[Federal Register Volume 87, Number 123 (Tuesday, June 28, 2022)]
[Proposed Rules]
[Pages 38343-38362]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-13696]
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DEPARTMENT OF LABOR
29 CFR Parts 1910 and 1926
[Docket No. OSHA-2018-0004]
RIN 1218-AD10
Advance Notice of Proposed Rule Making (ANPRM)--Blood Lead Level
for Medical Removal
AGENCY: Occupational Safety and Health Administration (OSHA), Labor.
ACTION: Advance Notice of Proposed Rulemaking (ANPRM).
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SUMMARY: OSHA is considering rulemaking to revise its standards for
occupational exposure to lead based on medical findings since the
issuance of OSHA's lead standards that adverse health effects in adults
can occur at Blood Lead Levels (BLLs) lower than the medical removal
level (>=60 [mu]g/dL in general industry, >=50 [mu]g/dL in
construction) and lower than the level required under current standards
for an employee to return to their former job status (<40 [mu]g/dL).\1\
The agency is seeking input on reducing the current BLL triggers in the
medical surveillance and medical removal protection provisions of the
general industry and construction standards for lead. The agency is
also seeking input about how current ancillary provisions in the lead
standards can be modified to reduce worker BLLs.
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\1\ OSHA's standard for lead in general industry expresses blood
lead in units of [mu]g/100g of whole blood. The standard for lead in
construction expresses blood lead in units of [mu]g/dL, which the
agency explained is essentially equivalent to [mu]g/100g of whole
blood (29 CFR 1926.62, Appendix A, II.B.3: Health Protection Goals
of the Standard). For simplicity, this ANPRM expresses blood lead in
units of [mu]g/dL throughout.
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DATES: Submit comments on or before August 29, 2022.
ADDRESSES: You may submit comments and attachments, identified by
Docket No. OSHA-2018-0004, electronically at www.regulations.gov, which
is the Federal e-Rulemaking Portal. Follow the instructions online for
making electronic submissions.
Instructions: All submissions must include the agency's name and
the docket number for this ANPRM (Docket No. OSHA-2018-0004). When
uploading multiple attachments into Regulations.gov, please number all
of your attachments because www.regulations.gov will not automatically
number the attachments. For example, Attachment 1_title of your
document, Attachment 2_title of your document, Attachment 3_title of
your document, etc. When submitting comments or recommendations on the
issues that are raised in this ANPRM, commenters should explain their
rationale and, if possible, provide data and information to support
their comments or recommendations. Wherever possible, please indicate
the title of the person providing the information and the type and
number of employees at your worksite.
All comments, including any personal information you provide, will
be placed in the public docket without change and will be publicly
available online at www.regulations.gov. Therefore, OSHA cautions
commenters about submitting information they do not want to be made
available to the public or submitting materials that contain personal
information (either about themselves or others) such as Social Security
Numbers and birthdates.
Docket: To read or download comments or other material in the
docket, go to Docket No. OSHA-2018-0004 at www.regulations.gov. All
comments and submissions are listed in the www.regulations.gov index;
however, some information (e.g., copyrighted material) is not publicly
available to read or download through that website. All submissions,
including copyrighted material, are available for inspection at the
OSHA Docket Office. Documents submitted to the docket by OSHA or
stakeholders are assigned document identification numbers (Document ID)
for easy identification and retrieval. The full Document ID is the
docket number plus a unique four-digit code. OSHA is identifying
supporting information in this ANPRM by author name and publication
year, when appropriate. This information can be used to search for a
supporting document in the docket at https://www.regulations.gov.
Contact the OSHA Docket Office at 202-693-2350 (TTY number: 877-889-
5627) for assistance in locating docket submissions.
FOR FURTHER INFORMATION CONTACT:
Press Inquiries: Contact Frank Meilinger, Director, Office of
Communications, U.S. Department of Labor; telephone (202) 693-1999;
email [email protected].
General and technical information: Contact Andrew Levinson, Acting
Director, Directorate of Standards and Guidance, U.S. Department of
Labor; telephone (202) 693-1950; email [email protected].
SUPPLEMENTARY INFORMATION: The Supplementary Information section
follows this outline:
Table of Contents
I. Background
A. Events Leading to This Action
B. Industry Profile Information
C. Health Effects of Lead Exposure
II. Request for Input
A. Blood Lead Triggers for Medical Removal Protection
B. Medical Surveillance Provisions
C. Permissible Exposure Limit (PEL)
D. Personal Protective Equipment (PPE), Hygiene, and Training
E. Safe Harbor Compliance Protocols
F. Environmental Effects
G. Duplicative, Overlapping, or Conflicting Rules
[[Page 38344]]
H. Questions for Employers on Current Practices
I. Background
A. Events Leading to This Action
OSHA's lead standard for general industry (29 CFR 1910.1025),
adopted in 1978, established a permissible exposure limit (PEL)
airborne concentration of 50 [mu]g/m\3\ averaged over an 8-hour period
and was based on consideration of health effects, feasibility issues,
and the goal to keep BLLs below 40 [mu]g/dL for the majority of workers
occupationally exposed to lead (43 FR 54191). During approximately the
same time-frame, the United States Congress enacted a law to provide
Federal financial assistance to help cities and communities eliminate
the causes of lead-based paint poisoning and detect and treat
incidences of lead poisoning (Pub. L., 91-695; 42 U.S.C. Ch. 63).
Additionally, the Consumer Products Safety Commission (CPSC)
implemented regulations prohibiting lead from most consumer products
and banned lead from residential paint (16 CFR 1303). The U.S.
Environmental Protection Agency (EPA) and the U.S. Department of
Housing and Urban Development (HUD) enacted rules to reduce human and
environmental exposure to lead (24 CFR 35; 40 CFR 80; 40 CFR 745).
In 1992, OSHA promulgated an interim final rule for lead exposure
in construction (29 CFR 1926.62) as required by Title X of the Housing
and Community Development Act of 1992 (102 Pub. L. 550). This rule
amended Subpart D of 29 CFR part 1926 by adding a new section, 1926.62,
that lowered the existing lead PEL in construction to 50 [mu]g/m\3\ and
included ancillary provisions similar to those in the general industry
lead standard. OSHA's general industry and construction standards
contain medical removal provisions for workers whose BLLs exceed a
certain level: in general industry, when a periodic and a follow-up
blood test result show BLL >=60 [mu]g/dL, or an average of the last
three blood lead tests show BLL >=50 [mu]g/dL; and in construction,
when a periodic and a follow-up blood test result show BLL >=50 [mu]g/
dL. These workers must be temporarily removed to a job with exposures
at or below the action level (58 FR 26590).
In 1992, the U.S. Congress passed the Workers' Family Protection
Act (29 U.S.C. 671a). The Act required the National Institute for
Occupational Safety and Health (NIOSH) to report on take-home
contamination from workplace chemicals and substances, including
lead.\2\ NIOSH found take-home exposure to be a widespread problem
(NIOSH, 1995). The report identified workplace measures that are
effective in reducing take-home exposure such as changing clothes
before going home and leaving soiled clothing at work for laundering,
storing street clothes in areas separate from work clothes, showering
before leaving work, and prohibiting removal of toxic substances or
contaminated items from the workplace, in addition to citing the
importance of primary prevention by limiting exposure in the workplace.
NIOSH noted that preventing take-home exposure is critical because
decontaminating homes and vehicles is not always effective.
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\2\ Take-home lead contamination occurs when lead dust is
transferred from the workplace on employees' skin, clothing, shoes,
and other personal items to their vehicle and home. Take-home lead
can be a chronic source of exposure for workers and exposures to
household members (NIOSH 1995).
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In 1996, OSHA implemented a Special Emphasis Program (SEP) for lead
in construction (CPL 2.105) in response to documented elevated BLLs in
construction workers. The SEP established a mechanism for programmed
health inspections of construction sites where lead may be present. In
2001, OSHA implemented a National Emphasis Program (NEP) for lead (CPL
2-0.130). The NEP was implemented to direct OSHA's field inspection
efforts to reduce occupational exposures to lead. This ongoing NEP
includes general industry, construction, longshoring, and marine
terminals. OSHA updated its NEP for lead in 2008 and expanded its
targeting in 2013 to include indoor and outdoor firing ranges and
recycling industries (OSHA, 2008; OSHA, 2013). In 2007, OSHA completed
a Regulatory Flexibility Act Section 610 review and Executive Order
12866 lookback review of 29 CFR 1926.62 Lead in Construction (OSHA,
2007). The agency found that for the hazards associated with lead in
the construction industry, a mandatory standard remains necessary to
adequately protect employees. The lookback study also concluded that
the lead in construction standard has not had negative economic impacts
on business, including small businesses, and therefore remains
economically feasible.
Exposure to lead is associated with adverse health effects,
including but not limited to effects on the reproductive,
cardiovascular, neurological, respiratory, and immune systems. Since
promulgation of OSHA's lead standards, extensive research has been
published indicating adverse health effects in adults at lower levels
than had been previously documented (see, e.g., AOEC 2007; NTP 2012;
ATSDR 2020; ACGIH 2013; EPA 2013). A variety of public health and
government organizations have developed recommendations or revisions to
standards to more stringently limit occupational exposures to lead and
manage the effects of exposure in exposed workers. In 2007, the
Association of Occupational and Environmental Clinics (AOEC) published
guidelines for medical management of lead exposed adults (with special
emphasis on those exposed to lead at work). The recommendations
included: clinical assessment with detailed medical, occupational, and
environmental history, physical exam, BLL determination, and other labs
(CBC, BUN, Creatinine, Urine Analysis, EP); medical surveillance with
follow-up BLL; and medical management with evaluation of exposures and
risk factors, family and social context, and consideration for
potential removal from exposure (AOEC, 2007). In 2016, the American
College of Occupational and Environmental Medicine (ACOEM) released a
Position Statement on Workplace Lead Exposure recommending revisions to
OSHA's AL and PEL; workplace hygiene requirements; medical surveillance
and medical removal protection provisions; and introduction of surface
lead dust requirements (ACOEM 2016, p. e371). The Department of Defense
(DOD) commissioned the National Research Council (NRC) to conduct a
study to determine whether current OSHA exposure standards used on
firing ranges are protective. The committee concluded that the current
OSHA standard of a BLL of under 40 [mu]g/dL is not sufficiently
protective of personnel who have repeated lead exposures on firing
ranges (NRC, 2013). DOD subsequently lowered the medical removal
triggers for BLLs in military and civilian DOD personnel. DOD's medical
removal is based on BLLs at or greater than 20 [mu]g/dl, and employee
return to work when BLL is at or below 15 [mu]g/dL (DOD, 2018, p. 55;
Table C4.T2, pp. 57-61). In 2018, NIOSH published a Request for
Information (RFI) indicating NIOSH's intent to update its recommended
exposure limit (REL) for inorganic lead and to develop updated
recommendations for handling of inorganic lead and medical surveillance
in the workplace (NIOSH 2018).
Several states have initiated updates to their occupational lead
standards. In 2018 Michigan OSHA's State Plan
[[Page 38345]]
(MIOSHA) in the Michigan Department of Licensing & Regulatory Affairs
revised its lead standards for general industry and construction. The
revisions included changing the BLL at which an employee is required to
be removed from lead exposure, previously 50 [mu]g/dL, to 30 [mu]g/dL
for both standards. In addition, the BLL at which an employee may be
returned to work involving lead exposure was changed from < 40 [mu]g/dL
to 15 [mu]g/dL in both standards. MIOSHA also removed a previous
requirement to analyze for the zinc protoporphyrin (ZPP) level.
MIOSHA's revisions followed recommendations developed by a group of
stakeholders over the course of meetings held in 2017 and 2018. The
group's proposed revisions to the occupational standards were the
subject of public hearings in August 2018 and became effective in
December 2018 (MOEMA 2019, p. 8). Michigan's revisions did not alter
the PEL for lead.
The California Department of Public Health (CDPH) Occupational Lead
Poisoning Prevention Program made recommendations for revisions to the
California OSHA (Cal/OSHA) lead standards for general industry in 2010
and construction in 2011, including recommendations to lower the BLLs
for medical removal and return to former job status; require more
frequent BLL testing; broaden the provision and notification processes
for BLL testing for exposed workers; and lower the 8-hour time-weighted
average (TWA) PEL (CDPH, 2010; CDPH, 2011). CDPH's recommendation for
lowering the PEL was based on a report produced by the California
Environmental Protection Agency (Cal/EPA, Office of Environmental
Health Hazard Assessment (OEHHA)) that used an updated physiologically-
based pharmacokinetic (PBPK) model to characterize the relationship
between air lead levels and BLLs (OEHHA, 2014).
Cal/OSHA has held advisory meetings to discuss potential changes to
its lead standards and has published a discussion draft of possible
amendments to the existing regulations in general industry and
construction operations. California's most recent discussion draft
includes a medical removal level of 30 [mu]g/dL for a single test
result; or when the last two monthly blood lead tests are >= 20 [mu]g/
dL; or when the average of the results of all blood lead tests
conducted in the last 6 months is at or above 20 [mu]g/dL of whole
blood. The discussion draft includes a return to former job status when
two consecutive blood lead tests are <= 15 [mu]g/dL. The discussion
draft also includes a reduction in the PEL from 50 [mu]g/m\3\ to 10
[mu]g/m\3\ and the AL from 30 [mu]g/m\3\ to 2 [mu]g/m\3\, among other
changes. The discussion draft and related documents are available at
https://www.dir.ca.gov/dosh/DoshReg/5198Meetings.htm.
