Medical surveillance of the lead exposed worker. Current guidelines.

1. The "lead standards" established by OSHA for general industry in 1978 and the construction industry in 1993 require employers and clinicians to follow very specific guidelines for protecting lead exposed workers. Depending on the level of exposure, medical surveillance may be legally required. 2. Lead affects multiple body systems and can cause permanent damage. Low level exposures that in the past were thought safe are now considered hazardous as new information emerges about the toxicity of lead. 3. Lead poisoning, if undetected, often results in misdiagnosis and costly care. Adults are exposed to lead in many different workplace settings. All clinicians caring for lead exposed workers need to be informed about the health effects of lead, employer and physician responsibilities, and worker rights. 4. Occupational and environmental health nurses can help identify workers at risk and prevent lead poisoning by education and early intervention through collaboration with the workers, the employer, the company physician, and other health and safety professionals.