By Olivia Halabicky, M.Sc.,PhD, RN, University of Michigan, School of Nursing
CONTRACTORS ALERT!!
Construction work in older houses can expose you and your family to lead poisoning!
The EPA Renovation, Repair and Painting training can help!
1. Lead Exposure Is a Routine Occupational Hazard
Workplace exposure is the leading cause of elevated adult blood lead levels (BLLs).1 In 2024, there were 1,199 cases of adult elevated blood lead levels (>3.5 µg/dL), with nearly ¾ of people being exposed at work.
Evidence confirms that construction, renovation, and painting contractors regularly encounter, and unknowingly spread, lead dust.2 Workers most affected are in their 20s–50s, overlapping with key child-bearing and caregiving years.1
2. Lead Dust Follows Workers Home—Putting Families at Risk
It is well documented that workers can carry lead dust home to their families. Reviews show consistent lead contamination of workers’ vehicles, clothing, and homes.3 In fact, in a pilot study of Michigan workers, 95% of contractor vehicle samples exceeded EPA dust clearance levels.4 In Boston, construction workers’ homes had significant take-home lead and other heavy metal dust linked to lack of lockers, mixing work/personal gear, dusty tasks, and not washing or changing clothes.5
Studies show that children of lead-exposed workers have significantly higher blood lead levels.6 In Michigan, children’s BLLs are strongly associated with lead-contaminated household dust, especially on floors.7
Even very low blood lead levels in children cause permanent cognitive and behavioral harm.8 Childhood exposure is also linked to adult brain disease9, lifelong mental health impacts,10 and lower socioeconomic outcomes.11
3. Even Low-Level Lead Exposure Harms Adult Workers
Lead exposure, even at low levels, has documented health consequences for adults, including:
- Higher mortality from lung and larynx cancer and associations with COPD, heart disease, and non-Hodgkin’s lymphoma (U.S. cohort of 58,368 workers).12
- Cardiovascular disease and hypertension effects at even low blood lead levels (<5 µg/dL).13-15
- Suggestive evidence linking occupational lead exposure to malignant brain tumors.16
- Evidence to suggest adult lead exposure is associated with risk for Alzheimer’s disease later in life.17, 18
Reproductive harms:
- In pregnant workers, lead exposure is associated with miscarriage19, preeclampsia20, 21, and other reproductive complications.22
- Elevated blood lead levels in male workers is associated with men’s reproductive health, including reduced sperm volume, count, motility, and vitality.23
References
1. Hotchkiss G, Rosenman KD. Adult Blood Lead Epidemiology and Surveillance (ABLES) Program January 1, 2024 – December 31, 2024 Department of Medicine, Division of Occupational and Environmental Medicine: Michigan State University, 2025.
2. (NIOSH) NIfOSaH. Trends in Workplace Lead Exposure: Centers for Disease Control and Prevention; 2024. Available from: https://www.cdc.gov/niosh/lead/data/index.html.
3. Kalweit A, Herrick RF, Flynn MA, Spengler JD, Berko JK, Levy JI, Ceballos DM. Eliminating Take-Home Exposures: Recognizing the Role of Occupational Health and Safety in Broader Community Health. Ann Work Expo Health. 2020;64(3):236-49. doi: 10.1093/annweh/wxaa006. PubMed PMID: 31993629; PMCID: PMC7064272.
4. Oliveri AN, Fagerstrom LA, Wang L, Rosenman KD. A County-Level Program for the Evaluation of the Potential for Take-Home Lead Exposures Among Children in Michigan. Public health reports (Washington, DC : 1974). 2022;137(6):1153-61. Epub 20211217. doi: 10.1177/00333549211061327. PubMed PMID: 34918567; PMCID: PMC9574318.
5. Ceballos DM, Dong Z, Peters JL, Herrick RF, Gupta P, Spengler JD. Metals dust in workers’ homes and potential for take home in the Greater Boston area: Pilot study. Environmental Research. 2022;209:112893. doi: https://doi.org/10.1016/j.envres.2022.112893.
6. Roscoe RJ, Gittleman JL, Deddens JA, Petersen MR, Halperin WE. Blood lead levels among children of lead-exposed workers: A meta-analysis. American journal of industrial medicine. 1999;36(4):475-81. doi: 10.1002/(sici)1097-0274(199910)36:4<475::aid-ajim9>3.0.co;2-o. PubMed PMID: 10470013.
7. Wilson J, Dixon SL, Wisinski C, Speidel C, Breysse J, Jacobson M, Crisci S, Jacobs DE. Pathways and sources of lead exposure: Michigan Children's Lead Determination (the MI CHILD study). Environ Res. 2022:114204. Epub 20220905. doi: 10.1016/j.envres.2022.114204. PubMed PMID: 36075478.
8. Ruckart PZ, Jones RL, Courtney JG, LeBlanc TT, Jackson W, Karwowski MP, Cheng PY, Allwood P, Svendsen ER, Breysse PN. Update of the Blood Lead Reference Value - United States, 2021. MMWR Morbidity and mortality weekly report. 2021;70(43):1509-12. Epub 2021/10/29. doi: 10.15585/mmwr.mm7043a4. PubMed PMID: 34710078.