Washington State Department of Labor & Industries, Division of
Occupational Safety and Health (Washington DOSH), is also developing a
variety of updates to Washington State's occupational lead standards.
In 2012, Public Health--Seattle and King County (PHSKC) petitioned the
Washington State Department of Labor & Industries to update the
occupational lead standards, including the BLLs for medical removal and
return to former job status; the AL and PEL; and provisions for
protective clothing, hygiene, medical surveillance, training, and
education. Washington DOSH has proposed lowering its medical removal
BLL to >= 30 [mu]g/dL for a single test result, >= 20 [mu]g/dL for
multi-test results, and a return to former work status BLL of < 15
[mu]g/dL. Washington DOSH has also proposed a reduction in the PEL from
50 [mu]g/m\3\ to 20 [mu]g/m\3\, among other changes to the lead
standard. Washington DOSH's stakeholder review draft (2019) and other
information related to its stakeholder meetings on the lead rule
revision process are available at https://lni.wa.gov/safety-health/safety-rules/rulemaking-stakeholder-information/sh-rules-stakeholder-lead.
OSHA is also considering revisions to its lead standards. Through
this ANPRM, OSHA seeks input on the BLL triggers used for medical
removal and return to work status. The agency also requests information
on other potential changes to the current standards to reduce the risk
of adverse health effects from occupational lead exposure.
B. Industry Profile Information
In accordance with OSHA's intent to assess the potential impacts of
revising blood lead triggers for medical removal protection, the agency
made preliminary estimates of the annual number of firms, by industry,
expected to have workers with elevated BLLs. For these estimates, OSHA
used the reporting levels in CDC's Adult Blood Lead Epidemiology and
Surveillance (ABLES) dataset of 5 [mu]g/dL, 10 [mu]g/dL, and 25 [mu]g/
dL, and OSHA's lead standards' medical removal levels (50 [mu]g/dL for
construction and 60 [mu]g/dL for general industry).
OSHA identified the industry sectors associated with lead exposure
as those found in the ABLES dataset. This dataset shows that the
national prevalence rate of BLLs >=10 [mu]g/dL for adults declined from
26.6 adults per 100,000 employed in 2010 (among 37 reporting states) to
15.8 in 2016 (among 26 reporting states). For context, the geometric
mean BLL for all adults in the US (including workers) was 0.855 [mu]g/
dL in 2018 (HHS, 2022). Historically, in the U.S., most lead exposures
among adults have been occupational. Among the 11,695 adults with known
lead exposures at BLL of >=10 [mu]g/dL in 2016, 90.3% had occupational
exposures. The majority of these adults were employed in four main
industry sectors: manufacturing, construction, services, and mining
(NIOSH, 2016).
To help inform the rulemaking process, OSHA contracted with Abt
Associates to generate preliminary estimates of the number of
establishments and cases across all states at the ABLES reporting
levels of 5 [mu]g/dL, 10 [mu]g/dL, 25 [mu]g/dL, and the lead standards'
medical removal levels (50 [mu]g/dL for construction and 60 [mu]g/dL
for general industry). The first step was to identify industry sectors
associated with lead exposure by 4-digit NAICS that were identified in
a 2017 CDPH report (Payne, 2017), industries identified by OSHA in the
personal sampling data reported by the OSHA Information System (OIS)
(OSHA, 2020a), and industries with violations of lead exposure medical
surveillance requirements in the last 10 years of OSHA inspections and
violations (OSHA, 2020b; OSHA, 2020c). To estimate the number of
workers with BLLs at or above each ABLES reporting level and the OSHA
standards' medical removal levels by NAICS, BLL data from the ABLES
program and the CDPH Occupational Blood Lead Registry for the years
2012-2014 and 2015-2018 (Payne, 2017; CDPH, 2020a; CDPH, 2020b) were
pooled. Because ABLES data are limited to those states that report
testing results to ABLES, the next step was to use U.S. Census data to
extrapolate a preliminary estimate of the national number of cases from
the ABLES state data. The method and results are described in full in
the memorandum entitled Estimated Number of Work-Related BLL Cases and
Firms (Abt Associates, 2021). This memorandum includes a table that
provides the number of firms with preliminary BLL estimates at or above
the relevant levels (the ABLES reporting levels and the OSHA standards'
medical removal levels) and a table that provides the number of workers
with preliminary BLL estimates at or above the relevant levels; the
preliminary BLL estimates are presented by industry. In Appendix A at
the end of this ANPRM, Table 1 ``Summary of Annual Number of Firms
[[Page 38346]]
with BLL Tests and Cases'' presents the estimated number of firms where
employees received test results that were at or above each ABLES
reporting level and the OSHA standards' medical removal levels.
Of 44,144 firms where employee BLLs are tested, 8,611 firms were
estimated to have recorded BLLs equal to or above 5 [mu]g/dL, while
2,087, were estimated to have recorded BLLs at or above 25 [mu]g/dL;
only 137 firms were estimated to have baseline BLL cases annually
resulting in medical removal protection under OSHA's existing
requirements (BLLs greater than or equal to 50 and 60 [mu]g/dL for
construction and general industry, respectively).
This preliminary analysis shows that, among all affected employers,
approximately 44 percent of firms where employee BLL is tested are in
five industry groups: NAICS 7139: Other Amusement and Recreation
Industries (6,656 firms); NAICS 3272: Glass and Glass Product
Manufacturing (5,156 firms); NAICS 8111: Automotive Repair and
Maintenance (3,333 firms); NAICS 2383: Building Finishing Contractors
(2,746 firms); and NAICS 5629: Remediation and Other Waste Management
Services (1,663 firms). OSHA requests public input on the agency's
preliminary profile of affected industries, in particular the list of
affected NAICS industries and the estimated number of firms that have
workers with BLLs at or above the selected thresholds.
C. Health Effects of Lead Exposure
Exposure to lead is associated with adverse health effects,
including but not limited to effects on the reproductive,
cardiovascular, neurological, respiratory, and immune systems. As
highlighted by a National Research Council report (NRC, 2013), lead has
been shown to have both acute and chronic toxic effects, affecting
virtually every organ and system in the body (ATSDR, 2020). Since
OSHA's lead standard for general industry was promulgated, BLLs in the
general adult population have declined from an overall mean blood-lead
level of 15.8 [mu]g/dL (1976-1980) to 0.855 [mu]g/dL in 2018, primarily
reflecting the decrease in lead used in gasoline production, as well as
the removal of lead from consumer paint (CDC, 1982; HHS, 2022, p. 212;
ATSDR, 2020, p. 2). However, extensive research has emerged indicating
that adverse health effects can occur in adults with lower BLLs than
was previously recognized (ATSDR, 2020; ACGIH, 2013; CDPH, 2009 and
2013; EPA, 2013; NTP, 2012). For example, BLLs as low as 5 [mu]g/dL
have been associated with impaired kidney and reproductive function,
high blood pressure, and cognitive effects attributed to prenatal
exposure. Poorer performance on neurocognitive and neuropsychologic
assessments were observed in adults with BLLs as low as 5-19 [mu]g/dL
compared with adults with BLLs below 5 [mu]g/dL (Kosnett, 2007, pp.
464, 466; EPA, 2013, pp. 4-311--4-313, 2013; NTP, 2012, pp. 19-42).
While there is also evidence of adverse health effects in adults with
BLLs below 5 [mu]g/dL, those are not discussed in OSHA's literature
review (please see ATSDR, 2020). Table 1 provides an overview of the
adverse health effects associated with adult lead exposure, including
the effects of exposure on pregnant workers and their developing
fetuses, and longer-term effects on children/adolescents exposed in
utero to lead.
Table 1--Overview of Adverse Health Effects Associated With Exposure to
Lead in Adults
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Health Effect Descriptive Detail of Health Effect
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Reproductive and Developmental Reduced fertility, low sperm mobility,
\3\. increased risk of miscarriage.
Effects on developing fetus due to
lead exposure in utero--decreased
birth size, adverse effects on
developing brain, kidney, nervous
system, cognitive and learning
disabilities, decreased child growth,
delayed onset puberty.
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Vascular/Cardiovascular......... Hypertension...... Increased systolic
and/or diastolic
pressure, stroke,
heart disease.
Cerebrovascular... Stroke.
Cardiac/ Heart disease,
cardiovascular. atherosclerosis,
altered cardiac
conduction.
---------------------------------------
Hematological................... Heme synthesis (interference with iron
uptake), anemia, altered levels of
plasma erythropoietin.
Neurological.................... Reduced performance on neurocognitive
and neuropsychological tests,
peripheral neuropathy, psychiatric
symptoms (depression, panic
disorders, anxiety, hostility, anger,
schizophrenia) cognitive decrements,
lead intoxication, dementia, hearing
loss.
Renal........................... Nephrotoxicity (proximal tubular
nephropathy, glomerular sclerosis,
interstitial fibrosis, tubular
necrosis).
Respiratory..................... Decreased lung function, increased
bronchial hyperreactivity, increased
risk of asthma and obstructive lung
disease.
Endocrine (excluding Alteration of serum thyroid levels
reproductive). (T3, T4, TSH), decreased levels of
serum vitamin D.
Hepatic......................... Liver enlargement, increased gall
bladder wall thickness, increased
total cholesterol.
Musculoskeletal................. Bone loss, increased bone metabolism/
turnover, adverse periodontal and
dental effects.
Gastrointestinal................ Constipation, colic, abdominal cramps.
Body weight..................... Decreased body mass index (BMI) in
adolescents and adults.
Immunological................... Decreased complement, changes in
indicators of inflammation
(monocytes, macrophages, neutrophils)
and cell-mediated immunity (T cells,
natural killer cells).
Cancer.......................... Lung, stomach, kidney, and brain
cancer.
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Based on information contained in ATSDR, 2020.
[[Page 38347]]
1. Routes and Kinetics of Lead Exposure
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\3\ For more information on pregnancy and lead exposure please
see https://www.cdc.gov/nceh/lead/publications/leadandpregnancy2010.pdf.
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Lead exposures in adults above background or baseline levels are
typically associated with occupational exposures. Background or
baseline levels occur from incidental exposures through ambient air,
foods, drinking water, soil, and dust and result in an average BLL for
adults of 0.855 [mu]g/dL (geometric average) (ATSDR, 2020; HHS, 2022).
Occupational exposure to lead can occur through inhalation, oral, and/
or dermal routes (EPA, 2013, pp. 7-18; NAS, 2013, pp. 9, 15-17, 47).
The Agency for Toxic Substances and Disease Registry (ATSDR) has stated
that all the health effects discussed here can result from all three of
these routes of exposure (ATSDR, 2020).
Lead accumulates in the body with continued or chronic exposure
(ATSDR, 2020; AOEC, 2007; EPA, 2013; NTP, 2012; Shih, 2007). In adults,
90 percent of lead is stored in bone, with only 1 percent in blood
(EPA, 2013, pp. 4-324--4-326). Lead can be released from bone to blood
and other soft tissues over time. In particular, lead can be mobilized
from bone even after removal from occupational exposure; after use of
chelation therapy to reduce BLLs; during age-related bone loss,
especially menopause and osteoporosis; and during pregnancy and
lactation (EPA, 2013; NTP, 2012). Because lead is retained in the bones
and can be released into the bloodstream over time, it is difficult to
predict individuals' BLLs from their recent external exposures (NAS,
2013; ATSDR, 2020).
Multiple factors can influence the toxico- and pharmacokinetics of
lead in the body, including genetic polymorphisms, nutrition and diet,
smoking, gender, and age (NAS, 2013). California OEHHA developed a
pharmacokinetic model which indicated that when BLLs during the working
lifetime (characterized in the model as 40 hours per week over a 40-
year working life) are maintained below 20 [mu]g/dL, medical removal is
expected to result in a fairly rapid decline to a BLL of 15 [mu]g/dL,
which was selected as an acceptable BLL for the purposes of the model
(OEHHA, 2014, pp. 3-4). For example, the 95th percentile worker \4\
removed after forty years of exposure with a BLL of 20 [mu]g/dL would
be expected to decline to 15 [mu]g/dL within ten weeks. If BLLs are
allowed to reach the 50 [mu]g/dL currently allowed under OSHA
standards, the California OEHHA model estimates that medical removal
periods greater than 18 months would be generally necessary to reduce
BLLs to 15 [mu]g/dL, even among workers with only one year of
occupational exposure (OEHHA, 2014, pp. 3-4).
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\4\ The phrase `95th percentile worker' in this context means
that ninety five percent of the workers removed from lead exposure
after a 40-year work life of lead exposure resulting in a BLL of 20
[mu]g/dL would be expected to take 10 weeks for their BLLs to
decline 5 [mu]g/dL to 15 [mu]g/dL.
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Table 2 highlights some of the adverse health effects associated
with various BLLs. While these findings are based on clinical
assessments from comprehensive reviews, they do not necessarily
represent strict threshold values as certain health endpoints may
manifest at lower or higher levels in some individuals or groups.
