Several metals and metalloids, including lead, cadmium, mercury, manganese and arsenic, are among the most extensively studied environmental and occupational health risks. As a result of such research, public health policy decisions in many countries have reduced environmental exposures by restricting uses and releases. However, occupational health policy has not kept pace. In part, this reflects a policy gulf in public health, dividing considerations of children’s health from that of adults. Driven by justified concerns about children’s exposures and responses,¹ the children’s environmental health movement may have generated an unintended assumption that adults are not at risk from similar exposure to the same toxic agents. The failure to critically examine this assumption adversely affects the protection of working adults. In addition, failure to consider health effects on adults can bias risk-based policies when the potential benefits of interventions are analysed only in terms of reducing risk to children.

Much recent concern for children’s environmental health came from experience with lead and mercury. To prevent neurodevelopmental toxicity from these metals, public health decisions in many countries during the past 30 years have focused on fetal and early childhood exposure. On this basis only, some policies also cover adult women in their reproductive years. Child-specific biomonitoring guidelines have also been developed and serve as a basis for policy in the USA. By contrast, there has been little change in policy regarding exposures of adults (aside from …