Alaska Lead Surveillance Program
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What is lead?
The Centers for Disease Control and Prevention summarizes: "Lead is a soft, heavy, blue-gray metal. It occurs naturally in the earth's crust, and human activities such as burning fossil fuels, mining, and manufacturing have spread it throughout the environment, including our homes and workplaces. Exposure to lead should be avoided. Lead is highly toxic to humans, especially young children. It has no known physiologic value to the human body." (Childhood Lead Poisoning Prevention)
Great effort has been undertaken in the United States over the last two decades to remove lead from gasoline, paints, and many other products. However, lead is still found in some types of ammunition, batteries, medical and scientific equipment and other products. Because lead does not break down or decompose, lead from past products remains in the environment.
Visit the Agency for Toxic Substances and Disease Registry for more detailed information on lead.
How do people get exposed to lead?
Occupational Exposures
People who work in certain industries can be exposed by breathing in air that contains lead particles or fumes. In Alaska, such industries include:
- Mining of lead, zinc, silver or gold ore
- Demolition
- Lead paint remediation
- Home renovation
- Working at an indoor firing range
- Soldering and welding
- Automotive repair
- Metal recycling
Families of workers may be exposed to lead when workers bring lead dust home on their work clothes. This can be avoided if employers and employees follow the federal Occupational Safety & Health Administration (OSHA) regulations and use protective clothing that is cleaned properly. See 1910.1025 (g) (1) and (2).
The U.S. Environmental Protection Agency has guidance for homeowners, tenants, childcare providers and parents on lead safety during renovation, repair, and painting.
Non-occupational Exposures
People who enjoy certain hobbies can be exposed to lead by breathing in air that contains lead particles or fumes (people can also bring home lead dust from their hobbies on their shoes and clothing and potentially expose other people in the household). In Alaska, such hobbies include:
- Shooting and reloading firearms
- Shooting at an indoor firing range
- Casting lead bullets or fishing weights
- Metal recycling
- Stained glass
People can also be exposed to lead in the home through various sources such as:
- Water (from lead plumbing or solder in older homes)
- Lead-based paint in homes built before 1978
- Imported items such as glazed pottery, toys, candy, nutritional pills or vitamins, and foods canned or packaged outside the U.S.
- Cosmetics such as kohl, surma, and sindoor
- Traditional medicines such as ayurvedic, greta, azarcon, alarcon, alkohl,
bali goli, coral, ghasard, luiga, pay-loo-ah,
and rueda
Exposures in Children
Fetuses and children under the age of 6 are the most vulnerable to the negative health effects of lead. If exposure levels are high enough during critical growth stages, children can sustain permanent damage. Lead can delay or impair brain development in children and adversely affect IQ, and can cause anemia and impaired metabolism of vitamin D. Absorption of lead appears to be higher in children who have low dietary iron or calcium intakes, so a healthy diet is important. Adequate intake of zinc is also important to help protect against health effects from lead exposure.
Exposure routes for children include:
- Chipped lead-based paint in homes built before 1978
- Ingesting or mouthing items that contain lead, such as lead-painted toys or jewelry
- Water (from lead plumbing or solder in older homes)
- Take-home lead, when family members bring home lead dust on their work clothes
- In utero (womb), when the mother is exposed through any previously mentioned route
Older children's brains continue to develop, so they are also vulnerable to the toxic effects of lead. In Alaska, we have identified additional sources of lead exposures in older children including:
- Shooting and reloading firearms
- Shooting at an indoor firing range
To learn about past lead exposures in Alaska, search the Section of Epidemiology Bulletin Archive for lead.
Lead Screening in Children
The decision to test a child's blood lead level is best made by the child's parents and health care provider, taking into consideration the child's exposure risk factors. Interested parents should discuss blood lead testing during their child's physical exam.
