BACKGROUND: Chronic health effects from accumulated occupational exposures manifest as the workforce ages. The Health and Retirement Study (HRS), a panel survey of U.S. adults nearing/in retirement, allows assessment of associations among industry and occupation (I/O), workplace exposures, and incident chronic obstructive pulmonary disease (COPD). METHODS: The study population comprised respondents from the 1992 HRS cohort employed in 1972 or later and not diagnosed with COPD as of initial interview. We examined associations with incident COPD through 2016 and: (1) broad and selected detailed I/O, (2) workplace exposures, and (3) exposures within I/O. Given the cohort's baseline age (50-62), we calculated subhazard ratios (SHRs) for COPD accounting for competing risk of death. RESULTS: SHRs for COPD were significantly elevated for several industries: mining; blast furnaces, steelworks, rolling and finishing mills; groceries and related products; and automotive repair shops. Occupations with significantly elevated SHRs were maids and housemen; farmworkers; vehicle/mobile equipment mechanics and repair workers; material moving equipment operators; and nonconstruction laborers. Significantly elevated COPD SHRs were observed for specific I/O-exposure pairs: blast furnace/steelworks/rolling/finishing mills and asbestos; automotive repair shops and aerosol paints; farmworkers and pesticide exposures; and both material moving equipment operators and nonconstruction laborers exposed to dust and ash. CONCLUSIONS: Certain jobs and occupational exposures are associated with increased risk for developing COPD in late preretirement and during retirement. Given the disability and economic costs of COPD, these findings support focusing exposure prevention and medical monitoring resources on groups of workers at increased risk.

OBJECTIVE: The objective of the study is to examine associations between use of specific pesticides and lifetime allergic rhinitis and current asthma in US primary farm operators. METHODS: The 2011 Farm and Ranch Safety Survey data from 11,210 primary farm operators were analyzed. Pesticide use on the farm was determined using an affirmative response to the question of whether the operator ever mixed, loaded, or applied pesticides on their farm in the 12 months prior to the interview. Operators who answered "yes" were further asked about the specific trade name and formulation identifiers of the product they used and personal protective equipment (PPE) used. Data were weighted to produce national estimates. Adjusted prevalence odds ratios (PORs) were calculated using logistic regression. The referent group included operators who did not use any pesticides in the 12 months prior to the interview. RESULTS: Of an estimated 2.1 million farm operators, 40.0% used pesticides, 30.8% had lifetime allergic rhinitis, and 5.1% had current asthma. Insecticide and herbicide use were significantly associated with lifetime allergic rhinitis and current asthma. The use of 2,4-dichlorophenoxyacetic acid (POR = 1.5; 95% CI 1.2-1.9) and carbaryl (POR = 2.3; 1.4-3.7) was significantly associated with lifetime allergic rhinitis. Of operators using pesticides, 64.9% used PPE the last time they mixed, loaded, or applied pesticides. CONCLUSIONS: Pesticide use was associated with lifetime allergic rhinitis and current asthma among farm operators. Further studies are needed to clarify the dose-response relationship between pesticide use and adverse respiratory health effects.

Total release foggers (TRFs) (also known as "bug bombs") are pesticide products often used indoors to kill insects. After an earlier report found that TRFs pose a risk for acute illness (1), the Environmental Protection Agency required improved labels on TRFs manufactured after September 2012 (2). To examine the early impact of relabeling, the magnitude and characteristics of acute TRF-related illness were evaluated for the period 2007-2015. A total of 3,222 TRF-related illnesses were identified in 10 participating states, based on three data sources: Sentinel Event Notification System for Occupational Risk-Pesticides (SENSOR) programs, the California Department of Pesticide Regulation (CDPR) program, and poison control centers (PCCs) in Florida, Texas, and Washington. No statistically significant decline in the overall TRF-illness incidence rate was found. Failure to vacate treated premises during application was the most commonly reported cause of exposure. To reduce TRF-related illness, integrated pest management strategies (3) need to be adopted, as well as better communication about the hazards and proper uses of TRFs. Redesigning TRFs to prevent sudden, unexpected activation might also be useful.

