MEDICAL-MANAGEMENT OF LEAD-EXPOSED WORKERS - RESULTS OF PHYSICIAN INTERVIEWS IN NEW-JERSEY

Between July 1990 and April 1992, a questionnaire was administered to the physicians who saw 62 individuals with a blood lead (PbB) level eq ual to or higher than 2.40 mumol/liter with occupational inorganic lea d exposure, to ascertain the medical management of workers with elevat ed PbB levels. Most of the 62 cases were seen by their personal physic ian (50%) or a private physician under contract with the company for w hich the patient worked (40%). Only eight (13%) patients were seen by a physician in a medical specialty assumed to include training relevan t to occupational lead exposure. Fifteen percent of the patients' phys icians reported taking no action for the elevated PbB level. Twenty-ni ne percent did not report retesting the patient (all should have been retested). Twenty-one percent of the 62 patients' physicians reported informing no one, including the patient, of the elevated PbB reported informing no one, including the patient, of the elevated PbB level. Th e majority of the physicians did not know the answer or declined to an swer a question about what PbB level would prompt them to take six fol low-up actions. The results of the physician interviews indicate that medical follow-up on workers with elevated PbB levels may not be adequ ate to prevent lead poisoning of the workers and their co-workers. Rec ommendations include methods to increase physician and employer knowle dge of the medical management of workers with elevated PbB levels and to increase employer compliance with OSHA standards regarding medical surveillance of lead-exposed workers.