Elevated Blood Lead Levels Among Employed Adults — United States, 1994–2012
Corresponding author: Walter A. Alarcon, MD, National Institute for Occupational Safety and Health, CDC. Telephone: 513-841-4451 e-mail: wda7@cdc.gov.
Preface
The National Institute for Occupational Safety and Health (NIOSH) and state health departments collect data on laboratory-reported adult blood lead levels (BLLs). This report presents data on elevated blood lead levels among employed adults in the United States for 1994–2012. This report is a part of the first-ever Summary of Notifiable Noninfectious Conditions and Disease Outbreaks, which encompasses various surveillance years but is being published in 2015 (1). The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases (2).
Background
Since 1987, the National Institute for Occupational Safety and Health (NIOSH) and state health departments have maintained a state–based surveillance program of laboratory-reported adult blood lead levels (BLLs) known as the Adult Blood Lead Epidemiology and Surveillance (ABLES) Program (3). The BLL is an often-used estimate of recent external exposure to lead (4,5). This report summarizes data on elevated blood lead levels among employed adults, defined as persons aged ≥16 years, during January 1, 1994–December 31, 2012.
Reported cases of elevated BLLs in 2012 are provided in tabular form (Tables 1–4). Information is provided by geographic division and reporting state, for "all cases" reported by a state (these include cases among adult residents in the reporting state plus cases identified by the reporting state but who reside in another state) and "state-residents" only, by exposure source, age, and sex groups, for BLLs ≥10 µg/dL (current definition of elevated BLL) (3,6), and for BLLs ≥25 µg/dL (former definition of elevated BLL)(7). The current case definition was adopted in 2009 on the basis of mounting evidence for adverse health outcomes among adults with BLLs between 10 µg/dL and 25 µg/dL (4,6). State prevalence rates of elevated BLLs (≥10 µg/dL) for 2012 are categorized into two groups (above or below the national rate) (Figure 1). Trends of national prevalence rates of BLLs ≥10 µg/dL and BLLs ≥25 µg/dL from 1994 to 2012 are provided (Figure 2). Prevalence rates are provided for "all cases" (these include cases among adult residents in the reporting state plus cases identified by the reporting state but who reside in another state) and "state-residents" when available. National and state numbers of cases, employed populations, and prevalence rates of elevated BLLs are provided in tabular form (Tables 5–10). Available data include BLLs ≥10 µg/dL from 2010 to 2012 and BLLs ≥25 µg/dL from 1994 to 2012. Prevalence rates and numerators are provided for "all cases" and "state residents" when available. The number of employed adults (state residents) used as denominators for calculating rates are provided in tabular form (Tables 11 and 12).
ABLES is the only program conducting nationwide adult lead exposure surveillance. It has provided the occupational safety and health community with essential information for setting research and intervention priorities. ABLES' impact is achieved through its longstanding strategic partnerships with State ABLES programs, federal agencies, and worker-affiliated organizations. For example, in 2008, the Occupational Safety and Health Administration (OSHA) updated its National Lead Emphasis Program to reduce occupational lead exposure by targeting unsafe conditions and high-hazard industries (8). To accomplish this objective, OSHA utilized ABLES data to identify industries with elevated BLL problems and has agreements with State ABLES programs to obtain their lead exposure data to target workplace inspections.
Although federal funding for State ABLES programs was discontinued in September 2013, a total of 34 states continue to collaborate with NIOSH (down from a peak of 41). These states self-fund their ABLES programs to sustain lead exposure surveillance and prevention activities. To assist with accomplishing these objectives, State ABLES programs share resources with two other CDC programs: the Healthy Homes and Childhood Lead Poisoning Prevention Program and Environmental Public Health Tracking. Since September 2013, NIOSH has continued to provide technical assistance to states with adult blood lead surveillance programs and maintains the ABLES website for reporting ongoing analyses of ABLES data.
