Part IX, factories and machinery (lead) regulation 1984 contain 8 regulations. Why this part is really special? Because it is specifically for the medical practitioner to know and it elaborate for about medical surveillance in lead.

In general it is a duty of the employer to institute medical surveillance programme for employees who are or maybe exposed above the action level (75 microgram/m3 of air) for more than 30 days per year, and the cost is on the employer expenses.

We have to remember this figures for blood lead monitoring :

1. a) Period of 6 months,
2. b) 3 months and
3. c) Monthly

and the blood lead level range :

1. a) 40 microgram/100 gram of blood,
2. b) 60 microgram,
3. c) 80 microgram and
4. d) 73 microgram…why?

Because blood lead sampling and analysis must be done at least every 6 months to each employee exposed to lead as mention above, 3 monthly if the blood lead at or above 40 microgram/ 100 gram of whole blood but less than 60 microgram/100 gm of whole blood. And this monitoring must be done until 2 consecutive blood samples and analysis indicate blood lead level below 40 microgram/100 gm of whole blood.

The monitoring must be done monthly if the blood lead is at 60 microgram/ 100 gram of whole blood and the monitoring must be continue until two consecutive blood samples ana analysis indicate blood level below 60 microgram/ 100 gm of whole blood but above 40 microgram/100 gm or whole blood and once the blood lead has reached below 40 microgram/100 gram whole bood and the monitoring should follow the guide as stated before.

The monitoring must be done monthly during period of medical protection period and for a female employee of child bearing capacity J

Remember that this unit is lead measured in the blood not in the air (PEL).

If employee blood level make him eligible for medical removal protection, the employer shall provide a second follow up blood sampling test within two weeks after receive the results of first blood sampling test.

The sample of blood must be analysed by an approved laboratory, and must have accuracy to a confident level of 95 % with in a margin of plus or minus 6 microgram/100 gm which ever greater.

The employee should be notified if the blood lead level exceeds 40 microgram/100 rm whole blood.

Medical Examination

1) Annually when blood lead level is at or above 40 microgram/ 100 gm whole bloodat any time during the preceeding 12 months

2) Prior to assignment for the first time in which airborne concentrations of lead are at or above the action level

3) As soon as possible if the employee develop s&s of lead intoxication

4) As medically appropriate

And the medical examination should contained :

1) Detailed history and physical examination – occupational, smoking, lead related PE and History

2) blood pressure

3) Related Blood sample and analysis

4) UFEME

5) Any lab ix deemed necessary and shall include pregnancy test if necessary

“Clinicallt Smart, Financially Educated”

– Azhari Hiddleston