Table 2--Overview of Health Effects Associated With Elevated BLL in
Adults
------------------------------------------------------------------------
BLL ([mu]g/dL) Health effects
------------------------------------------------------------------------
5-10.............................. Acute decrease in renal function.
Elevated blood pressure.
Altered heme synthesis.
Impaired neurocognitive and
neuropsychological assessment.
Developmental effects (e.g.,
decreased cognitive and reduced
birthweights)--fetuses exposed to
lead in utero through pregnant
worker lead exposure.
10-20............................. Spontaneous abortion (miscarriage).
Hypertension.
Decreased renal function.
Decreased platelet count.
Decreased blood hemoglobin.
20-40............................. Headache.
Fatigue.
Anemia.
Sleep disturbance.
Anorexia.
Bowel changes.
Arthralgia.
Myalgia.
Decreased libido.
Personality changes
40-60............................. Sperm effects (decreased number and
function).
Subclinical peripheral neuropathy.
Altered red blood cell function.
Renal damage.
Cognitive dysfunction.
60-80............................. Hemolytic anemia.
Renal failure.
Stroke.
Above 80.......................... Central Nervous System (CNS)
effects.
Nephropathy.
Gout.
Hearing loss.
Encephalopathy.
------------------------------------------------------------------------
Adapted from AOEC, 2007. For additional resources please also see: NTP
Monograph on Health Effects of Low-Level Lead, available at https://ntp.niehs.nih.gov/ntp/ohat/lead/final/monographhealtheffectslowlevellead_newissn_508.pdf.
[[Page 38348]]
2. Medical Surveillance and Management for Elevated Blood Lead
A comprehensive medical surveillance program can be an invaluable
tool in assessing the healthfulness of a workplace. Medical
surveillance incorporates a systematic assessment of employees' health
through medical monitoring and management practices (NIOSH, 2018). OSHA
included a medical surveillance provision in the 1978 lead standard in
part to mitigate some of the most detrimental effects of lead exposure
to workers. However, since OSHA promulgated the standard, much more has
become known regarding acute and chronic exposures (especially at low
levels) and susceptible populations.
Measurement and Management of Blood Lead Levels (BLLs)
OSHA, as well as a number of agencies and public health groups
state that the BLL is the best method available to monitor lead
exposure (1910.1025, Appendix C; ACOEM 2016, p. e372; AOEC 2007, p. 4;
CDPH 2009, p. 4; CSTE 2015, p. 2). OSHA and others have noted that BLL
is generally a good indicator of current or recent external lead
exposure; however, it is not necessarily correlated with total body
burden of lead or cumulative exposure (29 CFR 1910.1025, Appendix C;
AOEC 2016, pp. 4-7; CDPH 2009, p. 4; NAS 2013, pp. 48-56). This is
because, over time, a high percentage of lead is deposited in bone, and
after exposure ends, mobilization from bone occurs very slowly. As a
result, a high BLL may represent a high recent exposure without an
excess of total body burden, and a low BLL does not necessarily mean
that total body burden is low (29 CFR 1910.1025). For long-term, long-
latency, or cumulative exposures, lead body burden is generally
considered the most adequate method (NAS 2013, p. 64). Lead body burden
can be measured using x-ray fluorescence techniques but such methods
are currently not widely or readily available (ACOEM 2016, p. e372;
CSTE 2015, p. 2).
Medical management guidelines for adult lead exposure were
developed by a national expert panel coordinated by the Association of
Occupational and Environmental Clinics (AOEC 2007, pp. 5-9, 13), in
collaboration with the ABLES program. The authors recommend that
maintaining BLLs below 20 [mu]g/dL over a twenty-year period, or under
10 [mu]g/dL over a forty-year period, would be sufficient to prevent
chronic effects associated with adult lead exposure. They further
recommend maintaining BLLs below 20 [mu]g/dL in order to prevent
recognized acute health effects (Schwartz and Hu, 2007). ACOEM states
that the most compelling evidence for adverse health effects occurs at
moderate levels of blood lead ranging from 10 to 20 [mu]g/dL (ACOEM
2016, p. 1). In the context of general population screening, the CDC
recommends adult BLLs (persons >=16 years of age) from a venous blood
specimen of >=5 [mu]g/dL be considered for case classification for the
purposes of medical surveillance (CDC 2016, p. 260); ABLES uses 5
[mu]g/dL to indicate an elevated BLL for surveillance purposes (ABLES,
2021). NIOSH additionally provides a reference guide to BLL regulations
and recommendations (ABLES, 2021).
The following sections outline the current medical management and
monitoring practices required under OSHA's lead standards, in order to
contextualize OSHA's later questions regarding possible changes to
these requirements in Section II, Request for Input.
Methods for Monitoring Blood Lead Levels in OSHA's Standards
OSHA's lead standards do not specify a particular method for
analyzing BLL but require that the method of sampling and analysis used
is accurate to plus or minus 15 percent or 6 [mu]g/100 ml, whichever is
greater (to a 95 percent confidence level). The general industry
standard once required the analysis to be conducted by a laboratory
licensed by the CDC or which has received a satisfactory grade in blood
lead proficiency testing from the CDC within the previous 12 months
(per 29 CFR 1910.1025(j)(2)(iii)), but now allows testing to be
conducted in a CLIA compliant laboratory (OSHA, 2018).\5\ The
construction standard requires the analysis to be conducted by a
laboratory approved by OSHA (29 CFR 1926.62(j)(2)(iii)). The medical
surveillance guidelines in Appendix C of OSHA's lead standards indicate
that any method that meets the accuracy specified by the standards can
be used to analyze the blood sample.
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\5\ In a memorandum to OSHA Regional Administrators, the agency
specified that in lieu of approval by OSHA or CDC, the agency will
accept the use of a blood lead analysis laboratory that has been
approved under the U.S. Department of Health and Human Services
(HHS), Centers for Medicare and Medicaid Services (CMS), blood lead
laboratory monitoring system pursuant to the Clinical Laboratory
Improvement Amendments (CLIA) regulations, 42 CFR part 493 (OSHA
2018).
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OSHA's Requirements for Blood Lead and Zinc Protoporphyrin Testing,
Worker Notification of Blood Lead Levels, Medical Removal, and Return
to Work
The medical surveillance and medical removal protection provisions
in OSHA's lead standards contain BLL triggers for medical removal,
return to work status, and employee notification of blood test results.
The general industry standard requires employers to institute a medical
surveillance program for all employees who are or may be exposed at or
above the action level of 30 [mu]g/m\3\ for more than 30 days per year
(29 CFR 1910.1025(j)). Employers must make biological monitoring in the
form of blood lead testing and ZPP levels available to these employees
in accordance with the following schedule provided in 29 CFR
1910.1025(j)(2)(i):
At least every six months to each employee covered under
paragraph (j)(1)(i) of the standard;
At least every two months for each employee whose last
blood lead test indicated a BLL at or above 40 [mu]g/dL. This frequency
shall continue until two consecutive blood lead tests indicate a BLL
below 40 [mu]g/dL; and
At least monthly during the removal period of each
employee removed from exposure to lead due to an elevated BLL.
OSHA's lead standard for construction requires the employer to make
blood sampling and analysis for lead and ZPP levels available to
employees occupationally exposed on any day to lead at or above the
action level (29 CFR 1926.62 (j)(1)(i)). It further requires the
employer to institute a medical surveillance program for all employees
who are or may be exposed by the employer at or above the action level
for more than 30 days in any consecutive 12 months (29 CFR 1926.62
(j)(1)(ii)) and requires employers to provide blood lead testing to
employees in the medical surveillance program at least every two months
for the first six months, and every six months thereafter (29 CFR
(1926.62 (j)(2)(i)(A)). Furthermore, the employer is required to
provide blood lead testing at least every two months for employees
covered under (j)(1)(i) or (ii) whose last test indicated a BLL at or
above 40 [micro]g/dL, until two consecutive tests show the BLL has
declined below 40 [micro]g/dL. And, the standard requires the employer
to provide blood lead testing at least monthly during the removal
period of each employee removed from exposure to lead due to an
elevated BLL (29 CFR 1926.62(j)(2)(i)(C)).
[[Page 38349]]
OSHA's general industry standard requires the employer to notify
each employee whose BLL is at or above 40 [micro]g/dL within five
working days after the receipt of biological monitoring results. OSHA's
construction standard requires the employer to notify each employee in
writing of their BLL within five working days after the receipt of
biological monitoring results, regardless of the BLL detected.
The general industry standard requires an employer to remove an
employee from work involving exposure to lead at or above the action
level when two consecutive blood lead tests are at or above 60
[micro]g/dL; or when the average of the last three tests (or the
average of all tests conducted over the previous six months, whichever
period is longer) is at or above 50 [micro]g/dL, with the exception
that medical removal is not required if the last test indicates a BLL
below 40 [micro]g/dL. It also requires medical removal when a final
medical determination concludes that an employee has a medical
condition that places the employee at increased risk of material
impairment to health from exposure to lead (29 CFR 1910.1025(k)). The
construction standard requires an employer to remove an employee from
work involving exposure to lead at or above the action level when the
employee's BLL is at or above 50 [micro]g/dL for two consecutive tests
or a final medical determination concludes that the employee has a
medical condition that places the employee at increased risk of
material impairment to health from exposure to lead (29 CFR
1926.62(k)). Both standards specify that the employer shall return an
employee to the employee's former job status when two consecutive blood
sampling tests indicate that the BLL is below 40 [micro]g/dL (29 CFR
1910.1025(k)(1)(iii)(A)(1); 29 CFR 1926.62(k)(1)(iii)(A)(1)).
Zinc Protoporphyrin (ZPP) Testing
Along with BLLs, ZPP testing is required by OSHA's lead standards
as part of its medical surveillance and management plan (29 CFR
1910.1025(j)(2); 29 CFR 1926.62(j)(2)). ZPP is a metabolite found in
erythrocytes during hemoglobin synthesis. The zinc in ZPP replaces iron
in hemoglobin synthesis during times of iron deficiency. Elevated lead
levels in the blood interfere with iron ion transfer, creating a
condition similar to iron deficiency, thus elevating zinc in the
production of hemoglobin and ZPP.
The clinical utility of ZPP testing to identify elevated BLL is now
understood to be limited by several factors:
Low sensitivity: ZPP is generally not elevated until BLLs
exceed 25 [micro]g/dL (Kosnett et al 2007, p. 468). Thus, workers may
reach harmful BLLs well before the ZPP level registers as abnormal.
Low specificity: ZPP is not specific to lead. In other
words, elevated levels of ZPP can be caused by conditions other than
blood lead, such as iron deficiency anemia, jaundice, and sickle cell
anemia (ATSDR 2020, p. 336). Thus, an elevated ZPP does not always mean
that a worker has an elevated BLL.
Lag time: ZPP levels generally lag behind BLLs by two to
six weeks (CDPH 2009, p. 4). Thus, a worker may have an elevated BLL
while the ZPP level is still within normal range. The reverse is also
true; a worker's BLL may begin to decline, while the lagging ZPP level
remains elevated (Martin 2004, pp. 589-590). This delay limits the
utility of ZPP as a screening or biomonitoring tool.
High individual variability: Individuals with the same BLL
can have widely differing ZPP levels (Martin 2004, pp. 588-590). This
may be due to differences in individual susceptibility to lead
(Grandjean 1991, pp. 111-112) or other factors. However, such
variations can complicate interpretation of test results.
Both AOEC and CDPH recommend against routine clinical use of ZPP--
unless legally required--for monitoring lead-exposed patients (AOEC,
2007; CDPH 2009, p. 4). Similarly, ATSDR notes that ``ZPP is not
sufficiently sensitive at lower BLLs and therefore is not as useful a
screening test for lead exposure as previously thought'' (ATSDR 2007,
pp. 232-233). OSHA's enforcement policy currently allows employers to
use methods other than the ZPP test for determining lead toxicity. See
www.osha.gov/laws-regs/standardinterpretations/1996-03-04-1. Due to
these issues, OSHA is requesting input on whether to eliminate the
requirement for ZPP monitoring (see Section II, Request for Input).
II. Request for Input
This ANPRM seeks input on the following areas: OSHA's triggers for
medical removal of workers with elevated BLLs and their return to lead-
exposed work; OSHA's requirements for medical surveillance and
management of lead-exposed employees; several additional provisions and
compliance protocols that are undergoing public review in State Plans'
ongoing work to update their occupational lead standards; and the costs
and effectiveness of lead exposure identification and control
strategies. This Request for Input section includes a series of
questions on the OSHA standards' requirements and possible revisions to
them, followed by a series of questions on employers' requirements,
which may in some cases be more protective than OSHA standards. While
the questions pertaining to current requirements are primarily
addressed to employers, OSHA will review and consider all information
submitted in response to these questions.
