Lead Paint Removal >> Lead Paint Removal Programs

Employers must instruct each physician not to reveal to the employer in writing or in any other way his or her findings, laboratory results, or diagnoses which are felt to be unrelated to occupational lead exposure. They must also instruct each physician to advise the employee of any occupationally or non-occupationally related medical condition requiring further treatment or Lead Paint Removal Programs evaluation. 

The standard provides for the use of respirators where engineering and other primary controls have not been fully implemented. However, Lead Paint Removal Programs the use of respirator protection shall not be used in lieu of temporary medical removal due to elevated blood lead levels or findings that an employee is at risk of material health impairment. 

This is based on the numerous inadequacies of respirators including skin rash where the facepiece makes contact with the skin, unacceptable stress to breathing in some workers with underlying cardiopulmonary impairment, difficulty in providing adequate fit, Lead Paint Removal Programs the tendency for respirators to create additional hazards by interfering with vision, hearing, and mobility, and the difficulties of assuring the maximum effectiveness of a complicated work practice program involving respirators. 

Respirators do, however, serve a useful function where engineering and work practice controls are inadequate by providing supplementary, interim, or short-term protection, provided they are properly selected for the environment in which the employee will be working, properly fitted to the employee, maintained and cleaned periodically, Lead Paint Removal Programs and worn by the employee when required. 

Prophylactic chelation is prohibited by the lead standard. Diagnostic and Lead Paint Removal Programs therapeutic chelation are permitted only under the supervision of a licensed physician with appropriate medical monitoring in an acceptable clinical setting. 

The decision to initiate chelation therapy must be made on an individual basis and must take into account the severity of symptoms felt to be a result of lead toxicity along with blood lead levels, Lead Paint Removal Programs ZPP levels, and other laboratory tests as appropriate. 

EDTA and penicillamine, Lead Paint Removal Programs which are the primary chelating agents used in the therapy of occupational lead poisoning, have significant potential side effects and their use must be justified on the basis of expected benefits to the worker. 

Unless frank and severe symptoms are present, therapeutic chelation is not recommended, Lead Paint Removal Programs given the opportunity to remove a worker from exposure and allow the body to naturally excrete accumulated lead. As a diagnostic aid, the chelation mobilization test using Ca-EDTA has limited applicability. According to some investigators, the test can differentiate between lead-induced and other nephropathies. 

The test may also provide an estimation of the mobile fraction of the total body lead burden. Employers are required to assure that accurate records are maintained on exposure monitoring, medical surveillance, and Lead Paint Removal Programs medical removal for each employee. 

Exposure monitoring and medical surveillance records must be kept for 40 years or Lead Paint Removal Programs the duration of employment plus 20 years, whichever is longer, while medical removal records must be maintained for the duration of employment. All records required under the standard must be available upon request to the Chief of the Division of Occupational Safety and Health and the Director of the National Institute for Occupational Safety and Health. 

Employees must also make environmental and biological monitoring and medical removal records available to affected employees and to former employees or Lead Paint Removal Programs their authorized employee representatives. Employees or their specifically designated representatives have access to their entire medical surveillance records. 

In addition, the standard requires that the employer inform all workers exposed to lead at or above the action level of the provisions of the standard and all its appendices, Lead Paint Removal Programs the purpose and description of medical surveillance and provisions for medical removal protection if temporary removal is required. 

An understanding of the potential health effects of lead exposure by all exposed employees along with full understanding of their rights under the lead standard is essential for an effective monitoring program. II. Adverse health effects of inorganiclead Although the toxicity of lead has been known for 2,000 years, Lead Paint Removal Programs the knowledge of the complex relationship between lead exposure and human response is still being refined. 

Significant research into the toxic properties of lead continues throughout the world, and it should be anticipated that our understanding of thresholds of effects and Lead Paint Removal Programs margin of safety will be improved in future years. The provisions of the lead standard are founded on two prime medical judgments.

First, the prevention of adverse health effects from exposure to lead throughout a working lifetime requires that worker blood lead levels be maintained at or Lead Paint Removal Programs below 40 µg/100 g; and second, the blood lead levels of workers, male or female, who intend to parent in the near future should be maintained below 30 µg/100 g to minimize adverse reproductive health effects to the parents and developing fetus. 

The adverse effects of lead on reproduction are being actively researched and the physician is encouraged to remain abreast of recent developments in the area to best advise pregnant workers or Lead Paint Removal Programs workers planning to conceive children. The spectrum of health effects caused by lead exposure can be subdivided into five developmental stages: normal, physiological changes of uncertain significance, overt symptoms (morbidity), and mortality. 

Within this process there are no sharp distinctions, but rather a continuum of effects. Boundaries between categories overlap due to the wide variation of individual responses and Lead Paint Removal Programs exposures in the working population. The development of the lead standard focused on pathophysiological changes as well as later stages of disease. 

1. Heme Synthesis Inhibition. The earliest demonstrated effect of lead involves its ability to inhibit at least two enzymes of the heme synthesis pathway at very low blood lead levels. Inhibition of delta aminolevulinic acid dehydrase (ALA-D) which catalyzes the conversion of delta-aminolevulinic acid (ALA) to protoporphyrin is observed Lead Paint Removal Programs at a blood lead level below 20 µg/100 g of whole blood. At a blood lead level of 40 µg/100 g, more than 20% of the population would have 70% inhibition of ALA-D. There is an exponential increase in ALA excretion at blood lead levels greater than 40 µg/100 g.

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