Prevention of lead poisoning in construction workers: a new public health approach.

BACKGROUND: In 1990, Yale University, the Connecticut Departments of Health Services and of Transportation, the Connecticut Construction Industries Association, and the state's construction trade unions created the Connecticut Road Industry Surveillance Project (CRISP). METHODS: Data from 90 bridge projects from 1991 to 1995 and approximately 2,000 workers were evaluated. The distribution of peak lead concentrations in the blood for CRISP workers classified into five groups were compared to that from workers outside of Connecticut. RESULTS: This demonstration project was instrumental in lowering bridge worker blood lead levels. After 1992, only the painting contract employees experienced peak blood lead levels with < or = 2% exceeding 50 microg/dl. Compared to similar workers in other states, Connecticut workers had significantly lower peak blood lead levels. CONCLUSIONS: Two thousand workers and over 120 contractors benefited directly from CRISP. Two key features of the CRISP model differed from the 1993 OSHA standard: a contract-specified lead health protection program and a centralized system of medical monitoring. These differences may account for the improved protection observed between the CRISP and non-Connecticut cohorts.

Asbestos review and update.

Concurrent with the widespread use of asbestos in buildings were noticeable increases in the incidence of certain types of lung disease and cancer among workers who mined, milled, manufactured, and applied asbestos containing products. OSHA and EPA initiated efforts to reduce exposure to asbestos in 1971 and 1973, respectively. The approach taken by these agencies can best be understood through knowing the epidemiology of asbestos. The role of the occupational health nurse is centered around prevention of exposure to asbestos by educating employees on the risks of exposure, implementing engineering controls, and enforcing OSHA standards.