This section includes questions about several provisions of OSHA's
lead standards that are addressed in recent or proposed changes to
State Plan lead standards in Michigan, Washington State, and
California. As previously discussed, in January 2019 MIOSHA revised its
lead standards for general industry and construction, changing the BLL
at which an employee is required to be removed from lead exposure and
the BLL at which an employee may be returned to lead exposure. Cal/OSHA
has held advisory meetings to discuss a variety of potential changes to
its lead standards and has published a draft of possible amendments to
the existing regulations in general industry and construction
operations. 6 7 Washington DOSH is also developing a variety
of updates to DOSH's occupational lead standards.\8\ For several lead
standard provisions that State Plans have made or proposed changes to,
this section describes the changes in the relevant State Plan(s) and
requests input on whether similar revisions to federal lead standards
should be considered. The State Plan changes and proposals include
revisions to state blood lead triggers for medical removal protection
and return to work; permissible exposure limits; and several ``safe
harbor'' protocols that employers in certain industries, or who meet
specified requirements, may opt to use as alternatives to complying
with the main rule.
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\6\ California's most recent discussion draft and other
materials related to the advisory meetings are available at https://www.dir.ca.gov/dosh/DoshReg/5198Meetings.htm.
\7\ The California Department of Public Health (CDPH)
Occupational Lead Poisoning Prevention Program (OLPPP) made
recommendations to Cal/OSHA for revising its General Industry Lead
Standard and Construction Industry lead standards for the protection
of workers who are exposed to lead on the job, available at https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/OLPPP/Pages/LeadStdRecs.aspx.
\8\ Washington DOSH's stakeholder review draft (2019) and other
information related to its stakeholder meetings on the lead rule
revision process are available at https://lni.wa.gov/safety-health/safety-rules/rulemaking-stakeholder-information/sh-rules-stakeholder-lead.
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Several questions in this section also relate to recommendations
made by the
[[Page 38350]]
Association of Occupational and Environmental Clinics (AOEC, 2007) and
ACOEM (2016, pp. e371-e372) for updates to OSHA's Lead standards.
ACOEM's recommendations refer to ``significant lead exposure'', defined
as an airborne or surface lead content known or reasonably anticipated
to cause elevated BLL (ACOEM 2016, p. e372, Table 1); and refer to a
``lead-exposed worker'', defined as ``any worker who is handling or
disturbing materials with a significant lead content in a manner that
could reasonably be expected to cause potentially harmful exposure
through lead dust inhalation or ingestion, regardless of airborne lead
concentrations or surface contamination levels'' (ACOEM 2016, p. e372).
OSHA notes that this ANPRM focuses primarily on medical
surveillance/medical removal protection and on state-based innovations.
Therefore, it does not request input on every provision OSHA might seek
to modernize or otherwise revise in its lead standards through a Notice
of Proposed Rulemaking (NPRM) in the future.
When answering the numbered questions below, please label your
responses with the number of the question, explain the reasons
supporting your views, and identify and provide relevant information on
which you rely, including, but not limited to, data, studies, and
articles.
A. Blood Lead Triggers for Medical Removal Protection
1. Requirements for Medical Removal
OSHA's general industry standard for lead requires an employer to
remove an employee from work involving exposure to lead at or above the
action level (30 [micro]g/m\3\) when two consecutive blood lead tests
are at or above 60 [micro]g/dL or when the average of the last three
tests is at or above 50 [micro]g/dL. OSHA's construction standard
requires an employer to remove an employee from work involving exposure
to lead at or above the AL when the employee's BLL is at or above 50
[micro]g/dL for two consecutive tests. (See Section I.C, Health Effects
of Lead Exposure, for a full description of OSHA's blood lead
requirements for Medical Removal Protection (MRP)).
ACOEM has recommended medical removal of workers who have repeat
BLLs over 20 [micro]g/dL (measured in four weeks), or if any single BLL
exceeds 30 [micro]g/dL (ACOEM 2016, p. e372, Table 1). MIOSHA's 2019
update to Michigan's occupational lead standard changed the BLL at
which an employee in general industry or construction is to be removed
from lead exposure, previously 50 [micro]g/dL, to 30 [micro]g/dL for
both standards. Cal/OSHA's discussion draft includes a medical removal
BLL of >= 30 [micro]g/dL; when the last two monthly blood lead tests
are >= 20 [micro]g/dL; or when the average of the results of all blood
lead tests conducted in the last six months is at or above 20 [micro]g/
dL of whole blood. Washington DOSH's stakeholder review draft would
lower its medical removal BLL to >= 30 [micro]g/dL for a single test
result and >= 20 [micro]g/dL for multi-test results for both general
industry and construction lead standards. After commissioning the
National Research Council (NRC) to conduct a study to determine whether
current OSHA exposure standards used on firing ranges are protective
(NRC, 2013), DOD lowered the medical removal triggers for BLLs in
military and civilian DOD personnel, which previously were aligned with
OSHA's standards. DOD's medical removal is now based on BLLs at or
greater than 20 [micro]g/dL (DOD, 2018, p. 55; Table C4.T2, pp. 57-
61)).
(1) Should OSHA consider changing the BLL at which an employee in
general industry or construction is to be removed from lead exposure to
match any of the approaches described above? Is there a different BLL
trigger for removing a worker from lead-exposed work that you would
suggest? Please explain your answer and provide supporting information
or data, if available.
2. Requirements for Return to Lead-Exposed Work
OSHA's lead standards for general industry and construction both
specify that the employer shall return an employee to their former job
when two consecutive blood-sampling tests indicate that the BLL is
below 40 [micro]g/dL.
ACOEM has recommended that return to lead-exposed work should be
considered after two BLLs are below 15 [micro]g/dL (ACOEM 2016, p.
e372, Table 1). MIOSHA changed the BLL at which an employee may return
to lead exposure from below 40 [micro]g/dL to below 15 [micro]g/dL in
both general industry and construction. Cal/OSHA's discussion draft
would provide that a removed worker may return to former job status
when two consecutive blood lead tests are below 15 [micro]g/dL.
Washington DOSH's stakeholder review draft similarly includes a return-
to-work BLL of below 15 [micro]g/dL for both general industry and
construction lead standards. DOD's updated policy provides for employee
return to work when BLL is at or below 15 [micro]g/dL (DOD, 2018, p.
55; Table C4.T2, pp. 57-61)).
(2) Should OSHA consider changing the BLL below which an employee
shall be returned to lead exposure to 15 [micro]g/dL? Is there a
different BLL trigger for returning a worker to lead-exposed work
following medical removal that you would suggest? Please explain your
answer and provide supporting information or data, if available.
B. Medical Surveillance Provisions
1. Medical Examination and Consultation Requirements
OSHA's lead standards require employers to make a full medical
examination and consultation available to an employee: (1) before the
first assignment to an area that has lead at or above the action level;
(2) at least once a year for an employee who had a BLL of 40 [micro]g/
dL or over at any time during the preceding 12 months; and (3) as soon
as possible on notification by an employee that they have developed
signs or symptoms of lead intoxication, desire medical advice
concerning the effects of lead (past or current) and the ability to
procreate a healthy child, or who has difficulty in breathing during
respirator fit test or use. In addition, an examination must be made
available as medically appropriate for each employee either removed
from exposure to lead due to a risk of sustaining material impairment
to health, or whose lead exposure is otherwise limited based on a final
medical determination.
For the purposes of the lead standard, a full medical examination
includes: (1) a detailed work and medical history; (2) a thorough
physical examination; (3) measurement of blood pressure; (4) analysis
of BLL, hemoglobin and hematocrit, erythrocyte indexes, peripheral
smear morphology, zinc protoporphyrin (ZPP), blood urea nitrogen and
creatinine, and urinalysis with microscopic examination; and (5) any
other tests that a physician thinks are appropriate, including a
pregnancy test or laboratory evaluation of male fertility if requested
by the employee.
(3) Are these still appropriate tests or should a full medical
examination include any other tests? OSHA is also requesting comment on
the appropriateness of including the ZPP given its limitations (see
also Section #6, ``ZPP'', below).
2. Triggers for Routine Blood Lead Monitoring
OSHA's lead standards require the employer to institute a medical
surveillance program, including blood lead testing prior to lead
exposure and at regular intervals thereafter, for employees who are or
may be exposed
[[Page 38351]]
to airborne lead at or above 30 [micro]g/m\3\ for more than 30 days per
year.
Airborne Lead Exposure Trigger for Blood Lead Monitoring
The Washington DOSH stakeholder review draft would require
employers to provide ongoing blood lead monitoring for employees
exposed to lead for more than 10 days per year, including any day with
airborne exposure totaling 10 [micro]g/m\3\ as an 8-hour TWA or greater
or any day with a task lasting 30 minutes or more that involves
exposure above 20 [micro]g/m\3\. Cal/OSHA's discussion draft would
require employers to institute a medical surveillance program,
including blood lead testing, for employees who are or may be exposed
at or above a revised action level of 2 [micro]g/m\3\ for 10 or more
days per year.
(4) Should OSHA consider expanding its criteria for blood lead
monitoring to resemble the ongoing blood lead monitoring criteria that
Washington DOSH and/or Cal/OSHA is considering? Are there different
criteria you would suggest? Please explain your answers.
Additional Triggers
In OSHA's lead standards, worker eligibility for blood lead
monitoring is based solely on airborne lead exposure criteria. In
contrast, the Washington DOSH stakeholder review draft would require
employers to provide ongoing blood lead monitoring for employees
exposed at or above any action level for more than 10 days per year,
including any day involving a combined total of at least one hour of:
(1) activity disturbing or touching metals containing 20 percent or
more lead (by weight); (2) activity disturbing non-metals containing
0.5 percent or more lead by weight; (3) creating aerosols or fumes from
materials containing 0.1 percent or more lead by weight; or (4) work in
areas with surfaces at a ``Surface Action Level'' of 1000 [micro]g/
dm\2\ (equivalent to 9290 [micro]g/ft\2\).\9\
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\9\ See Surface Sampling and Material Content Requirements below
for percentage and contamination specifications. The Washington DOSH
Stakeholder Review Draft states that ``work is timed from beginning
the contact or disturbance activity to the time when the worker
accesses washing facilities where personal protective equipment can
be doffed properly and the worker can thoroughly wash off lead
contamination.''
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Cal/OSHA's discussion draft includes a requirement that employers
must institute a medical surveillance program, including blood lead
testing, for employees who perform a ``trigger amount of lead work'',
defined as altering or disturbing material that is known or reasonably
anticipated to contain at least 0.5 percent lead by weight, or torch
cutting any scrap metal, for a combined total of at least 8 hours
during any 30-day period.
In addition, ACOEM has recommended that BLL be measured routinely
for all lead workers, where a ``lead-exposed worker'' is defined as
``any worker who is handling or disturbing materials with a significant
lead content in a manner that could reasonably be expected to cause
potentially harmful exposure through lead dust inhalation or ingestion,
regardless of airborne lead concentrations or surface contamination
levels'' (ACOEM 2016, p. e372).
(5) Should OSHA consider adding criteria other than airborne lead
exposure to its requirements for blood lead testing, such as contact
with lead-contaminated surfaces, disturbance of lead-containing
materials or direct contact with high-percentage lead materials? In
particular, should OSHA consider adopting criteria based on contact
with lead-contaminated surfaces, disturbance of lead-containing
materials, or contact high lead-content metals, as Washington DOSH's
stakeholder review draft and Cal/OSHA's discussion draft contemplate?
Please explain your answer.
3. Frequency of Blood Lead Monitoring
OSHA's lead standard for general industry requires employers to
provide blood lead testing to employees in the medical surveillance
program at least every six months, with the following exceptions: (1)
every two months if a previous BLL was at or above 40 [micro]g/dL of
whole blood, until two consecutive results are below 40 [micro]g/dL and
(2) at least monthly during the removal period of each employee removed
from exposure to lead due to an elevated BLL.
For those employees who are in the medical surveillance program
because they are or may be exposed to airborne lead at or above the
action level (30 [micro]g/m\3\) for more than 30 days in any
consecutive 12 months, OSHA's lead standard for construction requires
the employer to provide blood lead testing at least every two months
for the first six months, and every six months thereafter. In addition,
for employees who were exposed on any day to lead at or above the
action level, and for employees who have been exposed to lead at or
above the action level for more than 30 days in a 12 month period and
whose last blood sample indicated a BLL at or above 40 ug/dL, the
standard requires blood testing at least every two months until two
consecutive results indicate a BLL below 40 [micro]g/dL. The standard
also requires the employer to provide blood lead testing at least
monthly during the removal period of each employee removed from
exposure to lead due to an elevated BLL. (See Section I.C, Health
Effects of Lead Exposure, for a full description of OSHA's blood lead
requirements for MRP).
ACOEM has recommended that lead workers' BLLs be measured every two
months for the first six months of placement, or upon change to tasks
resulting in higher exposure, and that BLLs should be measured every
six months thereafter (ACOEM 2016, p. e372, Table 1). In addition,
ACOEM has recommended BLL measurement every two months for workers with
results between 10 and 19 [micro]g/dL and monthly measurement for
workers with results of at least 20 [micro]g/dL.\10\
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\10\ ACOEM's recommendations refer to ``significant lead
exposure'', defined as an airborne or surface lead content known or
reasonably anticipated to cause elevated BLL (ACOEM 2016, p. e372,
Table 1); and refer to a ``lead-exposed worker'', defined as ``any
worker who is handling or disturbing materials with a significant
lead content in a manner that could reasonably be expected to cause
potentially harmful exposure through lead dust inhalation or
ingestion, regardless of airborne lead concentrations or surface
contamination levels'' (ACOEM 2016, p. e372).