The BLL is a direct index of a worker's recent exposure to lead as well as an indication of the potential for adverse effects from that exposure (4,5). The half-life of lead in blood is about 40 days in men (9), so the BLL is an estimate primarily of recent exposure to lead. Because lead accumulates in bone and BLL is in equilibrium with bone lead, the BLL might be elevated in some persons who have not had recent exposure to lead. Because this equilibrium can lead to persistent BLL elevations, the public health burden of elevated BLLs in adults is measured as prevalence. In contrast, the public health burden of elevated BLLs in children aged <5 years is measured as incidence because these young children have little lead storage in their bones at birth and thus their early childhood blood lead tests reflect recent exposures.
Over the past several decades in the United States, a marked reduction has occurred in environmental sources of lead and improved protection from occupational lead exposure. As a result, there is an overall decreasing trend in the prevalence of elevated BLLs among adults. Nonetheless, lead exposures continue to occur at unacceptable levels (3). In 2012, the prevalence rate of BLLs ≥10 µg/dL was 22.5 adults per 100,000 employed population. During 2011–2012, the mean BLL in adults in the United States was 1.09 µg/dL (10).
Research continues to find that low BLLs are associated with harmful effects in adults (11). In 2009, NIOSH and State ABLES programs led the occupational safety and health community to establish a new case definition for an elevated BLL (i.e., BLLs ≥10 µg/dL) (3). The Council of State and Territorial Epidemiologists also recommended that CDC use this case definition (12). In 2010, for the first time, CDC included elevated BLLs, defined as those ≥10 µg/dL, in the List of Nationally Notifiable Noninfectious Conditions (6). The U.S. Department of Health and Human Services' Healthy People 2020 initiative also uses the 10 µg/dL level for its Occupational Safety and Health Objective No. 7 (OSH-7), which is to reduce the proportion of persons who have elevated blood lead concentrations from work exposures (13). Before 2009, the case definition for an elevated BLL was ≥25 µg/dL.
Data Sources
The ABLES program is an occupational health state-based surveillance system. The number of cases (numerator) is provided by 41 State ABLES programs. The number of employed adults (denominator) is obtained from the Local Area Unemployment Statistics (LAUS), Bureau of Labor Statistics, in the U.S. Department of Labor (available at http://www.bls.gov/data). A direct link to annual averages of states employment status of the civilian noninstitutionalized population is available at http://www.bls.gov/lau/staadata.txt).
State ABLES programs 1) collect data on adult BLLs from laboratories and physicians through mandatory reporting; 2) assign unique identifiers to each adult to account for multiple BLL records to protect individual privacy and permit longitudinal analyses; 3) follow-up on adults with BLLs ≥10 or ≥25 µg/dL with laboratories, health-care providers, employers, or workers to ensure completeness of information (e.g., the industry in which the adult is employed and whether the exposure source is occupational, nonoccupational, or both); 4) provide guidance and information to workers and employers to prevent lead exposures; and 5) submit data annually to NIOSH. Most ABLES states submit data on all BLLs (both occupational and nonoccupational) to NIOSH, including records from adults whose BLLs fall below the state mandatory reporting requirement. NIOSH conducts data quality control, analyzes the data, and disseminates the findings among stakeholders.
Interpreting Data
The primary measure of adult lead exposure in the United States is the National Prevalence Rate of Elevated BLLs. This measure is provided by the ABLES program and can be used to estimate the magnitude and monitor trends of lead exposures and to target areas requiring further investigation or interventions. The results indicate that efforts to reduce the prevalence of elevated BLLs have resulted in considerable progress towards reducing lead exposures. However, the ABLES data from 2012 establish that lead exposure remains a national health problem and that continued efforts to reduce lead exposures both within and outside the workplace are needed.
Many adults in the United States continue to have BLLs above levels known to be associated with acute and chronic adverse effects in multiple organ systems ranging from subclinical changes in function to symptomatic intoxication. These include neurologic, cardiovascular, reproductive, hematologic, and kidney adverse effects. The risks for adverse chronic health effects are even higher if the exposure is maintained for many years (4,5). Current research has found decreased renal function associated with BLLs at 5 µg/dL and lower, and increased risk of hypertension and essential tremor at BLLs below 10 µg/dL (11).