The Environmental Public Health Program provides lead testing kits to State Public Health Centers. The test uses a finger stick to collect a capillary blood sample. Testing tubes, lancets, and supporting paperwork will be provided. State Public Health Centers can obtain lead testing kits by contacting the Environmental Public Health Program at eph@alaska.gov or call 907-269-8000.
What are the health effects of lead exposure?
Lead poisoning occurs when blood lead levels (BLLs) are elevated. Exposures occur primarily through breathing or ingesting lead. BLLs are currently the best indicators of personal lead exposure. People can minimize the risk of adverse health effects by preventing lead exposures.
The effects of lead are the same whether lead enters the body through breathing or ingestion. Lead can affect almost every organ and system in your body. The main target for lead toxicity is the nervous system, both in adults and children. To learn more about the potential health effects of lead exposure in adults and children, please see the Agency for Toxic Substances and Disease Registry's Case Studies in Environmental Medicine.
Alaska Blood Lead Epidemiology and Surveillance Program
Alaska has a comprehensive statewide blood lead surveillance program and targeted screening program to identify and control sources of lead exposure and assist in the medical management of patients with elevated blood lead levels (BLLs).
In Alaska, elevated lead levels are found mostly in adults, usually as a result of mining occupations, casting of lead bullets or fishing weights, or exposure in shooting ranges. Present efforts are being directed towards targeted screening of populations potentially at risk for elevated lead exposures. These include occupational and non-occupational exposures.
In Alaska, follow-up investigations are conducted for children under age 18 when the initial BLL is 3.5 µg/dL or higher and for adults when the initial BLL is 25 µg/dL or higher. For occupational exposures, OSHA (Occupational Safety and Health Administration) requires follow-ups when BLLs exceed 40 µg/dL.
To learn more about the lead surveillance program, contact the Environmental Public Health Program either by phone (907-269-8000) or email (eph@alaska.gov)
Blood Lead Reference Value Update
On October 28, 2021, the Centers for Disease Control and Prevention (CDC) updated its blood lead reference value (BLRV) from 5 μg/dL (micrograms per deciliter) to 3.5 μg/dL. The BLRV is intended to identify children with higher levels of lead in their blood compared to most children, based on the 97.5th percentile of the blood lead level (BLL) distribution in U.S. children ages 1–5 years. The Alaska Lead Surveillance Program has adopted the updated BLRV of 3.5 μg/dL as the threshold for when to conduct a follow-up investigation of a child under age 18 with lead exposure. By adopting the updated BLRV, we will be able to make additional progress in reducing lead exposure among more Alaska children. Additional information about the updated BLRV as well as specific information for health care providers can be found in the 
Alaska Brief of CDC BLRV Changes.
Alaska Public Health Reporting Law (Alaska Administrative Code 27.014)
Health care providers and laboratories are required to report all blood lead levels to the Section of Epidemiology and include the patient's date of birth, sex, race, and community of residence, as well as the provider's name. Reporting of levels 5 µg/dL or higher in children aged <18 years and levels 10 µg/dL or higher for adults ≥18 years of age is required within 1 week of receiving the result. All other levels are required within 4 weeks of receiving the result. Reports may be made may be made by fax (907-561-4239) or by mail to: Section of Epidemiology, 3601 C Street, Suite 540, Anchorage, AK 99503.
For guidance on how to report blood lead test results to the State of Alaska, refer to the Blood Lead Level Report Guidelines.
Additional information about the Alaska Public Health Reporting Law (AAC 27.014) and how to correctly submit blood lead test reports can be found in Alaska State Legislature statute 7 AAC 27.014.
Additional Information on Common Lead Exposures in Alaska:
Shooting Firearms/Hunting
Indoor Firing Range
Hand Reloading Ammunition
Fishing weight melting/casting
Other Hobbies, Stained Glass, Soldering
Lead in Toys, Jewelry and Other Consumer Products
EPA:
Lead in Toys and Toy Jewelry
Consumer Product Safety Commission:
Consumer products recalled due to lead poisoning hazard (search “lead”)