Lead Paint Removal >> Lead Paint Removal Health Risks

The zinc protoporphyrin test, unlike the blood lead determination, measures an adverse metabolic effect of lead and as such is a better indicator of lead toxicity than the level of blood lead itself. The level of ZPP reflects lead absorption over the preceding 3 to 4 months, and therefore is a better indicator of lead body Lead Paint Removal Health Risks burden. 

The ZPP requires more time than the blood lead to reach significantly elevated levels; the return to normal after discontinuing lead exposure is also slower. Furthermore, the ZPP test is simpler, faster, and less expensive to perform and Lead Paint Removal Health Risks no contamination is possible. Many investigators believe it is the most reliable means of monitoring chronic lead absorption. 

Zinc protoporphyrin results from the inhibition of the enzyme ferrochelatase which catalyzes the insertion of an iron molecule into the protoporphyrin molecule, Lead Paint Removal Health Risks which then becomes heme. If iron is not inserted into the molecule then zinc, having a greater affinity for protoporphyrin, takes the place of the iron, forming ZPP. 

An elevation in the level of circulating ZPP may occur at blood lead levels as low as 20–30 µg/100 g in some workers. Once the blood lead level has reached 40 µg/100 g there is more marked rise in the ZPP value from its normal range of less than 100 µg/100 ml. Increases in blood lead levels beyond 40 µg/100 g are associated with Lead Paint Removal Health Risks exponential increases in ZPP. 

Whereas blood lead levels fluctuate over short time spans, ZPP levels remain relatively stable. ZPP is measured directly in red blood cells and is present for the cell's entire 120-day life span. Therefore, the ZPP level in blood reflects the average ZPP production over the previous 3 to 4 months and Lead Paint Removal Health Risks consequently the average lead exposure during that time interval. 

It is recommended that a hematocrit be determined whenever a confirmed ZPP of 50 µg/100 ml whole blood is obtained to rule out a significant underlying anemia. If the ZPP is in excess of 100 µg/100 ml and not associated with abnormal elevations in blood lead levels, Lead Paint Removal Health Risks the laboratory should be checked to be sure that blood leads were determined using atomic absorption spectrophotometry.

Anodic stripping voltammetry or Lead Paint Removal Health Risks other method meeting the accuracy requirements set forth by the standard and by a CDC-approved laboratory which is experienced in lead level determinations. Repeat periodic blood lead studies should be obtained in all individuals with elevated ZPP levels to be certain that an associated elevated blood lead level has not been missed due to transient fluctuations in blood leads. 

ZPP has a characteristic fluorescence spectrum with a peak at 594 nm which is detectable with a hematofluorimeter. The hematofluorimeter is accurate and portable and can provide on-site, instantaneous results for workers who can be frequently tested via a finger prick. However, careful attention must be given to calibration and Lead Paint Removal Health Risks quality control procedures. 

Limited data on blood–lead ZPP correlations and Lead Paint Removal Health Risks the ZPP levels which are associated with the adverse health effects discussed in Section II are the major limitations of the test. Also it is difficult to correlate ZPP levels with environmental exposure and there is some variation of response with age and sex. 

Nevertheless, the ZPP promises to be an important diagnostic test for the early detection of lead toxicity and Lead Paint Removal Health Risks its value will increase as more data are collected regarding its relationship to other manifestations of lead poisoning. Levels of delta-aminolevulinic acid (ALA) in the urine are also used as a measure of lead exposure. 

Increasing concentrations of ALA are believed to result from the inhibition of the enzyme deltaaminolevulinic acid dehydrase (ALA-D). Although the test is relatively easy to perform, inexpensive, and rapid, the disadvantages include variability in results, Lead Paint Removal Health Risks the necessity to collect a complete 24-hour urine sample which has a specific gravity greater than 1.010, and also the fact that ALA decomposes in the presence of light. 

The pattern of porphyrin excretion in the urine can also be helpful in identifying lead intoxication. With lead poisoning, the urine concentrations of coproporphyrins I and II, porphobilinogen and uroporphyrin I rise. The most important increase, however, Lead Paint Removal Health Risks is that of coproporphyrin III; levels may exceed 5,000 µg/l in the urine in lead poisoned individuals, but its correlation with blood lead levels and ZPP are not as good as those of ALA. 

Increases in urinary prophyrins are not diagnostic of lead toxicity and may be seen in porphyria, some liver diseases, and in patients with high reticulocyte counts. Summary. The standard for inorganic lead places significant emphasis on the medical surveillance of all Lead Paint Removal Health Risks workers exposed to levels of inorganic lead above the action level of 30 µg/m3 TWA. 

The physician has a fundamental role in this surveillance program, and in the operation of the medical removal protection program. Even with adequate worker education on the adverse health effects of lead and appropriate training in work practices, personal hygiene and Lead Paint Removal Health Risks other control measures, the physician has a primary responsibility for evaluating potential lead toxicity in the worker. 

It is only through a careful and detailed medical and work history, a complete physical examination and Lead Paint Removal Health Risks appropriate laboratory testing that an accurate assessment can be made. Many of the adverse health effects of lead toxicity are either irreversible or only partially reversible and therefore early detection of disease is very important. 

This document outlines the medical monitoring program as defined by the occupational safety and Lead Paint Removal Health Risks health standard for inorganic lead. It reviews the adverse health effects of lead poisoning and describes the important elements of the history and physical examinations as they relate to these adverse effects. Additional exposure assessments. 

Whenever there has been a change of equipment, process, control, personnel or a new task has been initiated that may result in additional employees being exposed to lead at or Lead Paint Removal Health Risks above the action level or may resultin employees already exposed at or above the action level being exposed above the PEL, the employer shall conduct additional monitoring in accordance with this subsection. 

(8) Employee notification. (A) Within 5 working days after completion of the exposure assessment the employer shall notify each Lead Paint Removal Health Risks employee in writing of the results which represent that employee's exposure.

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