Prevalence rates of adults with BLLs ≥25 µg/dL are available since 1994. Beginning in 2002, State ABLES programs reported individual BLL laboratory test and state of residence. Formerly, state-resident and non-resident data could not be separated. When an adult has multiple blood lead tests in a given year, only the highest blood lead level for that adult in that year was counted. Prevalence rates of BLLs ≥10 µg/dL are provided since 2010. Prevalence rates of BLLs ≥25 µg/dL are a subset of rates of BLLs ≥10 µg/dL. In the U.S. most lead exposures are occupational. Among all participating states in 2012, when an exposure source was known, the proportion of BLLs ≥25 µg/dL from occupational exposures was 93.3%. The greatest proportions of adults with elevated BLLs were employed in four main industry sectors: manufacturing, construction, services, and mining.
These counts and rates of elevated BLLs must be considered minimum estimates of the actual magnitude of the problem of lead exposures in the U.S. This is for multiple reasons:
- not all states are included in the system;
- not all employers provide BLL testing to lead-exposed workers as required by OSHA regulations;
- not all nonoccupationally exposed adults are tested; and
- some laboratories might not report all tests as required by state laws or regulations.
For specific explanations, interpretation, and possible updates on data for any individual state, we strongly recommend contacting the State ABLES program investigator. Their contact information is available from the ABLES State-based Programs webpage (http://www.cdc.gov/niosh/topics/ABLES/state.html).
Methods for Identifying Elevated BLLs Among Employed Adults
A nationally reportable case of an employed adult with an elevated BLL is defined as a case in an employed adult (≥16 years at the time of blood collection) with a venous blood lead level ≥10 µg/dL (0.48 µmol/L) of whole blood. The standardized diagnostic test is the blood lead level test using a venous blood sample. All participating state health departments have a requirement for laboratories and/or health-care providers to report laboratory blood lead results to the state health department. However, this requirement varies among ABLES states, ranging from the reporting of all BLLs to only BLLs ≥40 µg/dL (3). The ABLES program ultimately aims to collect a complete list of variables for all BLL tests, including BLLs <10 µg/dL, and encourages all states to supply this information to NIOSH.
Publication Criteria
Adult cases meet the publication criteria if between 1994 and 2012 a venous BLL was ≥25 µg/dL and since 2010 if the venous BLL was ≥10 µg/dL. BLLs ≥25 µg/dL are a subset of BLLs ≥10 µg/dL and are included for historical comparison. When an adult had multiple blood lead tests in a given year, only the highest blood lead level for that adult in that year was counted.
Highlights
In 2012, a total of 41 states submitted data on 7,529 adults with BLLs ≥25 µg/dL and 38 states submitted data on 27,218 adults with BLLs ≥10µg/dL. Overall, the prevalence of BLLs ≥10 µg/dL among state residents and nonresidents declined from 26.6 adults per 100,000 employed in 2010 to 22.5 in 2012. The prevalence of BLLs ≥25 µg/dL among state residents and nonresidents declined from 14.0 adults per 100,000 employed in 1994 to 5.7 in 2012. In 2012, state prevalence rates of BLLs ≥25 µg/dL were above the national rate (5.7/100,000) in 10 states and state prevalence rates of BLLs ≥10µg/dL were above the national rate (22.5/100,000) in 12 states.
In 2012, more than half (53.0%) of adults with BLLs ≥10 µg/dL were aged 40–64 years 33.3% were aged 25–39 years, and the great majority (91.5%) were males. Historically, in the United States, most lead exposures have been occupational. During 2002–2012, the annual proportion of BLLs ≥25 µg/dL from occupational exposures was 94.7% among participating states (minimum: 93.3% in 2012; maximum: 95.5% in 2004). In 2012, among the 37 states that reported the exposure source for adults with BLLs ≥25µg/dL, the proportion of occupational cases ranged from 38.9% to 100%.
References
- CDC. Summary of notifiable noninfectious conditions and disease outbreaks—United States. MMWR Morb Mortal Wkly Rep 2013;62(54).
- CDC. Summary of notifiable infectious diseases—United States. MMWR Morb Mortal Wkly Rep 2013;62(53).