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The Washington DOSH stakeholder review draft and Cal/OSHA's
discussion draft would require that blood lead testing be made
available every two months for a worker's first six months of testing,
and every six months after that. In addition, testing would be made
available at least every two months if a worker's BLL is greater than
10 [micro]g/dL.
The Washington DOSH stakeholder review draft would require testing
to be offered monthly if an employee has been medically removed, until
two consecutive tests show the worker's BLL has decreased to below the
proposed return-to-work level.\11\ Cal/OSHA's discussion draft
stipulates testing at least monthly for each employee whose last BLL
was at or above 20 [micro]g/dL of whole blood, and during the removal
period of each employee removed from exposure to lead due to an
elevated BLL.
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\11\ The proposed return-to-work level is 15 [micro]g/dL in
Washington and 10 [micro]g/dL in California.
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(6) Should OSHA consider revising the required frequency and the
BLLs related to the schedule of blood lead testing? Would requirements
similar to those included in Washington DOSH and Cal/OSHA's drafts be
appropriate? If not, what would be an appropriate frequency for blood
lead testing? Please explain your answer.
4. Analytical Methods for BLL Testing
As discussed previously in Section I.C.2, Medical Surveillance and
Management for Elevated Blood Lead, OSHA standards do not specify a
[[Page 38352]]
particular method for analyzing BLL but require that the method of
sampling and analysis used is accurate to plus or minus 15 percent or 6
[micro]g/100 ml, whichever is greater (to a 95 percent confidence
level). In a memorandum to OSHA Regional Administrators, the agency
specified that in lieu of approval by OSHA or CDC, the agency will
accept the use of a blood lead analysis laboratory that has been
approved under the U.S. Department of Health and Human Services (HHS),
Centers for Medicare and Medicaid Services (CMS), blood lead laboratory
monitoring system pursuant to the Clinical Laboratory Improvement
Amendments (CLIA) regulations, 42 CFR part 493 (OSHA 2018). All blood
lead analysis performed in a CLIA-compliant lab must meet the
Proficiency Testing requirement of 4 [micro]g/dL or 10%,
whichever is greater.
(7) Should OSHA consider revising its standard to require the use
of a blood lead analysis laboratory that has been approved under the
CMS blood lead laboratory monitoring system pursuant to the CLIA
regulations, consistent with OSHA's 2018 memorandum? Please explain
your answer.
(8) Are there methods other than collecting a venous sample that
would meet the accuracy requirements of the lead standard? Please
describe the advantages and limitations of such methods.
(9) Are portable direct reading instruments for measuring BLL
available that meet the accuracy requirements of the OSHA lead
standards and would be considered equivalent to an analysis conducted
by a laboratory approved by OSHA or CDC?
(10) Do you use or have knowledge of other measures of lead in the
body? Please describe and explain whether and how they could be used
effectively for medical monitoring of workers exposed to lead and the
relative costs of those measures (i.e., cost-effectiveness).
5. Employee Notification of BLL Results
OSHA's general industry standard requires the employer to notify
each employee whose BLL is at or above 40 [micro]g/dL within five
working days after the receipt of biological monitoring results. OSHA's
construction standard requires the employer to notify each employee in
writing of their BLL within five working days after the receipt of
biological monitoring results, regardless of the BLL detected.
The Washington DOSH stakeholder review draft and Cal/OSHA's
discussion draft include a requirement that employers must make sure
workers receive all blood testing results, regardless of level, within
five days of receiving them from the medical providers.
(11) Should OSHA revise its general industry standard to require
employers to notify all employees who receive blood lead testing of
their results, similar to the requirements of its construction standard
and requirements under consideration by Washington DOSH and Cal/OSHA?
If not, what criteria should be used to determine which employees
should be notified of their results? Please explain your answer.
6. ZPP
ACOEM's Position Statement (2016) advised OSHA that ZPP testing is
insufficiently sensitive as a measure of lead exposure when BLLs are
below 25 mg/dL and is no longer needed since BLL testing is superior
and readily available (ACOEM 2016, p. e372). In January 2019, MIOSHA
removed a previous requirement to analyze for the zinc protoporphyrin
level. Washington DOSH's stakeholder review draft and Cal/OSHA's
discussion draft also would eliminate ZPP testing requirements.
(12) Should OSHA remove the requirement for ZPP testing currently
included in its lead standards? Please explain your recommendation to
continue or discontinue ZPP testing as part of medical surveillance for
lead-exposed workers.
7. Provisions for Worker Privacy
Under the medical surveillance provisions of OSHA's lead standards,
employers are provided with the results of an individual employee's BLL
measurements, in addition to the physician's opinion as to whether the
employee has any detected medical condition that would place the
employee at increased risk from lead exposure; recommended special
protective measures or lead exposure limitations; and any recommended
limitation upon the employee's use of respirators. Physicians are
prohibited from revealing to the employer any findings, including
laboratory results, or diagnoses unrelated to an employee's
occupational exposure to lead.
More recent OSHA standards include measures to enhance employee
privacy and encourage employees to participate in medical surveillance
by minimizing fears about retaliation or discrimination based on
medical findings. In OSHA's beryllium standard, for example, the
information provided to the employer may not contain the results of
medical exams performed. The physician may, if authorized by the
employee in writing, inform the employer of any recommendations for
limitations on exposure to beryllium and for further testing at another
facility and/or continued medical surveillance.
(13) Should OSHA update the lead standards' employee privacy
protections, including restriction of employer access to an individual
employee's BLL measurements? Please explain your recommendation.
C. Permissible Exposure Limit (PEL)
For workers exposed to lead above the PEL of 50 [micro]g/m\3\ for
more than 30 days per year, OSHA's general industry lead standard
requires employers to implement engineering and work practice controls
(including administrative controls) to maintain exposures at or below
the PEL. For workers exposed to lead above the PEL for 30 days or less
per year, the standard requires employers to implement engineering
controls to reduce exposures to lead to 200 [micro]g/m\3\ and then
allows the use of any combination of controls (engineering, work
practice, respiratory controls) to maintain exposures at or below 50
[micro]g/m\3\.
California and Washington State's drafts include revisions to their
permissible exposure limits. Cal/OSHA's discussion draft includes a
reduction in the PEL from 50 [micro]g/m\3\ to 10 [micro]g/m\3\ and the
action level from 30 [micro]g/m\3\ to 2 [micro]g/m\3\.\12\ The
Washington DOSH stakeholder review draft includes a reduction in the
PEL from 50 [micro]g/m\3\ to 20 [micro]g/m\3\.
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\12\ CDPH contracted with Cal/EPA to evaluate the relationship
between occupational airborne lead exposure and BLLs. Using health-
based biokinetic modeling, Cal/EPA found that workplace air lead
levels should be limited to an 8-hour time-weighted average (TWA) of
2.1 [micro]g/m\3\ in order to prevent BLLs exceeding 10 [micro]g/dL
in at least 95% of workers with regular and long-term exposure. See
CDPH 2013 for further details. CDPH's PEL recommendation can be
viewed at: https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/OLPPP/CDPH%20Document%20Library/LeadStdPELRec.pdf.
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(14) Should OSHA consider reducing its PEL of 50 [micro]g/m\3\ for
occupational lead exposure or its action level of 30 [micro]g/m\3\? At
what level do you believe the PEL should be set to reduce the harmful
effects of lead exposure in exposed workers? Do you think this level
would be technologically and economically feasible for affected
industries (see OSH Act Sec. 6(b)(5), 29 U.S.C. 655(b)(5))? Please
explain your answer and, if available, provide data pertinent to the
benefits, feasibility, and expected increase in costs of revising the
federal PEL or action level for airborne lead. (Please note that OSHA
requests detailed information on costs of already-existing requirements
and voluntary
[[Page 38353]]
practices in a series of provision-specific questions in Section H,
Questions for Employers on Current Practices).
(15) Cal/OSHA's discussion draft includes a Separate Engineering
Control Airborne Limit (SECAL) for selected processes in lead acid
battery manufacturing.\13\ Should OSHA consider implementing a SECAL
for occupational lead exposure for specific processes if industry-wide
compliance with a proposed revision to the PEL is demonstrably
infeasible for specific processes?
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\13\ Specifically, the Cal/OSHA Discussion Draft's SECAL for
oxide production, paste mixing, grid pasting and parting, and
battery assembly would require employers to comply with a 50
[micro]g/m\3\ exposure limit at the effective date, then with a
limit of 40 [micro]g/m\3\ at five years from the effective date. The
Cal/OSHA Discussion Draft SECAL for grid production and small parts
casting, and plate formation would require employers to comply with
an exposure limit of 50 [micro]g/m\3\ at the effective date, then
with a limit of 30 [micro]g/m\3\ at five years from the effective
date.
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(16) Should OSHA consider removing the provision of OSHA's general
industry lead standard that allows employers to use respiratory
protection to comply with the PEL for workers exposed to lead above the
PEL for 30 days or less per year? Please explain your answer and, if
applicable, your recommendation on how employers should be required to
limit exposures of workers exposed above the PEL for 30 days or less
per year.
D. Personal Protective Equipment (PPE), Hygiene, and Training
(17) The Washington DOSH stakeholder review draft would require
employers to provide and ensure the use of impermeable PPE when
employees are working with lead compounds that may be absorbed through
the skin for any work covered by the scope of the rule. Should OSHA
consider a similar requirement for its lead standards? Please explain
your answer and any evidence available on the feasibility and cost of
this requirement if adopted by OSHA.
(18) The Washington DOSH stakeholder review draft would require
employers to prohibit workers covered by the scope of the rule from
cleaning or laundering protective clothing or equipment at home. Should
OSHA consider a similar requirement for its lead standards? Please
explain your answer and any evidence available on the feasibility and
cost of this requirement if adopted by OSHA.
(19) The Washington DOSH stakeholder review draft includes
requirements that employees be provided with hygiene facilities and PPE
when any of the following criteria are met:
1. Employees work in areas with surfaces at a ``Surface Action
Level'' of 1000 [micro]g/dm\2\ (equivalent to 9290 [micro]g/ft\2\);
\14\
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\14\ The Washington DOSH stakeholder review draft defines
surface contamination as ``free lead in dust or residues on a
surface that can be transferred to other surfaces on contact'' and
specifies that single sample testing is sufficient for determining
whether surfaces are contaminated.
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2. Employees disturb or touch metals with a ``Metals Action Level''
of 20 percent or more lead content by weight;
3. Employees disturb any materials with a ``Non-metal Action
Level'' of 0.5 percent or more lead content by weight (5000 ppm); or
4. Employees welding, burning, or grinding, or otherwise creating
aerosols or fumes from materials with a ``Burning/Grinding/Blasting
Action Level'' of 0.1 percent or more lead content by weight (1000
ppm).
Material content criteria (items #2 through 4) are applied during
any activity that could release lead or lead compounds from the
material in a form that could be inhaled, ingested, or absorbed through
the skin. The metals action level (item #2) also applies when workers
directly contact the metal with skin, personal protective equipment, or
clothing.
Should OSHA add hygiene and PPE provisions similar to any or all of
those described above, which are being considered for adoption by
Washington DOSH? Please explain your answer and, if available, provide
information on the feasibility and cost of these requirements if
adopted by OSHA.
(20) Are there issues or concerns related to surface contamination
or material content criteria for hygiene and PPE requirements that OSHA
should consider?
OSHA's lead standards require employers to provide PPE in a clean
and dry condition daily to employees whose exposure levels (without
regard to respirator use) are over 200 [micro]g/m\3\ of lead as an 8-
hour TWA, and weekly for other lead-exposed employees. Cal/OSHA's
discussion draft would require the employer to provide PPE in a clean
and dry condition daily to employees whose exposure levels (without
regard to respirator use) exceed 30 [micro]g/m\3\ of lead as an 8-hour
TWA. It would maintain the requirement to provide required PPE at least
weekly for all other lead workers exposed above the proposed PEL (10
[micro]g/m\3\). Washington DOSH's stakeholder review draft would
require the employer to replace or launder PPE at least daily for
employees whose exposure levels exceed 50 [micro]g/m\3\ of lead as an
8-hour TWA. In addition, it would require the employer to repair,
replace, or launder protective clothing at least weekly, and when
visibly contaminated or damaged, for employees whose exposure levels
exceed 20 [micro]g/m\3\ of lead as an 8-hour TWA.
(21) Should OSHA consider revising the requirements for employers
to provide clean or new PPE to workers? Please provide specific
recommendations for frequency and exposure triggers, and please explain
your answers.
(22) Washington DOSH's stakeholder review draft would require that
the training provided to all lead-exposed workers include information
on special precautions for pregnant workers. Should OSHA consider
including a similar requirement to include material on precautions for
pregnant workers in the training provisions of its lead standards?
E. Safe Harbor Compliance Protocols
The Washington DOSH stakeholder review draft includes several safe
harbor protocols which provide employers alternative methods of
compliance, including some provisions that would relax requirements for
exposure monitoring and for use of engineering and work practice
controls to meet the proposed PEL. Employers following a safe harbor
compliance protocol completely would be considered in compliance with
the lead rule for tasks covered and would not be cited for departing
from the main body of requirements of the lead rule for those tasks.
