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Occupational & Environmental Epidemiology

Adult Blood Lead

Begun in 1987, the national Adult Blood Lead Epidemiology and Surveillance (ABLES) Program is a state-based surveillance system created to identify and prevent cases of elevated blood lead levels in adults. Children's blood lead levels are tracked and addressed separately through the N.C. Division of Public Health's Environmental Health Section Childhood Lead Poisoning Prevention Program. Learn more about the health effects of lead exposure.

The national ABLES External link program of the Centers for Disease Control and Prevention / National Institute of Occupational Safety and Health (NIOSH) provides funding and technical assistance to participating states, including North Carolina. The states are required to provide data transmissions biannually to NIOSH for the national database.

States participating in ABLES must require laboratories to report blood lead level results to the state health department or its designee. State ABLES programs collect both occupational and non-occupational blood lead level data from both private and state reporting laboratories, local health departments, and private health care providers. Most of the reports are occupational.

To prevent over-exposure to lead, ABLES programs:

  • Track adult blood lead levels to find out who is exposed to lead;
  • Conduct follow-up interviews with workers, employers, and physicians to learn more about exposure circumstances and provide guidance on exposure prevention;
  • Perform work-site evaluations;
  • Provide technical assistance to employers and others;
  • Make referrals to regulatory agencies for consultation or enforcement; and
  • Develop educational materials and outreach programs.

Set by Healthy People 2020, the public health goal for reducing elevated blood lead levels is to reduce the proportion of persons aged 16 years and older who have elevated blood lead concentrations (10 µg/dL or greater) from work exposure.

North Carolina's ABLES Program

The North Carolina Adult Blood Lead Epidemiology and Surveillance program was established in 1994. The mandatory reporting requirement in North Carolina requires laboratories to report any blood lead level (BLL) 40 µg/dL and above for individuals 18 years and older. Physicians are exempt if laboratories report for them. In an effort to meet public health goals, North Carolina has elected to try to collect data on ALL blood lead levels for individuals 16 years old and older. N.C. Department of Labor assists the N.C. Division of Public Health by providing consultation and enforcement services. Childhood lead poisoning is separately tracked by the Children's Environmental Health Branch of the Environmental Health Section, N.C. Division of Public Health.

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