- CDC. Adult Blood Lead Epidemiology and Surveillance (ABLES) Program. Cincinnati, OH: US Department of Health and Human Services, CDC, National Institute for Occupational Safety and Health; 2014. Available at http://www.cdc.gov/niosh/topics/ables/description.html.
- Association of Occupational and Environmental Clinics. Medical management guidelines for lead-exposed adults. Washington, DC: Association of Occupational and Environmental Clinics; 2007. Available at http://www.aoec.org/documents/positions/mmg_revision_with_cste_2013.pdf.
- Kosnett MJ, Wedeen, RP, Rothenberg SJ, et al. Recommendations for medical management of adult lead exposure. Environ Health Perspect 2007;115:463–71.
- CDC. National Notifiable Diseases Surveillance System (NNDSS). Lead, elevated blood levels; 2010. Atlanta, GA: US Department of Health and Human Services, CDC; 2015. Available at http://wwwn.cdc.gov/nndss/conditions/lead-elevated-blood-levels.
- CDC. Adult blood lead epidemiology and surveillance—United States, 2005–2007. MMWR Morb Mortal Wkly Rep 2009;58:365–9.
- Occupational Safety and Health Administration. Directive number: CPL 03-00-009. OSHA instruction: National Emphasis Program on Lead. Washington, DC: US Department of Labor, Occupational Safety and Health Administration; 2008. Available at https://www.osha.gov/OshDoc/Directive_pdf/CPL_03-00-0009.pdf.
- Barbosa F, Tanus-Santos JE, Gerlach RF, Parsons PJ. A critical review of biomarkers used for monitoring human exposure to lead: advantages, limitations, and future needs. Environ Health Perspect 2005;113:1669–74.
- CDC. Fourth national report on human exposure to environmental chemicals. Updated tables, August 2014. Atlanta, GA: US Department of Health and Human Services, CDC; 2014. Available at http://www.cdc.gov/exposurereport/pdf/FourthReport_UpdatedTables_Aug2014.pdf.
- National Toxicology Program. Health effects of low-level lead evaluation. Research Triangle Park, NC: US Department of Health and Human Services, National Toxicology Program; 2013. Available at http://ntp.niehs.nih.gov/go/36443.
- Council of State and Territorial Epidemiologists (CSTE) Position Statement 09-OH-02. Public Health Reporting and National Notification for Elevated Blood: Lead Levels; 2009. Available at http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/PS/09-OH-02.pdf.
- US Department of Health and Human Services. Healthy people 2020: occupational safety and health objectives. Washington, DC: US Department of Health and Human Services; 2013. Available at http://www.healthypeople.gov/2020/topics-objectives/topic/occupational-safety-and-health/objectives.
FIGURE 1. Prevalence rate* of adults with elevated blood lead levels ≥10 µg/dL, by state — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2012†
Abbreviation: ABLES = Adult Blood Level Epidemiology and Surveillance.
* Rate per 100,000 employed adults aged ≥16 years. State-resident rate might be lower for some states. Data from the Adult Blood Epidemiology and Surveillance Program, National Institute for Occupational Safety and Health (NIOSH/CDC). Denominators for 2012 extracted from 2013 U.S. Department of Labor, Bureau of Labor Statistics, Local Area Unemployment Statistics (LAUS) program available at http://www.bls.gov/lau/staadata.txt.
† A total of 41 states submitted data in 2012: Alabama, Alaska, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Washington, Wisconsin, and Wyoming. Kentucky and Illinois submitted BLLs ≥25 µg/dL and Massachusetts submitted BLLs ≥15 µg/dL. In 2012, the two states reporting the highest prevalence of elevated blood lead levels were Missouri (106.66) and Kansas (77.32). The national rate in 2012 was 22.5 cases per 100,000 employed adults aged ≥16 years.
Alternate Text: The figure shows a map of the United States indicating the prevalence rate per 100,000 employed persons aged ≥16 years of elevated blood lead levels ≥10 μg/dL for 2012 in the 41 states that participated in the State Adult Blood Lead Epidemiology and Surveillance programs. Results varied by state. The national rate in 2012 was 22.5 cases per 100,000 employed adults aged ≥16 years.
