A battery manufacturing worker shows blood lead level (BLL) of 48 µg/dL. According to occupational health guidelines, the appropriate action is:

• A Continue working with increased ventilation at worksite
• B Recheck BLL after 3 months before taking any action
• C Remove from lead exposure and initiate chelation therapy with dimercaprol or succimer ✓
• D Initiate chelation only if BLL exceeds 70 µg/dL

Explanation

A BLL of 45–70 µg/dL in adults warrants removal from exposure and consideration of chelation therapy. Oral chelation (succimer/DMSA for BLL 45–70 µg/dL) is preferred; EDTA or DMSA IV for levels >70 µg/dL or with symptomatic encephalopathy. The CDC action level in workers is BLL ≥ 25 µg/dL (NIOSH recommends medical removal at ≥ 50 µg/dL or after two consecutive levels ≥ 40 µg/dL). Continuing work at 48 µg/dL is inappropriate as progressive accumulation causes nephrotoxicity, peripheral neuropathy, and anaemia.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.