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Original research
Industry-specific prevalence of elevated blood lead levels among Pennsylvania workers, 2007–2018
  1. Rebecca J Tsai1,2,
  2. John W Lu1,2,
  3. Scott A Henn1,2,
  4. Stephanie H Hasanali3,
  5. Laurel Harduar-Morano2,3,
  6. Anil Nair3
  1. 1 Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
  2. 2 Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  3. 3 Bureau of Epidemiology, Division of Environmental Health Epidemiology, Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA
  1. Correspondence to Dr Rebecca J Tsai, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA; rtsai{at}


Objectives To use industry-specific denominators to more accurately examine trends in prevalence rates for occupational cases of elevated blood lead levels (eBLLs) in Pennsylvania.

Methods We used adult (aged ≥16 years) blood lead level data from Pennsylvania (2007–2018) and industry-specific denominator data from the US Census Bureau’s County Business Patterns to calculate prevalence rates for eBLLs, defined as ≥25 µg/dL.

Results Of the 19 904 cases with eBLLs, 92% were due to occupational lead exposure, with 83% from workers in the battery manufacturing industry. In 2018, the prevalence rate of eBLLs for battery manufacturing (8036.4 cases per 100 000 employed battery manufacturing workers) was 543 times the overall Pennsylvania prevalence rate. The prevalence rate for battery manufacturing steeply declined 71% from 2007 to 2018.

Conclusions The battery manufacturing industry had the highest burden of occupational lead exposure in Pennsylvania, illustrating the importance of using industry-specific denominators to accurately identify sources of lead exposure. Although the prevalence rate of eBLLs declined over time, lead exposure remains a major concern among battery manufacturing workers.

  • Lead
  • Occupational Health
  • Public Health Surveillance

Data availability statement

No data are available.

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  • Contributors RJT and JWL conceptualised the study, analysed the data and drafted and revised the article. RJT serves as the guarantor of this manuscript. SAH, SHH, LH-M and AN contributed to the design, data analysis, interpretation of data and revision of article. All authors approved the final version of the manuscript.

  • Funding All authors are federal or state government employees. The preparation of this manuscript was completely funded by the Federal and State Government.

  • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.