FIGURE 2. National prevalence rate* of reported cases of elevated blood lead levels (BLLs),† by year — State Adult Blood Epidemiology and Surveillance Programs, United States, 1994–2012§
Abbreviations: All cases = all reported cases by a state, including adult residents in the reporting state and residents in other states; state residents = adult residents in the reporting state.
* Per 100,000 employed adults aged ≥16 years. Denominators for 1994–2012 extracted from 2013 US Department of Labor, Bureau of labor Statistics Local Area Unemployment Statistics (LAUS) program available at http://www.bls.gov/lau/staadata.txt.
† Since 2009, the case definition for an elevated blood lead level is a BLL ≥10 µg/dL. For historical comparisons, prevalence rates at the previous case definition (BLL ≥25 µg/dL) are provided.
§ Numbers of states reporting BLL ≥25 µg/dL data are in parentheses. From 2010, numbers of states reporting BLLs ≥10 µg/dL data also are provided. A total of 41 states submitted data in 2012: Alabama, Alaska, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Washington, Wisconsin, and Wyoming.
Alternate Text: The figure shows a line graph presenting the national prevalence rate per 100,000 employed adults aged ≥16 years of elevated blood lead levels in the United States during 1994–2012.
TABLE 1. (Continued) Reported numbers of cases of adults* with blood lead levels ≥10 µg/dL and blood lead levels ≥25 µg/dL, by geographic division and area — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2012† |
|||||
---|---|---|---|---|---|
Division/Area |
No. of employed state-resident adults (in 1,000s) |
Blood lead levels |
Blood lead levels |
||
All |
State residents** |
All |
State |
||
East South Central |
|||||
Alabama |
2,010 |
970 |
969 |
380 |
380 |
Kentucky |
1,900 |
— |
— |
138 |
122 |
Tennessee |
2,846 |
985 |
838 |
214 |
195 |
Louisiana |
1,944 |
382 |
381 |
67 |
67 |
Oklahoma |
1,698 |
175 |
117 |
80 |
65 |
Texas |
11,762 |
1,149 |
1,144 |
261 |
260 |
Mountain |
|||||
Arizona |
2,774 |
238 |
238 |
43 |
43 |
Colorado |
2,531 |
107 |
69 |
44 |
37 |
Montana |
477 |
27 |
27 |
2 |
2 |
New Mexico |
860 |
50 |
50 |
7 |
7 |
Utah |
1,303 |
164 |
56 |
26 |
8 |
Wyoming |
289 |
56 |
55 |
12 |
12 |
Pacific |
|||||
Alaska |
340 |
219 |
139 |
30 |
23 |
California |
16,590 |
1,797 |
1,783 |
221 |
218 |
Hawaii |
612 |
28 |
27 |
2 |
2 |
Oregon |
1,777 |
344 |
226 |
53 |
38 |
Washington |
3,203 |
283 |
178 |
87 |
78 |
* A person aged ≥16 years at the time of blood collection. When an adult had multiple blood lead tests in a given year, only the highest blood lead level for that adult in that year was counted. † A total of 41 states participated in the ABLES Program in 2012. § Adults with BLLs ≥25 µg/dL are a subset of adults with BLLs ≥10 µg/dL. ¶ All cases reported by a state. These include cases among adult residents in the reporting state plus cases identified by the reporting state but who reside in another state. ** Adults residing in the reporting state. States did not report this variable before 2002. †† 10–24 µg/dL BLL data were not complete. |