CDC's National Institute for Occupational Safety and Health (NIOSH) and state health departments collect data on laboratory-reported adult blood lead levels (BLLs). This report presents data on elevated BLLs among employed adults (defined as persons aged ≥16 years) in the United States for 1994-2013. This report is a part of the Summary of Notifiable Noninfectious Conditions and Disease Outbreaks - United States, which encompasses various surveillance years but is being published in 2016. The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of the Morbidity Mortality Weekly Report (MMWR) as the annual Summary of Notifiable Infectious Diseases.

The National Institute for Occupational Safety and Health (NIOSH) and state health departments collect data on laboratory-reported adult blood lead levels (BLLs). This report presents data on elevated blood lead levels among employed adults in the United States for 1994–2012. This report is a part of the first-ever Summary of Notifiable Noninfectious Conditions and Disease Outbreaks, which encompasses various surveillance years but is being published in 2015 (1). The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases (2). | Background | Since 1987, the National Institute for Occupational Safety and Health (NIOSH) and state health departments have maintained a state–based surveillance program of laboratory-reported adult blood lead levels (BLLs) known as the Adult Blood Lead Epidemiology and Surveillance (ABLES) Program (3). The BLL is an often-used estimate of recent external exposure to lead (4,5). This report summarizes data on elevated blood lead levels among employed adults, defined as persons aged ≥16 years, during January 1, 1994–December 31, 2012. | Reported cases of elevated BLLs in 2012 are provided in tabular form (Tables 1–4). Information is provided by geographic division and reporting state, for "all cases" reported by a state (these include cases among adult residents in the reporting state plus cases identified by the reporting state but who reside in another state) and "state-residents" only, by exposure source, age, and sex groups, for BLLs ≥10 µg/dL (current definition of elevated BLL) (3,6), and for BLLs ≥25 µg/dL (former definition of elevated BLL)(7). The current case definition was adopted in 2009 on the basis of mounting evidence for adverse health outcomes among adults with BLLs between 10 µg/dL and 25 µg/dL (4,6). State prevalence rates of elevated BLLs (≥10 µg/dL) for 2012 are categorized into two groups (above or below the national rate) (Figure 1). Trends of national prevalence rates of BLLs ≥10 µg/dL and BLLs ≥25 µg/dL from 1994 to 2012 are provided (Figure 2). Prevalence rates are provided for "all cases" (these include cases among adult residents in the reporting state plus cases identified by the reporting state but who reside in another state) and "state-residents" when available. National and state numbers of cases, employed populations, and prevalence rates of elevated BLLs are provided in tabular form (Tables 5–10). Available data include BLLs ≥10 µg/dL from 2010 to 2012 and BLLs ≥25 µg/dL from 1994 to 2012. Prevalence rates and numerators are provided for "all cases" and "state residents" when available. The number of employed adults (state residents) used as denominators for calculating rates are provided in tabular form (Tables 11 and 12). | ABLES is the only program conducting nationwide adult lead exposure surveillance. It has provided the occupational safety and health community with essential information for setting research and intervention priorities. ABLES' impact is achieved through its longstanding strategic partnerships with State ABLES programs, federal agencies, and worker-affiliated organizations. For example, in 2008, the Occupational Safety and Health Administration (OSHA) updated its National Lead Emphasis Program to reduce occupational lead exposure by targeting unsafe conditions and high-hazard industries (8). To accomplish this objective, OSHA utilized ABLES data to identify industries with elevated BLL problems and has agreements with State ABLES programs to obtain their lead exposure data to target workplace inspections. | Although federal funding for State ABLES programs was discontinued in September 2013, a total of 34 states continue to collaborate with NIOSH (down from a peak of 41). These states self-fund their ABLES programs to sustain lead exposure surveillance and prevention activities. To assist with accomplishing these objectives, State ABLES programs share resources with two other CDC programs: the Healthy Homes and Childhood Lead Poisoning Prevention Program and Environmental Public Health Tracking. Since September 2013, NIOSH has continued to provide technical assistance to states with adult blood lead surveillance programs and maintains the ABLES website for reporting ongoing analyses of ABLES data. | The BLL is a direct index of a worker's recent exposure to lead as well as an indication of the potential for adverse effects from that exposure (4,5). The half-life of lead in blood is about 40 days in men (9), so the BLL is an estimate primarily of recent exposure to lead. Because lead accumulates in bone and BLL is in equilibrium with bone lead, the BLL might be elevated in some persons who have not had recent exposure to lead. Because this equilibrium can lead to persistent BLL elevations, the public health burden of elevated BLLs in adults is measured as prevalence. In contrast, the public health burden of elevated BLLs in children aged <5 years is measured as incidence because these young children have little lead storage in their bones at birth and thus their early childhood blood lead tests reflect recent exposures. | Over the past several decades in the United States, a marked reduction has occurred in environmental sources of lead and improved protection from occupational lead exposure. As a result, there is an overall decreasing trend in the prevalence of elevated BLLs among adults. Nonetheless, lead exposures continue to occur at unacceptable levels (3). In 2012, the prevalence rate of BLLs ≥10 µg/dL was 22.5 adults per 100,000 employed population. During 2011–2012, the mean BLL in adults in the United States was 1.09 µg/dL (10). | Research continues to find that low BLLs are associated with harmful effects in adults (11). In 2009, NIOSH and State ABLES programs led the occupational safety and health community to establish a new case definition for an elevated BLL (i.e., BLLs ≥10 µg/dL) (3). The Council of State and Territorial Epidemiologists also recommended that CDC use this case definition (12). In 2010, for the first time, CDC included elevated BLLs, defined as those ≥10 µg/dL, in the List of Nationally Notifiable Noninfectious Conditions (6). The U.S. Department of Health and Human Services' Healthy People 2020 initiative also uses the 10 µg/dL level for its Occupational Safety and Health Objective No. 7 (OSH-7), which is to reduce the proportion of persons who have elevated blood lead concentrations from work exposures (13). Before 2009, the case definition for an elevated BLL was ≥25 µg/dL.