9. Reuben A. Childhood Lead Exposure and Adult Neurodegenerative Disease. Journal of Alzheimer's Disease. 2018;64(1):17-42. doi: 10.3233/JAD-180267.
10. Reuben A, Schaefer JD, Moffitt TE, Broadbent J, Harrington H, Houts RM, Ramrakha S, Poulton R, Caspi A. Association of childhood lead exposure with adult personality traits and lifelong mental health. JAMA psychiatry. 2019;76(4):418-25.
11. Reuben A, Caspi A, Belsky DW, Broadbent J, Harrington H, Sugden K, Houts RM, Ramrakha S, Poulton R, Moffitt TE. Association of childhood blood lead levels with cognitive function and socioeconomic status at age 38 years and with IQ change and socioeconomic mobility between childhood and adulthood. JAMA - Journal of the American Medical Association. 2017;317(12):1244-51. doi: 10.1001/jama.2017.1712.
12. Barry V, Todd AC, Steenland K. Bone lead associations with blood lead, kidney function and blood pressure among US, lead-exposed workers in a surveillance programme. Occupational and environmental medicine. 2019;76(5):349-54. doi: 10.1136/oemed-2018-105505.
13. Lanphear BP, Rauch S, Auinger P, Allen RW, Hornung RW. Low-level lead exposure and mortality in US adults: a population-based cohort study. The Lancet Public Health. 2018;3(4):e177-e84. doi: 10.1016/S2468-2667(18)30025-2. PubMed PMID: 29544878.
14. Navas-Acien A, Guallar E, Silbergeld EK, Rothenberg SJ. Lead exposure and cardiovascular disease -- a systematic review. Environmental Health Perspectives. 2007;115(3):472-82. PubMed PMID: 105983769. Language: English. Entry Date: 20080215. Revision Date: 20150711. Publication Type: Journal Article.
15. Sirivarasai J, Kaojarern S, Chanprasertyothin S, Panpunuan P, Petchpoung K, Tatsaneeyapant A, Yoovathaworn K, Sura T, Kaojarern S, Sritara P. Environmental lead exposure, catalase gene, and markers of antioxidant and oxidative stress relation to hypertension: An analysis based on the EGAT study. BioMed Research International. 2015;2015. doi: 10.1155/2015/856319.
16. Ahn J, Park MY, Kang M-Y, Shin I-S, An S, Kim H-R. Occupational Lead Exposure and Brain Tumors: Systematic Review and Meta-Analysis. International journal of environmental research and public health [Internet]. 2020; 17 11.
17. Dong X, Bai M, Qian J, Xiao J, Zhang S, Hou X, Zhou C. Harmful impact of blood lead on the prevalence of Alzheimer's disease among middle-aged and older adults and the modifying role of physical activity: Evidence from the National Health and Nutrition Examination Survey (NHANES) study. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2025;21(11):e70785. doi: 10.1002/alz.70785. PubMed PMID: 41208711; PMCID: PMC12598405.
18. Bakulski KM, Rozek LS, Dolinoy DC, Paulson HL, Howard H. Alzheimer's disease and environmental exposure to lead: the epidemiologic evidence and potential role of epigenetics. Current Alzheimer research. 2012;9(5):563-73.
19. Lamadrid-Figueroa H, Téllez-Rojo MM, Hernández-Avila M, Trejo-Valdivia B, Solano-González M, Mercado-Garcia A, Smith D, Hu H, Wright RO. Association between the plasma/whole blood lead ratio and history of spontaneous abortion: a nested cross-sectional study. BMC Pregnancy and Childbirth. 2007;7(1):22. doi: 10.1186/1471-2393-7-22.
20. Wells EM, Navas-Acien A, Herbstman JB, Apelberg BJ, Silbergeld EK, Caldwell KL, Jones RL, Halden RU, Witter FR, Goldman LR. Low-level lead exposure and elevations in blood pressure during pregnancy. Environmental Health Perspectives. 2011;119(5):664-9. doi: 10.1289/ehp.1002666.
21. Yazbeck C, Thiebaugeorges O, Moreau T, Goua V, Debotte G, Sahuquillo J, Forhan A, Foliguet B, Magnin G, Slama R, Charles MA, Huel G. Maternal blood lead levels and the risk of pregnancy-induced hypertension: the EDEN cohort study. Environ Health Perspect. 2009;117(10):1526-30. Epub 2009/12/19. doi: 10.1289/ehp.0800488. PubMed PMID: 20019901; PMCID: PMC2790505.
22. Kumar S. Occupational and Environmental Exposure to Lead and Reproductive Health Impairment: An Overview. Indian Journal of Occupational and Environmental Medicine. 2018;22(3).
23. Giulioni C, Maurizi V, De Stefano V, Polisini G, Teoh JY-C, Milanese G, Galosi AB, Castellani D. The influence of lead exposure on male semen parameters: A systematic review and meta-analysis. Reproductive Toxicology. 2023;118:108387. doi: https://doi.org/10.1016/j.reprotox.2023.108387.