TABLE 3. (Continued) Reported number of cases and prevalence rate of adults* with blood lead levels ≥10 µg/dL, by state and age group — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2012 |
||||||||||
---|---|---|---|---|---|---|---|---|---|---|
State |
16–24 yrs |
25–39 yrs |
40–64 yrs |
≥65 yrs |
Age not stated |
Total |
||||
No. |
(Rate) |
No. |
(Rate) |
No. |
(Rate) |
No. |
(Rate) |
No. |
No. |
|
Minnesota |
||||||||||
All cases |
40 |
(10.7) |
174 |
(19.6) |
253 |
(18.2) |
26 |
(20.0) |
— |
493 |
State residents |
40 |
(10.7) |
174 |
(19.6) |
253 |
(18.2) |
26 |
(20.0) |
— |
493 |
Missouri |
||||||||||
All cases |
222 |
(65.5) |
1,043 |
(115.8) |
1,650 |
(116.6) |
58 |
(37.2) |
— |
2,973 |
State residents |
222 |
(65.5) |
1,043 |
(115.8) |
1,650 |
(116.6) |
58 |
(37.2) |
— |
2,973 |
Montana |
||||||||||
All cases |
— |
(—) |
7 |
(5.0) |
17 |
(7.3) |
3 |
(7.2) |
— |
27 |
State residents |
— |
(—) |
7 |
(5.0) |
17 |
(7.3) |
3 |
(7.2) |
— |
27 |
Nebraska |
||||||||||
All cases |
15 |
(10.9) |
61 |
(20.1) |
84 |
(17.7) |
8 |
(11.6) |
168 |
|
State residents |
15 |
(10.9) |
61 |
(20.1) |
84 |
(17.7) |
8 |
(11.6) |
168 |
|
New Hampshire |
||||||||||
All cases |
7 |
(8.0) |
56 |
(30.4) |
81 |
(20.9) |
11 |
(26.8) |
— |
155 |
State residents |
7 |
(8.0) |
56 |
(30.4) |
81 |
(20.9) |
11 |
(26.8) |
— |
155 |
New Jersey |
||||||||||
All cases |
71 |
(14.7) |
450 |
(38.2) |
506 |
(23.0) |
73 |
(26.8) |
2 |
1,102 |
State residents |
71 |
(14.7) |
442 |
(37.5) |
497 |
(22.6) |
73 |
(26.8) |
2 |
1,085 |
New Mexico |
||||||||||
All cases |
4 |
(3.5) |
12 |
(4.4) |
31 |
(6.8) |
3 |
(6.8) |
— |
50 |
State residents |
4 |
(3.5) |
12 |
(4.4) |
31 |
(6.8) |
3 |
(6.8) |
— |
50 |
New York |
||||||||||
All cases |
176 |
(18.0) |
782 |
(27.5) |
1,091 |
(24.4) |
100 |
(22.7) |
— |
2,149 |
State residents |
161 |
(16.5) |
686 |
(24.1) |
980 |
(21.9) |
97 |
(22.0) |
— |
1,924 |
North Carolina |
||||||||||
All cases |
25 |
(4.7) |
101 |
(7.4) |
134 |
(6.1) |
17 |
(7.7) |
— |
277 |
State residents |
25 |
(4.7) |
100 |
(7.3) |
132 |
(6.0) |
17 |
(7.7) |
— |
274 |
Ohio |
||||||||||
All cases |
170 |
(22.5) |
748 |
(48.1) |
1,294 |
(47.8) |
110 |
(34.7) |
1 |
2,323 |
State residents |
157 |
(20.8) |
701 |
(45.0) |
1,206 |
(44.5) |
102 |
(32.2) |
1 |
2,167 |
Oklahoma |
||||||||||
All cases |
12 |
(5.4) |
66 |
(11.7) |
91 |
(11.1) |
5 |
(4.1) |
1 |
175 |
State residents |
7 |
(3.2) |
39 |
(6.9) |
67 |
(8.2) |
3 |
(2.4) |
1 |
117 |
Oregon |
||||||||||
All cases |
19 |
(8.6) |
103 |
(18.8) |
201 |
(22.1) |
21 |
(22.2) |
— |
344 |
State residents |
11 |
(5.0) |
68 |
(12.4) |
134 |
(14.7) |
13 |
(13.7) |
— |
226 |