However, if an employer does not follow the provided safe harbor
protocol properly, the criteria and requirements of the main body of
the Washington DOSH rule would be used to assess compliance. The
Washington DOSH stakeholder review draft includes protocols that could
potentially be used by an employer in any industry, including the Well
Managed Blood Lead Levels Safe Harbor Protocol and the Clean Areas Safe
Harbor Protocol described below, as well as industry- or task-specific
protocols, including the Safe Harbor Protocol for Handling Lead-
Containing Articles in Retail Settings, the Safe Harbor Protocol for
Office and Residential Settings, and the Safe Harbor Protocol for
Incidental Lead Paint in Construction/Renovation, Repair, and Painting
(RRP) Work described below.
1. Well Managed Blood Lead Levels Safe Harbor Protocol
The Washington DOSH stakeholder review draft describes a protocol
that
[[Page 38354]]
provides an employer greater flexibility than would otherwise be
required for implementing PPE, work practices, and other lead exposure
controls, where the employer demonstrates that their program
effectively controls employee BLLs. The compliance protocol would
provide a safe harbor for employers who voluntarily submit worksite
blood lead records demonstrating that employee BLLs are effectively
managed. To demonstrate effective control of employee BLLs, the
employer would be required to conduct blood lead testing for all
workers at the facility with known or potential exposure to lead;
provide ongoing documentation of effective blood level management to
Washington DOSH; and, upon request, communicate with Washington DOSH if
questions or concerns arise from review of the documentation provided.
Employers following this protocol would not be subject to scheduled
inspections for lead related issues, and the requirements associated
with a new PEL of 20 [micro]g/m\3\ (8-hour TWA) would not be enforced
where airborne exposures are below the proposed Secondary Permissible
Exposure Limit (SPEL) of 50 [micro]g/m\3\ (8-hour TWA).\15\
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\15\ Under this protocol, the following medical surveillance
provisions would apply: workers with BLLs found above 20 [micro]g/dL
would be tested monthly until their BLL is below 15 [micro]g/dL for
two monthly tests; workers would be eligible for the medical removal
requirements included in the rule; and workers with a BLL greater
than 10 [micro]g/dL for more than 4 months must have their case
reviewed by a physician.
---------------------------------------------------------------------------
In the Washington DOSH stakeholder review draft, effective
management of BLLs is indicated by: blood lead testing for all workers
at the facility with exposure to lead covered by the rule, including
baseline tests for all exposed workers, annual tests for all exposed or
potentially exposed workers, and more frequent tests for all workers
meeting the requirements for periodic testing in the Washington DOSH
lead rule; and a record of well managed BLLs, meaning that: (1) the
average BLLs for workers exposed above 20 [micro]g/m\3\ is below 10
[micro]g/dL and the BLLs for each worker in the group is kept below 20
[micro]g/dL; and (2) BLLs for the group of all other workers (those
exposed below 20 [micro]g/m\3\) are kept below 10 [micro]g/dL.\16\
---------------------------------------------------------------------------
\16\ Under the Washington DOSH stakeholder review draft,
infrequent elevated BLLs above 20 [micro]g/dL would not disqualify
an employer when: (1) the elevated BLL is documented as a baseline
level prior to work with the company at this facility or any other
facility operated by the employer, or (2) the employer documents the
exposure incident responsible for the elevated BLL and takes
corrective action to effectively prevent further exposures.
---------------------------------------------------------------------------
To qualify for this safe harbor, the employer would be required to
submit documentation annually for each establishment for which the safe
harbor will be claimed.\17\ The required documentation includes the
employer's lead control programs for the establishment; the employer's
assessments of lead exposures for the establishment; names of all
workers onsite during the previous two years (including workers of
other employers); for each worker, whether they are known to have had
exposures at any action level, at the PEL or at the SPEL; the record of
all blood lead testing for the establishment for the past two years (or
new testing only when resubmitting annually); and a report detailing
actions taken in response to increased lead exposure or elevated blood
BLLs found during the previous year.
---------------------------------------------------------------------------
\17\ Under the Washington DOSH stakeholder review draft,
documentation would be submitted annually to maintain coverage by
the safe harbor, using forms and formats supplied by the DOSH. The
employer would need to be responsive to questions from the
department regarding the submitted documentation and must allow for
onsite auditing of the submission by DOSH. If DOSH reviews the
documentation and does not agree that it shows that the
establishment qualifies for this safe harbor, the department would
notify the employer in writing, including a description of how the
documentation fails to qualify. If information in the submission
appears to constitute a violation of a Washington Industrial Safety
and Health Act (WISHA) rule, the employer would be informed and
asked to provide proof of abatement for serious violations.
---------------------------------------------------------------------------
(23) Should OSHA consider a safe harbor protocol approach similar
to the Well Managed Blood Lead Levels protocol described above, which
is being considered for adoption in Washington State? What aspects of
the protocol would be beneficial? Are there issues, concerns, or
different approaches to a ``safe harbor'' based on well-managed BLLs
that OSHA should consider?
2. Clean Areas Safe Harbor Protocol
The Washington DOSH stakeholder review draft describes a protocol
that would relieve employers from implementing the requirements of the
lead rule for workers in clean areas who do not have lead-related
tasks. The clean areas protocol described by Washington DOSH could be
used to designate parts of a facility, such as offices or work areas
where lead-containing materials are not present, as clean so that
workers in those areas are not covered by the lead rule. The protocol
could also be used for facilities where lead is present in building
materials, such as lead based paint, but is normally undisturbed by
activities of the employer. Where a clean area is designated within a
work establishment, workers and other individuals are not required to
use protective equipment, work practices, or controls to prevent lead
exposure and will not necessarily be trained about lead hazards.
The Washington DOSH stakeholder review draft sets out criteria for
establishing clean areas, wherein all worker-accessible surfaces must
be shown using ongoing surface sampling for free lead. Lead coatings
and lead-containing materials may be present where lead is well
contained and not released to surface sampling. When sampling indicates
that lead is being brought into the clean area or released from damaged
materials in the area, non-lead workers must be kept from the vicinity
until the hazard is abated and sampling in the area of the release
indicates the area is clean.
The following criteria would be used to determine if routine
cleaning is sufficient to maintain surface lead on all worker
accessible surfaces below 4.3 [mu]g/dm\2\ (equivalent to 40 [mu]g/
ft\2\). Single sample testing, conducted as specified in Washington
DOSH's stakeholder review draft, may be used to identify clean areas.
If initial sampling indicates that lead on worker accessible surfaces
is below 4.3 [mu]g/dm\2\, the area represented by such sampling is
considered ``clean'' and the employer would not be required to
implement requirements of the lead rule (outside of this protocol)
therein.\18\ When there is activity that could reintroduce lead into
the area, repeat sampling would be required every two years.
---------------------------------------------------------------------------
\18\ Note: Washington DOSH's stakeholder review draft
contemplates that maintenance and housekeeping staff working in a
clean area may be doing work covered by the lead rule.
---------------------------------------------------------------------------
In an area where initial sampling indicates the presence of surface
lead on worker accessible surfaces at or above 4.3 [mu]g/dm\2\,
Washington DOSH's proposed protocol would provide for representative
four-sample testing to demonstrate that ongoing cleaning is sufficient
to maintain minimal lead levels.
(24) Should OSHA consider a safe harbor protocol approach similar
to the Clean Areas protocol described above, which is being considered
for adoption in Washington State? What aspects of the protocol would be
beneficial? Are there issues, concerns, or different approaches to a
``safe harbor'' based on identification of clean areas using surface
sampling that OSHA should consider?
3. Safe Harbor Protocol for Handling Lead-Containing Articles in Retail
Settings
The Washington DOSH stakeholder review draft describes a protocol
that
[[Page 38355]]
could be applied to workers handling lead-containing products for sale
in retail settings where it is expected that lead will be generally
well controlled. The Retail Settings protocol would not cover areas of
a retail facility used for maintenance or repair work that may disturb
lead-containing materials, and would not cover retail gun shops co-
located with gun ranges. For areas of a retail establishment where lead
products are not sold, retail employers could selectively apply the
Clean Areas compliance protocol described above. Under the Retail
Settings protocol, retail employers could assume that workers are
covered by the Basic Rules set out in the DOSH stakeholder review
draft, which include requirements for cleaning practices, hygiene, PPE,
and provisions for hazard communication and training. Exposure
assessments would not be required for workers who only handle lead-
containing materials in retail activities including receiving,
stocking, sales, and housekeeping in the retail activity areas. In
addition, retail workers would not be covered under the Action Rules
(which include ongoing exposure monitoring and blood lead testing) or
the PEL and SPEL Rules (which include requirements covering routine
control of airborne lead exposure and respirator use, as well as
heightened requirements in the provisions for cleaning, hygiene, PPE,
hazard communication and training, exposure monitoring and medical
surveillance).
The Washington DOSH stakeholder review draft sets out several
conditions that must be met by the employer to implement the Retail
Settings Protocol, such as requiring that lead-containing materials be
kept segregated from other materials in the establishment and inspected
when received in the establishment for damage to packaging or the
product that could release lead; that any manufacturing, repair,
assembly, or maintenance work involving lead-containing products that
generates lead aerosols or dust must be performed in a separate area of
the establishment away from the retail space and must follow protocols
to prevent lead contamination of the retail space; and that the
employer must implement specific housekeeping practices (e.g.,
prohibition of dry sweeping, use of wet wiping/mopping and/or HEPA
filtered vacuums) around lead-containing products or areas where these
products are stored.
(25) Should OSHA consider a safe harbor protocol approach similar
to the Retail Settings Protocol described above, which is being
considered for adoption in Washington? What aspects of the Protocol
would be beneficial? Are there issues, concerns, or different
approaches to a ``safe harbor'' for retail settings that OSHA should
consider?
4. Safe Harbor Protocol for Office and Residential Settings
The Washington DOSH stakeholder review draft describes a protocol
for employees working within a facility that has lead-based paint or
paint with lead pigments doing work that does not disturb painted
surfaces. This protocol would, for example, allow the employer to
assume that workers in office and residential settings are not covered
by the lead rule unless doing maintenance, remodeling, or repair work.
Under this protocol, workers occupying a facility for office work are
not covered by the rule, except when there is an incident causing a
significant release and exposure to lead; and except for workers doing
housekeeping work, who would be covered under the Basic Rules
requirements for cleaning practices, hygiene, PPE, and provisions for
hazard communication and training.
To implement this protocol, employers and building owners may
assume that paint contains lead or conduct screening tests to determine
lead content. For this protocol, it is expected that there may be minor
releases due to normal wear and tear and light repair work in the
facility. The building owner or employer would be required to make
written documentation of the lead assessment available in the facility
for occupants, housekeeping workers, and maintenance workers.
Maintenance or housekeeping staff would be required to make at least
quarterly visual inspections of the facility for damage to lead paint
surfaces in occupied areas. Whenever damage is discovered, by
inspection, occupant report, or other observations, the building owner
or employer would be required to assess the damage and ensure any
repair and clean-up is done in a timely manner using methods that limit
the spread of lead-containing materials (e.g., wet wiping, use of HEPA
filtered vacuums).
(26) Should OSHA consider a safe harbor protocol approach similar
to the Office and Residential Settings protocol described above, which
is being considered for adoption in Washington? What aspects of the
protocol would be beneficial? Are there issues, concerns, or different
approaches to a ``safe harbor'' that OSHA should consider for work in
office and residential settings that does not involve maintenance,
remodeling, or repair work?
5. Safe Harbor Protocol for Incidental Lead Paint in Construction/
Renovation, Repair, and Painting (RRP) Work
The Washington DOSH stakeholder review draft describes a protocol
for use by contractors and maintenance operations handling lead-
containing paint. This protocol would apply to employers conducting
incidental lead paint work covered by the EPA renovation, repair and
painting work rules, or doing similar work. It is not intended for lead
abatement work as defined by the U.S. Department of Commerce and EPA,
which would be expected to involve greater levels of exposure than is
contemplated by this protocol.
This protocol assumes that: (1) work will be done with hand tools
or power tools with HEPA filtered dust collection systems; (2) the work
occurs in residential or similar construction where the primary lead-
containing material is finish paint on wood or wallboard substrates,
rather than structural steel; (3) contractors conducting this work are
in compliance with the Department of Commerce and EPA programs and have
certification from them when required; and (4) training required for
environmental certification will be supplemented with additional
information on Washington DOSH rules, including for personal protective
equipment, respiratory protection, hygiene practices, and work
practices.
This protocol would require workers disturbing painted surfaces to
wear half-face respirators with P100 filters or more protective
respirators and would allow for workers to request Powered Air
Purifying Respirators (PAPRs) with HEPA cartridges. The employer must
implement a respiratory protection program (including identification of
a respirator program administrator; identification of the respirator
models and configuration the employer will require for each task
performed; and the process for medical clearance and fit testing of
workers) and must provide personal protective equipment including
either safety glasses/goggles or full face respirators; disposable
overalls or overalls that are laundered per Washington DOSH rule
requirements; work boots; disposable shoe covers or dedicated work
boots that are not worn off the worksite for workers scraping or
sanding paint; gloves or a glove combination sufficient to prevent lead
accumulation on the hands and provide necessary protection from cuts or
other hand hazards; and other personal protective equipment
[[Page 38356]]
necessary based on other hazards at the worksite.