Indoor firing ranges are a source of lead exposure and elevated blood lead levels (BLLs) among employees, their families, and customers, despite public health outreach efforts and comprehensive guidelines for controlling occupational lead exposure. There are approximately 16,000-18,000 indoor firing ranges in the United States, with tens of thousands of employees. Approximately 1 million law enforcement officers train on indoor ranges. To estimate how many adults had elevated BLLs (≥10 microg/dL) as a result of exposure to lead from shooting firearms, data on elevated BLLs from the Adult Blood Lead Epidemiology and Surveillance (ABLES) program managed by CDC's National Institute for Occupational Safety and Health (NIOSH) were examined by source of lead exposure. During 2002-2012, a total of 2,056 persons employed in the categories "police protection" and "other amusement and recreation industries (including firing ranges)" had elevated BLLs reported to ABLES; an additional 2,673 persons had non-work-related BLLs likely attributable to target shooting. To identify deficiencies at two indoor firing ranges linked to elevated BLLs, the Washington State Division of Occupational Safety and Health (WaDOSH) and NIOSH conducted investigations in 2012 and 2013, respectively. The WaDOSH investigation found a failure to conduct personal exposure and biologic monitoring for lead and also found dry sweeping of lead-containing dust. The NIOSH investigation found serious deficiencies in ventilation, housekeeping, and medical surveillance. Public health officials and clinicians should ask about occupations and hobbies that might involve lead when evaluating findings of elevated BLLs. Interventions for reducing lead exposure in firing ranges include using lead-free bullets, improving ventilation, and using wet mopping or high-efficiency particulate air (HEPA) vacuuming to clean.

BACKGROUND: Lead hazards continue to be encountered in the workplace. OSHA's Integrated Management Information System (IMIS) is the largest available database containing sampling results in US workplaces. METHODS: Personal airborne lead sampling results in IMIS were extracted for years 1979-2008. Descriptive analyses, geographical mapping, and regression modeling of results were performed. RESULTS: Seventy-nine percent of lead samples were in the manufacturing sector. Lead sample results were highest in the construction sector (median = 0.03 mg/m(3) ). NORA sector, year, OSHA region, number of employees at the worksite, federal/state OSHA plan, unionization, advance notification, and presence of an employee representative were statistically associated with having a lead sample result exceed the PEL. CONCLUSIONS: Lead concentrations within construction have been higher than any other industry. Lead hazards have been most prevalent in the north and northeastern US. IMIS data can be useful as a surveillance tool and for targeting prevention efforts toward hazardous industries. Am. J. Ind. Med. (c) 2011 Wiley-Liss, Inc.