yield a much higher
dose in the child.
• Almost one million children have enough lead in their blood to
reduce intelligence and attention span.
• Minority and low-income children are at a greater risk for lead
poisoning than other population groups.
– They generally live in older housing units.
– They often have poor diets.
– To keep from worsening the situation, Weatherization
Programs serving this population must implement lead-safe
Weatherization LSW practices in all homes built before 1978.
12 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
How Does Lead Affect the
Body? The Heart and Blood
HEALTH EFFECTS OF LEAD
• Lead kills red blood cells through oxygen depravation.
• It reduces the ability to generate new red blood cells
resulting in anemia.
• Lead may cause high blood pressure which increases the
risk of heart attack, stroke, and kidney disease.
13 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
The Skeletal System
HEALTH EFFECTS OF LEAD
• Lead is deposited in bone tissue where it blocks the
production of new blood cells and competes with calcium.
• Bones and teeth store 95% of the lead in the body. If lead
is in the bones instead of calcium, it can be re-released
into the blood when the body needs calcium as often
occurs when the body is stressed.
• Once the lead returns to the blood, it once again causes
damage.
• Lead that stays in the body is called body burden.
14 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
The Male Reproductive System
HEALTH EFFECTS OF LEAD
• Lead poisoning causes decreased sex drive, erectile
dysfunction, infertility, and damaged sperm.
• Partners of lead-poisoned workers have more
miscarriages, premature births, and their children are
more likely to have more birth defects.
15 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
The Female Reproductive
System
HEALTH EFFECTS OF LEAD
• Lead poisoning causes decreased sex drive, abnormal
menstrual cycles, infertility, miscarriages, and premature
births.
• During pregnancy, the body absorbs up to 50% of
inhaled or ingested lead. Lead stored in the skeletal
system can be re-released.
• Lead damages fetuses causing low birth weight, birth
defects, learning problems, and behavioral problems.
16 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
The Nervous System
HEALTH EFFECTS OF LEAD
• Damage to the brain, spinal cord, and nerves can be
permanent.
• Lead poisoning can cause brain damage.
• At very high doses, lead can cause hallucinations,
swelling of the brain, coma, and death.
• Lead damage to nerves usually starts at the hands and
feet which may shake or, in severe cases, may become
paralyzed.
• The nervous system of a fetus, infant, or child is
affected by even smaller amounts of lead.
17 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
The Kidneys
HEALTH EFFECTS OF LEAD
• Kidneys help to filter out lead from the blood system.
• Lead damages the kidneys as the filtration process
occurs.
• Damage is not usually discovered until significant
function has been lost.
• Lead poisoning can cause kidney failure and result in
death.
18 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Symptoms of Lead Poisoning
HEALTH EFFECTS OF LEAD
19 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Worker Protection - OSHA
HEALTH EFFECTS OF LEAD
• Even if DOE and EPA did not have rules dealing with
lead exposure to workers, implementing Lead-Safe
Weatherization, the Occupational Safety and Health
Administration (OSHA) is an agency of the Department of
Labor which writes and enforces rules protecting workers
on the job.
• To protect employees from lead hazards, the OSHA Lead
in Construction Standard (29 CFR 1926.62) was
developed. The standard became law on June 3, 1993.
20 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Action Level
HEALTH EFFECTS OF LEAD
OSHA Lead in Construction Standard (29
CFR 1926.62) set two legal limits for the
amount of lead workers are allowed to
breathe.
•Action Level:
–The Action Level for lead is 30 micrograms
per cubic meter (μg/m3). The Action Level is
like a yield sign. It means caution!
If average 8-hr exposure is over 30 µg/m³ the employer must train the
workers on the hazards of working with lead and provide special medical
exams called medical surveillance.
21 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Permissible Exposure Level
HEALTH EFFECTS OF LEAD
Permissible Exposure Level:
•The permissible Exposure Limit (PEL) for lead is
50 μg/m³.
– The PEL is like a stop sign, it means go no
higher!
– The employer is not allowed to let workers
inhale lead in concentrations of more than 50
μg/m³ of air without proper protection.
– If the workers are in an area with more lead in
the air than the PEL, the employer must reduce
the exposure. The PEL is the highest average
amount of lead exposure allowed for workers.
22 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
OSHA Required Protection and
Responsibility
HEALTH EFFECTS OF LEAD
To protect workers from exposure to airborne levels of
lead above the PEL, the employer must implement
strategies to reduce the exposure. Such strategies
include:
• Training on lead hazards.
• Work practice and engineering controls (containment, HEPA
vacuum, shrouded tools).
• Protective clothing.
• Protective equipment.
• Respirators.
• Medical surveillance.
23 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Summary – What is Lead
Poisoning
HEALTH EFFECTS OF LEAD
• Health effects associated with an abnormally high
level of lead in the blood.
• The signs and symptoms are much like those of a
cold or the flu.
• Sometimes there are no symptoms until the damage
is significant.
• Sometimes the symptoms come and go.
24 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Summary – How Does Lead Get
into the Body?
HEALTH EFFECTS OF LEAD
• Lead dust particles or fumes can be inhaled.
• Children are at a higher risk because they have
more frequent hand-to-mouth contact.
• The major source of exposure for children is lead
dust.
• Children and pregnant women absorb up to 50% of
the lead they ingest of inhale.
• Non pregnant adults typically absorb about 10-15%
of the lead ingested or inhaled.
25 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Summary – How Does Lead
Harm the Body?
HEALTH EFFECTS OF LEAD
• Lead can cause permanent damage, even in small doses.
• Children’s developing brains and bodies are easily
damaged by lead.
• Lead affects EVERY major organ in the body system.
• Lead can stay in the blood stream for several months and in
the bones for more than 30 years.
• Lead can be released from the bones during times of stress.
• Lead can cause still births and miscarriages.
• Lead can cause behavioral, developmental, and learning
problems in children.
26 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov
Summary – How Much Lead…?
HEALTH EFFECTS OF LEAD
How is lead measured in the body?
•Blood tests determine how much lead is in the blood.
•Results of blood tests are called “Blood Lead Levels (BLLs).”
•Blood Lead Levels are reported in μg/dL (micrograms of lead
per deciliter of blood).
How much lead in the blood is dangerous?
•The CDC’s reference lead level for children is 5 μg/dL.
•At 50 μg/dL, OSHA requires that a worker be removed from a
lead-related task until Blood Lead Levels are reduced.
•Even relatively low lead levels in blood can cause serious health
problems.
27 | WEATHERIZATION ASSISTANCE PROGRAM STANDARDIZED CURRICULUM – December 2012
eere.energy.gov