Relationship of blood lead levels to personal hygiene habits in lead battery workers: Taiwan, 1991-1997

Background: The blood lead concentrations of workers in lead battery factor ies are more than 4 times higher than those of the general population in Ta iwan. Therefore, efforts are needed to reduce lead exposure in this high-ri sk population. A health promotion program on personal habits that reduce le ad exposure has been carried out in a lead battery factory since 1991. This study investigated the longitudinal relationship of workers' blood lead co ncentrations and personal hygiene habits from 1991 through 1997 Methods: In each of the 7 years of the study, occupational physicians quest ioned workers regarding nine personal hygiene items, personal information a nd medical history before their annual health examination The relationship between blood lead concentrations and personal hygiene habits was analyzed by longitudinal multiple regression in a mixed effect model with adjustment for potential confounders. In addition, the risk ratio of a blood lead con centration exceeding 40 mu g/dL in men and 30 mu g/dL in women (the action levels set by the Department of Health, Taiwan) was estimated by generalize d estimating equations. Results: Blood lead levels decreased significantly in the first 5 years of the study. The personal habits most closely related to blood lead concentra tions were smoking at work sites (estimated coefficient = 3.13, P < 0.001), and eating at work sites (estimated coefficient = 1.38, P = 0.069). The ri sk ratio for workers with both these habits exceeding the action level of b lood lead was 2.93 (95% CI 1.27-6.77). Difference in job titles, however ac counted for a major portion of the variance in blood lead For example, work ing in "pasting" and "plate-cutting" was associated with blood lead elevati ons >20 mu g/dL in comparison to the "low- or no-exposure jobs. Conclusions: Health promotion programs cart decrease exposure of lend worke rs; reducing the practices of smoking and eating at work sites should be th e core of such programs. However; a major reduction in lead exposure for so me jobs (e.g., "pasting" and "plate-cutting") in lead battery factories in Taiwan is unlikely to occur without major engineering changes. Am. J. Ind. Med. 35:595-603, 1999. (C) 1999 Wiley-Liss, Inc.