Employers using this protocol would provide workers with workplace-
specific training (see DOSH Stakeholder Review Draft--Action Rules).
Work covered under the EPA/Department of Commerce rules must be
conducted by workers meeting the minimum training and certification
standards of that program, with additional training on worker safety
issues including health effects of lead, respiratory protection, PPE,
work practices specific to the worksite, and limits of work practices.
An on-site competent person must be able to recognize lead-related
hazards and have authority to take action to correct lead issues at the
worksite.
Under this protocol, direct monitoring of employee exposure would
not be required. The employer could presume that employee exposure to
airborne lead is no greater than 10 times the proposed PEL of 20 [mu]g/
m\3\ as an eight-hour TWA.\19\ While this presumption is used, the
employer must meet all requirements of the rule consistent with this
level of exposure, including: baseline blood lead testing for all
workers contacting lead-containing coatings \20\ or in the vicinity of
any work disturbing these materials, follow-up blood lead testing every
two months for the first six months and every six months thereafter,
and blood lead testing at the conclusion of work; lead control areas
around any work disturbing lead-containing coatings; respirator use for
all workers disturbing lead-containing coatings; and provision of
appropriate PPE, a clean change area, and hygiene facilities including
dedicated handwashing, boot cleaning, and showers as necessary.
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\19\ Employers could choose to conduct exposure assessments to
determine actual lead exposure levels and tailor their program under
this protocol as indicated by those results. However, direct
monitoring of exposure would not be required when not feasible in
the timeframe of the project. Employers would assume paint in
structures built before 1978 contains lead in quantities that will
require controls and PPE as specified in this protocol. Paint could
be tested by collecting samples for laboratory analysis, use of X-
ray fluorescence, or following EPA/Department of Commerce rules for
colorimetric testing kits. The protocol would require any paint
found to potentially contain 5000 ppm lead or more than 1 mg/cm\2\
of lead on the surface to be treated as a lead-containing material.
\20\ ``Lead-containing coatings'' refers to coatings that are
known or presumed to contain lead.
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(27) Should OSHA adopt a safe harbor protocol approach similar to
the protocol described above for incidental lead paint in RRP work that
is being considered for adoption in Washington? What aspects of the
protocol would be beneficial? Are there issues, concerns, or different
approaches to a protocol for RRP work that OSHA should consider?
F. Environmental Effects
The National Environmental Policy Act (NEPA) of 1969 (42 U.S.C.
4321, et seq.), the Council on Environmental Quality (CEQ) regulations
(40 CFR part 1500), and the Department of Labor (DOL) NEPA Compliance
Procedures (29 CFR part 11) require that OSHA give appropriate
consideration to environmental issues and the impacts of proposed
actions significantly affecting the quality of the human environment.
OSHA intends to collect written information and data on possible
environmental impacts that could occur outside of the workplace (e.g.,
exposure to the community through contaminated air/water, contaminated
waste sites, etc.) if the agency were to revise the existing standard
for occupational exposure to lead. Such information should include both
negative and positive environmental effects that could be expected to
result from guidance or a revised standard. Specifically, OSHA requests
comments and information on the following:
(28) What is the potential direct or indirect environmental impact
(for example, the effect on air and water quality, energy usage, solid
waste disposal, and land use) from a reduction in BLL triggers or other
changes to the OSHA lead standards?
(29) Are there any situations in which reducing lead exposures to
employees would be inconsistent with meeting environmental regulations?
G. Duplicative, Overlapping, or Conflicting Rules
This section examines whether there are any duplicative,
overlapping, or conflicting regulations concerning lead that OSHA
should be aware of. In your explanation, please explain in detail if
there are any such concerns of which the agency should be aware.
(30) Are there any federal regulations that might duplicate,
overlap, or conflict with modifications to the current lead standards?
If yes, please identify and explain how they would duplicate, overlap,
or conflict.
(31) Are there any federal programs in areas such as defense or
energy that might be impacted by modifications to the current lead
standards? If yes, please identify and explain how they would be
impacted.
H. Questions for Employers on Current Practices
OSHA requests that commenters, when answering questions regarding
economic impact, be as specific as possible. For example, if an
employer is using a modified medical surveillance program, then helpful
information would include the following: the medical testing necessary;
the exposure status or types of employees who would receive medical
testing; the frequency of the testing; and the medical surveillance
costs. The agency invites comment on the labor time and level of labor
expertise required to implement proposed methods, even if dollar-cost
estimates are not available. For discussion of equipment-related costs,
OSHA requests that commenters estimate relevant factors such as
purchase price, cost of installation, cost of equipment maintenance,
cost of training, and expected life of the equipment. Also, please
discuss the quantitative benefits (e.g., reductions in BLLs) and the
associated costs (e.g., cost of an exposure control method). Because
there are some differences between OSHA's lead standards for general
industry and construction, please specify which standard is applicable
to your work.
(32) If you use criteria more stringent than OSHA's requirements
for conducting blood lead testing on your employees, how do your
criteria differ from OSHA's requirements?
(33) If you use criteria more stringent than OSHA's requirements
for notifying employees of their BLL and ZPP results, how do your
criteria differ from OSHA's requirements?
(34) If you use criteria more stringent than OSHA's requirements
for medical removal protection in your work environment or industry,
how do your criteria differ from OSHA's requirements? Please include
the criteria, such as the BLL, for both medical removal and return to
work status.
(35) What are your current costs of medical removal per employee
(where possible, please monetize in terms of dollars per time unit
(e.g., per month, per year))? Would your company be able to reassign
the medically removed worker to a job at least at the clerical level
that the employee would find acceptable? Please include specific
examples of hourly wages (per job category) for the employee's regular
occupation and the hourly wages for the medically assigned clerical
job, if available.
(36) How many of your employees, over the past 10 years, have been
removed from lead-exposed work due to elevated BLLs? If possible,
please submit anonymized examples of employees who were brought into
the medical removal program, their BLL level at the time of removal,
and the
[[Page 38357]]
time required to bring the BLL level below 40 [mu]g/dL (or an
alternative specified level).
(37) Over the past ten years, how many, or what percentage, of your
employees were removed from lead-exposed work due to elevated BLLs
exceeding the maximum 18-month time period and were unable to return to
work?
(38) OSHA's lead standards set a BLL of below 40 [mu]g/dL (two
consecutive tests) for return to lead-exposed work for medically
removed workers. As discussed earlier in this ANPRM, in Section I.A.
Background; Events Leading to this Action, OSHA is considering lowering
the BLL for medical removal. If possible, please submit estimated
increases in the number of affected employees and in costs if the BLL
for allowing return to work were reduced to a level lower than OSHA's
current BLL of 40 [mu]g/dL. Please specify the BLL for return to work
you assume in your estimation.
(39) How many and what percentage of your employees are currently
in your medical surveillance program? How many of these employees
receive BLL testing? How many receive ZPP monitoring?
(40) What are your current costs of medical surveillance per
employee? Please include specific examples of resource requirements in
terms of additional staffing or time commitments (per job category),
costs for purchase of testing materials (dollar cost per unit),
expected life of equipment, and costs for energy usage and any other
additional expenses.
(41) The OSHA lead standard for general industry requires the
employer to institute a medical surveillance program for all employees
who are or may be exposed at or above the AL (30 [mu]g/m\3\) for more
than 30 days per year. There are three requirements for biological
monitoring that are triggered by the current AL (30 [mu]g/m\3\):
At least every 6 months for each employee;
At least every two months for each employee whose last
blood lead test indicated a BLL at or above 40 [mu]g/dL. This frequency
shall continue until two consecutive blood lead tests indicate a BLL
below 40 [mu]g/dL; and
At least monthly during the removal period of each
employee removed from exposure to lead due to an elevated BLL.
If possible, please discuss and/or submit quantitative estimates of
the increases in the number of affected employees and in medical
surveillance costs or other pertinent costs if the AL (30 [mu]g/m\3\)
were decreased. Please specify the AL you assume in your estimation.
(42) Have you upgraded engineering controls to reduce airborne
concentrations of lead in your facility? If yes, please describe the
controls and whether you observed a subsequent reduction in BLLs. If
so, did you monitor to what extent workers' BLLs were reduced following
implementation of upgraded controls? Please provide data, if available,
on airborne lead concentrations in your facility and on workers' BLLs
prior to and following the upgrades. Also provide related initial and
annual engineering control costs of upgraded controls, as well as the
expected life of the equipment.
(43) Please describe your control strategies to reduce lead surface
contamination and the potential for dermal exposure to lead in your
facility, such as housekeeping procedures, hygiene areas and practices,
and personal protective clothing and equipment (PPE). Please describe
such controls, their costs, and explain how well they work and why. To
what extent were you able to lower the surface levels of lead? Did you
see a subsequent reduction in employee BLLs? Please provide supporting
data, if available.
Personal Protective Clothing and Equipment (PPE)
Employers are required to provide work clothing and equipment if an
employee is exposed to lead above the PEL or where the possibility of
skin or eye irritation exists.
(44) Do you provide PPE in your workplace, including equipment
providing respiratory protection? If yes, has it reduced BLLs in your
workers? Please describe the type of PPE that you provide.
(45) Does your company have triggers for PPE that are different
from requirements under OSHA's lead standards? Please describe the
triggers used for providing PPE.
(46) If your firm purchases clothing and equipment to protect
employees from lead exposure, please estimate the PPE costs necessary
to comply with the current OSHA lead standard. Please give costs on a
per employee basis and at an aggregated level, if available.
(47) Have you upgraded PPE to reduce worker exposure to lead? If
yes, please describe the controls and whether you observed a subsequent
reduction in BLLs. If so, to what extent were workers' BLLs reduced
following implementation of upgraded PPE, if applicable? Please provide
data, if available.
Housekeeping
OSHA's lead standards contain a housekeeping provision that
requires employers to keep surfaces as free as practicable from lead,
encourages the use of vacuuming to clean surfaces, limits the use of
dry sweeping and shoveling, and prohibits using compressed air to clean
surfaces. Some variation exists between the housekeeping provisions for
general industry and construction.
(48) Do you have housekeeping procedures? If yes, please describe.
(49) Does your company have cleaning criteria specific to surfaces?
This may include a schedule for cleaning and periodic surface
cleanliness measurements, specific types of cleaning practices and
activities, or other activities associated with surface
decontamination.
(50) What are your current housekeeping costs to comply with the
OSHA lead standard? Please provide the amount of time allocated for
housekeeping costs calculated on an hourly basis.
Hygiene Facilities and Practices
OSHA's lead standards contain hygiene facilities and practices
provisions that require employers to provide showers, change rooms, and
lunchrooms when workers are exposed to lead above the PEL without
regard to the use of respirators. The employer must also ensure that
food or beverage is not present or consumed, tobacco products are not
present or used, and cosmetics are not applied in areas where workers
are exposed above the PEL. Some variation exists between the hygiene
facilities and practices provisions for general industry and
construction.
(51) Have you provided hygiene facilities or used hygiene practices
beyond the requirements of OSHA's lead standards? This may include more
frequent hand washing breaks or providing access and time for showers
at exposures below the PEL. Please describe how your practices differ
from requirements in OSHA's lead standards.
(52) What are your current costs to comply with the hygiene
provisions of OSHA's lead standards? Please provide the amount of time
allocated for hygiene costs calculated on an hourly basis.
BLLs and Lead Dust Contamination
Some federal agencies, such as the U.S. Department of Housing and
Urban Development (HUD) and the EPA, have established lead dust hazard
action levels for surfaces (HUD, 2012; EPA 2001). OSHA is interested in
[[Page 38358]]
information on using lead dust hazard surface measurements and any
observed correlation between surface lead dust levels and elevated
BLLs.
(53) Have you taken lead dust surface measurements in your work
environment? If so, what are your procedures and current costs for this
testing? Please specify the labor and equipment costs for the testing.
Have you experienced any impediments or limitations when using wipe
sampling to identify surface contamination with lead? What can be done
to overcome these barriers?
(54) If you have taken lead dust surface measurements, are they
qualitative (presence of lead only) or quantitative? If quantitative,
do you use lead dust hazard levels established by HUD and EPA? Please
provide any data you have on quantitative surface contamination
measurements in your work environment.
(55) Have you evaluated lead surface contamination to investigate
elevated employee BLLs in areas where airborne lead exposure was below
the PEL? If yes, what were your findings?
(56) Have you taken wipe samples of skin or clothing to identify
lead contamination? If yes, what were your findings?
(57) Have you found any correlation between BLLs and lead surface
contamination, particularly when airborne exposures are below the PEL?
Impact on Small Business Entities
Under the Regulatory Flexibility Act (5 U.S.C. 601 et seq.), OSHA
is required to assess the impact of proposed and final rules on small
entities. OSHA requests that members of the small business community,
or other parties familiar with regulation of small business, address
any special circumstances facing small firms in controlling
occupational exposure to lead.
