Adult Blood Lead Epidemiology and Surveillance (ABLES)
The Iowa Adult Blood Lead Epidemiology and Surveillance (ABLES) is a program in the Iowa Department of Public Health Acute Disease Prevention, Emergency Response, and Environmental Health Division that helps employers, workers, medical providers, and families learn about the risks of Iowa adult lead exposure in the workplace, community, or at home. ABLES is part of the Iowa Occupational Health & Safety Surveillance Program (OHSSP).
Iowa Department of Public Health ABLES
The IDPH ABLES Program collects all blood lead test results for Iowa adults 16 years of age or older as required by Iowa Administrative Code 641: Chapter 1. This information is used to report:
- The number of Iowa adults with lead exposure
- How Iowa adults get exposed
- Progress on objectives stated in Healthy Iowans: Iowans Health Improvement Plan 2017-2021
The program also helps clinical laboratories and medical providers comply with adult blood lead reporting requirements .
Finally, the program provides resources:
- For doctors, nurses, and other medical providers who care for lead-exposed adults
- For Iowans to help them avoid lead exposure on or off the job
- For workers to prevent “take-home lead” that can expose families
- For employers and workers to improve work-site lead safety practices, especially for low-level chronic exposures
Contact the ABLES program 8:30- 4:30 Monday - Friday at 800-972-2026 and ask for Kathy
Did You Know?
Data from 2012 to 2016 shows that an average of 2,907 Iowa adults were tested for lead each year.
- The blood lead levels (BLLs) ranged from <1 to 97 micrograms per deciliter (mcg/dL).
- An average of 767 Iowa adults had BLLs of 10 mcg/dL or higher.
- An average of 1,117 Iowa adults had BLLs of 5 mcg/dL or higher.
- The number of Iowa adults with BLLs of 40 mcg/dL or higher decreased from 21 in 2012 to 6 in 2016.
Iowa workers have significantly higher rates of lead exposure when compared to all U.S. workers.
- In 2014 the national prevalence rate of reported cases of elevated blood lead levels of 10 mcg/dL or higher in the U.S. was 19.1 cases/100,000 employed adults, while it was 46.1 cases/100,000 employed adults in Iowa.
- The U.S. prevalence rate at 25 mcg/dL or higher was 4.5 cases, but 9.0 cases/100,000 employed workers in Iowa.
In late 2015, the National Institute for Occupational Safety and Health (NIOSH) adopted a new reference level for adult blood lead tests. A venous BLL of 5 mcg/dL or higher is currently considered to be elevated for adults for public health purposes. The Iowa ABLES program also adopted the new reference level and has updated materials to reflect the change.
Iowa Data and Additional Information
FDA Issues Warning on Magellan LeadCare Analyzers
The U.S. Food and Drug Administration (FDA) has issued a safety communication warning about the use of Magellan Diagnostics’ LeadCare® analyzers (LeadCare, LeadCare II, LeadCare Ultra and LeadCare Plus) with venous blood samples because they might result in falsely low test results. The FDA is now advising that Magellan Diagnostics’ LeadCare® analyzers should no longer be used with venous blood samples. The safety alert does not currently apply to capillary blood lead test results collected by fingerstick or heelstick. The purpose of the Health Advisory is to notify state and local health departments, healthcare providers, and laboratories about CDC’s testing guidance in light of the safety alert.
Venous specimens are recommended for adult blood lead testing, especially for any adults being monitored for lead exposure in the workplace or from a known hobby involving lead products. Elevated capillary tests are not considered confirmatory tests and need to be retested using venous specimens. Laboratories and health care professionals using LeadCare instruments need to find alternative methodologies for venous testing, such as mass spectrometry or atomic absorption methods due to the current FDA warning to discontinue use of Magellan’s LeadCare testing systems for venous blood samples. These other technologies are not usually available as point-of-care tests in clinics, and may only be available from larger-capacity or reference laboratories, including the State Hygienic Laboratory at the University of Iowa. Contact IDPH OHSSP ABLES with questions at 800-972-2026 - ask for Kathy.
Kathy Leinenkugel, MPA, REHS, MT
ABLES program manager
Phone: 515-281-4930 or 800-972-2026