Lead Testing

[vickyp]

#102645

Forum: Community

Our company needs to have our employees tested for their lead count. Do you have a written policy on this’ Ontario

[vickyp]

#103030

What I can tell you is that such a policy should provide for:
*Pre-placement testing
*Periodic testing
*Testing after acute exposure
*Exit testing
As well as:
*Clinical tests to be used
*Criteria/Levels calling for removal or other actions.

Here are the MOL guidelines on Medical Surveillance Programs for both inorganic and organic lead under the OHS Designated Substances Reg. (Reg 490/09) which you should use as a template for your own policy:

INORGANIC LEAD

With respect to the medical examinations required under subsection 20 (4) of O. Reg. 490/09, the medical examinations for inorganic lead shall be carried out:
1. Prior to placement.
2. Periodically, at a frequency dependent on the findings of prior medical examinations
and clinical test results.
3. In the event of an acute exposure requiring immediate medical attention.
4. Upon exiting placement unless the most recent periodic medical examination was performed within the last 6 months.

Pre-placement Medical Examinations

Pre-placement medical examinations shall include:
i) Initial medical and occupational history including:
 Previous exposure (both occupational and non-occupational) to inorganic lead.
Note: Potential non-occupational sources may include: leaded paint in the home, leaded pipes, handling of munitions and firearm usage and some unlicensed
imported medications.
 Symptom history focusing on:
 Gastrointestinal, neurological (central and peripheral)
 Musculoskeletal, hematopoietic and renal systems, and
 Personal habits (e.g. smoking history)
ii) A physical examination focusing on:
 Gastrointestinal
 Neurological (central and peripheral)
 Musculoskeletal, and
 Renal systems
iii) Provision of health education consistent with Part I of this Code
iv) Clinical tests for inorganic lead in accordance with this Code.

Periodic Medical Examinations

Periodic medical examinations shall include the following:
i) An updating of a worker’s medical and occupational history only if there are positive findings at prior examination on clinical testing. A physical examination
only if there are positive findings at prior examination or clinical testing.
ii) Provision of health education consistent with Part I of this Code
iii) Clinical tests for inorganic lead in accordance with this Code.

Acute exposure medical examinations

A medical examination required in the event of an acute exposure to inorganic lead shall include.
i) Inquiry for signs and symptoms consistent with exposure to inorganic lead focusing on:
 Gastrointestinal, neurological (central and peripheral)
 Musculoskeletal, hematopoietic and renal systems,
ii) A physical examination focusing on:
 Gastrointestinal
 Neurological (central and peripheral)
 Musculoskeletal, and
 Renal systems
iii) Clinical tests for inorganic lead in accordance with this Code.

Exit Medical Examinations

Exit examinations shall include:
i) An updating of a worker’s medical and occupational history if there are positive findings at prior examination or clinical testing (blood lead levels > 0.5 µmol/L).
ii) A physical examination if there are positive findings at prior examination or clinical testing (blood lead levels > 0.5 µmol/L).
iii) Provision of health education consistent with Part I of this Code.
iv) Clinical tests for inorganic lead in accordance with this Code.
Note: No monitoring post cessation of exposure is recommended.

Clinical tests for Inorganic Lead
Types

The following clinical tests are required for pre-placement, periodic, acute exposure and exit medical examinations with respect to exposure to inorganic lead:
1. Blood lead level
Frequency
i) At a minimum, every 4 months for the first 12 months following testing in relation to pre-placement medical examinations to address potential exposures
through hygiene and work practices.
ii) Monthly for blood lead level > 1 µmol /L.
iii) Every 3 months for blood lead level 0.5 µmol/L – 1 µmol/L.
iv) Every 6 months or if change in work practices for blood lead level 0.25 µmol/L (single measure – confirmed by
immediate repeat testing)
2. Removal Criteria:
The levels for removal of the worker from exposure to inorganic lead are as follows:
 For general population of workers:
 Blood lead level > 1.0 µmol/L (two repeat measures, one month a part),
or
 Blood lead level >1.4 µmol/L (single measure – confirmed by immediate
repeat testing)
 For vulnerable worker subpopulations:
Blood lead level > 0.5 µmol/L
Return to Work in Exposure to Inorganic Lead Criteria
 For general population of workers:
 Blood lead level < 0.7µmol/L
 For vulnerable worker subpopulations
 Blood lead level 0.075 µmol/L (20µg/L)
Return to Work in Exposure to Organic Lead Criteria
Return to work in exposure to organic lead is at the discretion of the examining
physician.
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Hope that helps. Glenn

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