(58) How many and what kinds of small businesses or other small
entities in your industry could be affected by lower protective BLL
triggers in the OSHA lead standard for general industry? Describe any
such effects.
(59) How many and what kinds of small businesses or other small
entities in your industry could be affected by lower BLL triggers in
the OSHA lead standard for construction? Describe any such effects.
(60) Are there special issues or reasons that lower BLL triggers
are more difficult or costlier to implement in small firms? Please
describe.
(61) Are there any reasons why benefits from reducing worker BLLs
would be different in small firms than in larger firms? With regard to
potential impacts on small firms, please describe specific concerns
that OSHA should address and any alternatives that might serve to
minimize these impacts while meeting the requirements of the OSH Act.
Authority and Signature
Douglas Parker, Assistant Secretary of Labor for Occupational
Safety and Health, U.S. Department of Labor, 200 Constitution Avenue
NW, Washington, DC, 20210, authorized the preparation of this document
pursuant to the following authorities: sections 4, 6, and 8 of the
Occupational Safety and Health Act of 1970 (29 U.S.C. 653, 655, 657),
Secretary's Order 8-2020 (Sept. 18, 2020), and 29 CFR part 1911.
Signed at Washington, DC, on June 21, 2022.
Douglas L. Parker,
Assistant Secretary of Labor for Occupational Safety and Health.
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Appendix A
Table 1--Summary of Annual Number of Firms With BLL Tests and Cases \1\
----------------------------------------------------------------------------------------------------------------
Estimated Estimated number of firms with BLL cases
number of ---------------------------------------------------------------
firms where
NAICS NAICS description employees BLL >= medical
receive BLL BLL >=5 BLL >=10 BLL >=25 removal BLL
tests \2\
----------------------------------------------------------------------------------------------------------------
1151......... Support 2 1 0 0 0
Activities for
Crop Production.
2122......... Metal Ore Mining. 466 78 36 11 0
2123......... Nonmetallic 17 2 0 0 0
Mineral Mining
and Quarrying.
2131......... Support 35 5 0 0 0
Activities for
Mining.
2211......... Electric Power 25 22 22 10 0
Generation,
Transmission and
Distribution.
2212......... Natural Gas 138 19 11 2 0
Distribution.
[[Page 38360]]
2213......... Water, Sewage and 9 9 0 0 0
Other Systems.
2361......... Residential 769 145 83 37 2
Building
Construction.
2362......... Nonresidential 864 323 204 67 9
Building
Construction.
2371......... Utility System 87 50 36 10 1
Construction.
2373......... Highway, Street, 386 136 91 43 4
and Bridge
Construction.
2379......... Other Heavy and 51 10 10 8 1
Civil
Engineering
Construction.
2381......... Foundation, 251 171 95 11 1
Structure, and
Building
Exterior
Contractors.
2382......... Building 488 132 58 31 4
Equipment
Contractors.
2383......... Building 2,746 655 452 199 34
Finishing
Contractors.
2389......... Other Specialty 1,305 354 227 47 9
Trade
Contractors.
2399......... Construction 516 86 25 25 0
(Specific
industry
unknown).
3231......... Printing and 146 20 11 2 0
Related Support
Activities.
3241......... Petroleum and 11 11 0 0 0
Coal Products
Manufacturing.
3251......... Basic Chemical 42 20 11 2 0
Manufacturing.
3252......... Resin, Synthetic 175 25 13 3 0
Rubber, and
Artificial and
Synthetic Fibers
and Filaments
Manufacturing.
3255......... Paint, Coating, 38 21 12 2 0
and Adhesive
Manufacturing.
3259......... Other Chemical 158 22 12 2 0
Product and
Preparation
Manufacturing.
3271......... Clay Product and 99 50 27 5 0
Refractory
Manufacturing.
3272......... Glass and Glass 5,156 715 398 113 2
Product
Manufacturing.
3279......... Other Nonmetallic 12 2 0 0 0
Mineral Product
Manufacturing.
3311......... Iron and Steel 99 13 13 13 1
Mills and
Ferroalloy
Manufacturing.
3312......... Steel Product 184 26 14 3 0
Manufacturing
from Purchased
Steel.
3314......... Nonferrous Metal 1,431 224 189 187 13
(except
Aluminum)
Production and
Processing.
3315......... Foundries........ 1,103 152 102 28 1
3323......... Architectural and 994 142 91 44 2
Structural
Metals
Manufacturing.
3324......... Boiler, Tank, and 261 38 23 7 0
Shipping
Container
Manufacturing.
3325......... Hardware 166 23 13 2 0
Manufacturing.
3327......... Machine Shops; 53 15 15 14 0
Turned Product;
and Screw, Nut,
and Bolt
Manufacturing.
3328......... Coating, 256 39 22 10 0
Engraving, Heat
Treating, and
Allied
Activities.
3329......... Other Fabricated 1,100 187 154 46 1
Metal Product
Manufacturing.
3333......... Commercial and 133 19 10 2 0
Service Industry
Machinery
Manufacturing.
3336......... Engine, Turbine, 17 17 0 0 0
and Power
Transmission
Equipment
Manufacturing.
3339......... Other General 65 9 9 2 0
Purpose
Machinery
Manufacturing.
3341......... Computer and 6 1 0 0 0
Peripheral
Equipment
Manufacturing.
3342......... Communications 146 31 17 3 0
Equipment
Manufacturing.
3343......... Audio and Video 4 0 0 0 0
Equipment
Manufacturing.
3344......... Semiconductor and 323 37 25 9 1
Other Electronic
Component
Manufacturing.
3345......... Navigational, 394 72 37 11 0
Measuring,
Electromedical,
and Control
Instruments
Manufacturing.
3359......... Other Electrical 851 165 136 136 24
Equipment and
Component
Manufacturing.
3363......... Motor Vehicle 994 142 89 33 2
Parts
Manufacturing.
3364......... Aerospace Product 427 96 40 21 1
and Parts
Manufacturing.
3366......... Ship and Boat 23 23 13 13 0
Building.
3369......... Other 9 8 0 0 0
Transportation
Equipment
Manufacturing.
3399......... Other 296 53 53 12 0
Miscellaneous
Manufacturing.
4231......... Motor Vehicle and 305 57 31 6 0
Motor Vehicle
Parts and
Supplies
Merchant
Wholesalers.
4236......... Household 330 46 25 6 0
Appliances and
Electrical and
Electronic Goods
Merchant
Wholesalers.
[[Page 38361]]
4237......... Hardware, and 130 18 10 2 0
Plumbing and
Heating
Equipment and
Supplies
Merchant
Wholesalers.
4238......... Machinery, 12 2 0 0 0
Equipment, and
Supplies
Merchant
Wholesalers.
4239......... Miscellaneous 629 141 141 130 3
Durable Goods
Merchant
Wholesalers.
4244......... Grocery and 7 1 0 0 0
Related Product
Merchant
Wholesalers.
4247......... Petroleum and 14 2 0 0 0
Petroleum
Products
Merchant
Wholesalers.
4413......... Automotive Parts, 136 19 10 2 0
Accessories, and
Tire Stores.
4441......... Building Material 134 19 10 2 0
and Supplies
Dealers.
4451......... Grocery Stores... 8 1 0 0 0
4483......... Jewelry, Luggage, 125 18 10 2 0
and Leather
Goods Stores.
4511......... Sporting Goods, 780 109 60 11 0
Hobby, and
Musical
Instrument
Stores.
4821......... Rail 8 8 8 2 0
Transportation.
4841......... General Freight 13 13 0 0 0
Trucking.
4842......... Specialized 12 3 0 0 0
Freight Trucking.
4851......... Urban Transit 3 3 3 2 0
Systems.
4881......... Support 21 21 21 12 0
Activities for
Air
Transportation.
4883......... Support 306 45 25 6 0
Activities for
Water
Transportation.
4884......... Support 183 11 10 3 0
Activities for
Road
Transportation.
4911......... Postal Service... 0 0 0 0 0
4921......... Couriers and 8 1 0 0 0
Express Delivery
Services.
5111......... Newspaper, 131 18 10 2 0
Periodical,
Book, and
Directory
Publishers.
5173......... Wired and 10 1 0 0 0
Wireless
Telecommunicatio
ns Carriers.
5182......... Data Processing, 0 0 0 0 0
Hosting, and
Related Services.
5211......... Monetary 131 18 10 2 0
Authorities-
Central Bank.
5242......... Agencies, 10 3 0 0 0
Brokerages, and
Other Insurance
Related
Activities.
5311......... Lessors of Real 7 4 0 0 0
Estate.
5313......... Activities 231 32 18 3 0
Related to Real
Estate.
5323......... General Rental 53 19 10 4 0
Centers.
5324......... Commercial and 113 16 9 2 0
Industrial
Machinery and
Equipment Rental
and Leasing.
5413......... Architectural, 218 88 65 12 0
Engineering, and
Related Services.
5415......... Computer Systems 121 17 9 2 0
Design and
Related Services.
5416......... Management, 153 53 19 7 0
Scientific, and
Technical
Consulting
Services.
5417......... Scientific 12 12 8 2 0
Research and
Development
Services.
5419......... Other 125 18 10 2 0
Professional,
Scientific, and
Technical
Services.
5611......... Office 118 17 9 2 0
Administrative
Services.
5613......... Employment 119 45 34 10 0
Services.
5614......... Business Support 12 2 0 0 0
Services.
5616......... Investigation and 395 66 36 7 0
Security
Services.
5617......... Services to 127 18 10 2 0
Buildings and
Dwellings.
5621......... Waste Collection. 102 35 19 4 0
5622......... Waste Treatment 39 28 22 6 0
and Disposal.
5629......... Remediation and 1,663 739 494 190 4
Other Waste
Management
Services.
6111......... Elementary and 4 3 3 2 0
Secondary
Schools.
6112......... Junior Colleges.. 146 20 11 2 0
6113......... Colleges, 11 8 0 0 0
Universities,
and Professional
Schools.
6115......... Technical and 714 100 46 10 0
Trade Schools.
6116......... Other Schools and 745 111 61 19 0
Instruction.
6211......... Offices of 9 9 0 0 0
Physicians.
6214......... Outpatient Care 9 5 0 0 0
Centers.
6215......... Medical and 9 9 0 0 0
Diagnostic
Laboratories.
6219......... Other Ambulatory 9 4 4 4 0
Health Care
Services.
6221......... General Medical 10 4 0 0 0
and Surgical
Hospitals.
[[Page 38362]]
6222......... Psychiatric and 12 12 0 0 0
Substance Abuse
Hospitals.
6232......... Residential 15 15 0 0 0
Intellectual and
Developmental
Disability,
Mental Health,
and Substance
Abuse Facilities.
6241......... Individual and 51 18 10 2 0
Family Services.
6243......... Vocational 10 1 0 0 0
Rehabilitation
Services.
7115......... Independent 3 1 0 0 0
Artists,
Writers, and
Performers.
7121......... Museums, 309 50 30 21 0
Historical
Sites, and
Similar
Institutions.
7131......... Amusement Parks 3 3 0 0 0
and Arcades.
7139......... Other Amusement 6,656 1024 619 205 9
and Recreation
Industries.
8111......... Automotive Repair 3,333 553 310 72 1
and Maintenance.
8112......... Electronic and 29 17 17 11 0
Precision
Equipment Repair
and Maintenance.
8113......... Commercial and 79 14 10 6 0
Industrial
Machinery and
Equipment
(except
Automotive and
Electronic)
Repair and
Maintenance.
8114......... Personal and 953 133 71 34 1
Household Goods
Repair and
Maintenance.
8122......... Death Care 145 20 11 2 0
Services.
8131......... Religious 12 3 0 0 0
Organizations.
8139......... Business, 488 72 50 28 1
Professional,
Labor,
Political, and
Similar
Organizations.
9211......... Executive, 0 0 0 0 0
Legislative, and
Other General
Government
Support.
9221......... Justice, Public 0 0 0 0 0
Order, and
Safety
Activities.
9231......... Administration of 0 0 0 0 0
Human Resource
Programs.
9241......... Administration of 0 0 0 0 0
Environmental
Quality Programs.
9251......... Administration of 0 0 0 0 0
Housing
Programs, Urban
Planning, and
Community
Development.
9261......... Administration of 0 0 0 0 0
Economic
Programs.
9281......... National Security 0 0 0 0 0
and
International
Affairs.
----------------------------------------------------------------------------------------------------------------
Total 44,144 8,611 5,302 2,087 137
----------------------------------------------------------------------------------------------------------------
\1\ The Census Bureau defines an establishment as a single physical location at which business is conducted or
services or industrial operations are performed. The Census Bureau defines a business firm or entity as a
business organization consisting of one or more domestic establishments in the same state and industry that
are specified under common ownership or control. The firm and the establishment are the same for single-
establishment firms. For each multi-establishment firm, establishments in the same industry within a state
will be counted as one firm; the firm employment and annual payroll are summed from the associated
establishments.
\2\ Medical removal levels are BLL >=50 [micro]g/dL in Construction (NAICS 23) and BLL >=60 [micro]g/dL in
General Industry.
[FR Doc. 2022-13696 Filed 6-27-22; 8:45 am]
BILLING CODE 4510-26-P