Pennsylvania |
||||||||||
All cases |
429 |
(51.4) |
1,019 |
(60.0) |
1,608 |
(50.5) |
81 |
(25.6) |
1 |
3,138 |
State residents |
429 |
(51.4) |
1,019 |
(60.0) |
1,607 |
(50.4) |
81 |
(25.6) |
1 |
3,137 |
Rhode Island |
||||||||||
All cases |
6 |
(8.2) |
25 |
(18.3) |
62 |
(23.9) |
11 |
(38.0) |
— |
104 |
State residents |
6 |
(8.2) |
25 |
(18.3) |
62 |
(23.9) |
11 |
(38.0) |
— |
104 |
South Carolina |
||||||||||
All cases |
26 |
(10.9) |
90 |
(14.3) |
170 |
(16.8) |
5 |
(5.0) |
— |
291 |
State residents |
26 |
(10.9) |
90 |
(14.3) |
169 |
(16.7) |
5 |
(5.0) |
— |
290 |
Tennessee |
||||||||||
All cases |
77 |
(20.6) |
346 |
(38.1) |
531 |
(37.3) |
29 |
(18.1) |
2 |
985 |
State residents |
63 |
(16.9) |
298 |
(32.9) |
451 |
(31.7) |
24 |
(15.0) |
2 |
838 |
Texas |
||||||||||
All cases |
152 |
(10.3) |
368 |
(8.9) |
571 |
(10.1) |
58 |
(10.8) |
— |
1,149 |
State residents |
151 |
(10.2) |
366 |
(8.9) |
569 |
(10.1) |
58 |
(10.8) |
— |
1,144 |
Utah |
||||||||||
All cases |
9 |
(4.0) |
59 |
(12.2) |
79 |
(15.0) |
17 |
(33.2) |
— |
164 |
State residents |
2 |
(0.9) |
13 |
(2.7) |
32 |
(6.1) |
9 |
(17.6) |
— |
56 |
TABLE 3. (Continued) Reported number of cases and prevalence rate of adults* with blood lead levels ≥10 µg/dL, by state and age group — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2012 |
||||||||||
---|---|---|---|---|---|---|---|---|---|---|
State |
16–24 yrs |
25–39 yrs |
40–64 yrs |
≥65 yrs |
Age not stated |
Total |
||||
No. |
(Rate) |
No. |
(Rate) |
No. |
(Rate) |
No. |
(Rate) |
No. |
No. |
|
Vermont |
||||||||||
All cases |
4 |
(10.4) |
8 |
(8.8) |
29 |
(15.3) |
6 |
(28.3) |
— |
47 |
State residents |
4 |
(10.4) |
8 |
(8.8) |
29 |
(15.3) |
6 |
(28.3) |
— |
47 |
Washington |
||||||||||
All cases |
30 |
(7.9) |
99 |
(9.6) |
143 |
(8.7) |
11 |
(7.2) |
— |
283 |
State residents |
18 |
(4.8) |
62 |
(6.0) |
93 |
(5.7) |
5 |
(3.3) |
— |
178 |
Wisconsin |
||||||||||
All cases |
37 |
(9.0) |
184 |
(22.0) |
452 |
(31.0) |
33 |
(22.2) |
2 |
708 |
State residents |
37 |
(9.0) |
184 |
(22.0) |
452 |
(31.0) |
33 |
(22.2) |
2 |
708 |
Wyoming |
||||||||||
All cases |
1 |
(2.6) |
12 |
(13.5) |
38 |
(26.7) |
5 |
(26.3) |
— |
56 |
State residents |
1 |
(2.6) |
11 |
(12.4) |
38 |
(26.7) |
5 |
(26.3) |
— |
55 |
* A person aged ≥16 years at the time of blood collection. When an adult had multiple blood lead tests in a given year, only the highest blood lead level for that adult in that year was counted. To calculate rates, CDC estimated the number of employed adults (denominator) by age group and sex on the basis of data obtained from the Current Population Survey, U.S. Census Bureau. † All cases reported by a state. These include cases among adult residents in the reporting state plus cases identified by the reporting state but who reside in another state. § No cases were reported. ¶ Adults residing in the reporting state. States did not report this variable before 2002. |
