THE EPIDEMIOLOGY AND SURVEILLANCE OF BLOOD LEAD IN TAIWAN (ROC) - A REPORT ON THE PRESS-BLL PROJECT

To monitor the lead hazards in industries and to investigate the preva lence of elevated blood lead levels (BLLs) in lead-exposed workers, a lead surveillance system (PRESS-BLLs) has been established and operate d in Taiwan, Republic of China, since July 1993. A cohort of lead-expo sed workers who received a periodic annual health examination at 55 ac credited hospital laboratories was constructed. A total of 9807 separa te BLL measurements were reported to the system in 1994. The mean BLL was 15.8 mu g/dl in male workers and 11.6 mu g/dl in female workers. T he mean BLL of lead-exposed workers was significantly (P <0.05, z-test ) higher than that of the general Taiwanese population (8.6 mu g/dl fo r males and 6.7 mu g/dl for females). In addition, the BLLs of 983 (10 .0%) workers exceeded the regulatory action level (40 mu g/dl for male s; 30 mu g/dl for females). The workplaces ces and homes of 57% of the workers with elevated BLLs were thoroughly investigated to determine the sources of lead contamination, These actions identified the causes of elevated BLLs and set up strategies to reduce workers' lead exposu re. The establishment of this occupational lead surveillance system re presents a method for monitoring of lend hazards from occupational and environmental settings to prevent lead poisoning. The information acq uired from the system call help in the setting up of a priority of pre vention and the development of control measures. It is also useful for further monitoring of changes in the BLLs of the lead-exposed-worker cohort. The Health Department of Taiwan can use this information to ev aluate the effectiveness of current industrial hygiene practice. Subje cts with elevated BLLs have been medically treated and placed on long- term follow-up for sequelae.