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The Adult Blood Lead Epidemiology and Surveillance Program (ABLES) maintains a surveillance system of blood lead test results on individuals 15 years of age and older. Laboratories and physicians are required by the Texas Reportable Occupational Conditions Act to report all blood lead levels. Follow-up is conducted on blood lead levels that are 10 micrograms of lead per deciliter (10 mcg/dL) of blood or higher.

Historical reporting rules

In 1986, the Texas Legislature enacted the Health and Safety Code Chapter 84 “Reporting of Occupational Conditions” and required the reporting of adult blood lead levels DSHS. Initially, the reporting level was 40 mcg/dL. In 1999, the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH) defined an elevated blood lead level in an adult as 25 mcg/dL. In accordance with NIOSH’s case definition, the level at which blood lead levels were to be reported changed from 40 mcg/dL to 25 mcg /dL. In 2002, an amendment to the Texas Administrative Code (Title 25, Part 1, Chapter 99, Rule §99.1) required the reporting of all blood lead levels.

Recent research has documented harmful health effects of blood lead levels well below 25 mcg /dL. Because of this, NIOSH recommended lowering the elevated blood lead level in an adult from 25 mcg /dL to 10 mcg /dL.

Follow-Up Procedures

In conjunction with NIOSH’s case definition, the Texas ABLES program conducts follow-up activities on individuals with blood lead levels at or above 10 mcg /dL. This includes the collection of demographic and occupational information. The laboratory, health care provider, and/or employer is contacted for additional reportable information, when necessary.

Increased awareness of the sources of lead exposure and methods for reducing exposure are essential for the prevention of lead poisoning. The Texas ABLES program conducts follow-up activities according to the blood lead level:

Follow-up activities according to blood lead level

10-24 mcg/dL
25-39 mcg/dL
40-59 mcg/dL
60+ mcg/dL
Letter to patient Letter to patient Letter to patient Letter to patient
  Letter to provider
Letter to provider Letter to provider
  Letter to company (if occupational)
Letter to company (if occupational) Letter to company (if occupational)
  Mail interview form to patient
Phone interview of patient
Phone interview of patient
    Phone interview of provider
Phone interview of provider

Last updated November 28, 2012