TABLE 4. (Continued) Number of reported cases and prevalence of adults* with blood lead levels ≥10 µg/dL, by state and sex — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2012 |
||||||
---|---|---|---|---|---|---|
State |
Male |
Female |
Sex not stated |
Total |
||
No. |
(Rate) |
No. |
(Rate) |
No. |
||
Missouri |
||||||
All cases |
2,625 |
(178.9) |
348 |
(25.8) |
— |
2,973 |
State residents |
2,625 |
(178.9) |
348 |
(25.8) |
— |
2,973 |
Montana |
||||||
All cases |
21 |
(8.5) |
5 |
(2.2) |
1 |
27 |
State residents |
21 |
(8.5) |
5 |
(2.2) |
1 |
27 |
Nebraska |
||||||
All cases |
159 |
(30.7) |
5 |
(1.1) |
4 |
168 |
State residents |
159 |
(30.7) |
5 |
(1.1) |
4 |
168 |
New Hampshire |
||||||
All cases |
151 |
(41.4) |
4 |
(1.2) |
— |
155 |
State residents |
151 |
(41.4) |
4 |
(1.2) |
— |
155 |
New Jersey |
||||||
All cases |
1,059 |
(48.4) |
40 |
(2.1) |
3 |
1,102 |
State residents |
1,044 |
(47.7) |
38 |
(1.9) |
3 |
1,085 |
New Mexico |
||||||
All cases |
45 |
(9.7) |
5 |
(1.2) |
— |
50 |
State residents |
45 |
(9.7) |
5 |
(1.2) |
— |
50 |
New York |
||||||
All cases |
1,826 |
(40.1) |
323 |
(7.7) |
— |
2,149 |
State residents |
1,605 |
(35.2) |
319 |
(7.6) |
— |
1,924 |
North Carolina |
||||||
All cases |
253 |
(11.1) |
23 |
(1.1) |
1 |
277 |
State residents |
250 |
(10.9) |
23 |
(1.1) |
1 |
274 |
Ohio |
||||||
All cases |
2,160 |
(76.9) |
156 |
(6.1) |
7 |
2,323 |
State residents |
2,011 |
(71.6) |
152 |
(6.0) |
4 |
2,167 |
Oklahoma |
||||||
All cases |
159 |
(16.8) |
16 |
(2.0) |
— |
175 |
State residents |
104 |
(11.0) |
13 |
(1.7) |
— |
117 |
Oregon |
||||||
All cases |
322 |
(34.6) |
18 |
(2.1) |
4 |
344 |
State residents |
211 |
(22.7) |
14 |
(1.7) |
1 |
226 |
Pennsylvania |
||||||
All cases |
3,015 |
(94.2) |
118 |
(4.1) |
5 |
3,138 |
State residents |
3,014 |
(94.2) |
118 |
(4.1) |
5 |
3,137 |
Rhode Island |
||||||
All cases |
95 |
(37.5) |
9 |
(3.6) |
— |
104 |
State residents |
95 |
(37.5) |
9 |
(3.6) |
— |
104 |
South Carolina |
||||||
All cases |
262 |
(25.7) |
25 |
(2.6) |
4 |
291 |
State residents |
262 |
(25.7) |
24 |
(2.5) |
4 |
290 |
Tennessee |
||||||
All cases |
832 |
(54.3) |
82 |
(6.1) |
71 |
985 |
State residents |
709 |
(46.3) |
71 |
(5.3) |
58 |
838 |
Texas |
||||||
All cases |
1,079 |
(16.6) |
69 |
(1.3) |
1 |
1,149 |
State residents |
1,075 |
(16.6) |
68 |
(1.3) |
1 |
1,144 |
Utah |
||||||
All cases |
153 |
(21.1) |
10 |
(1.8) |
1 |
164 |
State residents |
52 |
(7.2) |
4 |
(0.7) |
— |
56 |
TABLE 4. (Continued) Number of reported cases and prevalence of adults* with blood lead levels ≥10 µg/dL, by state and sex — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2012 |
||||||
---|---|---|---|---|---|---|
State |
Male |
Female |
Sex not stated |
Total |
||
No. |
(Rate) |
No. |
(Rate) |
No. |
||
Vermont |
||||||
All cases |
43 |
(24.7) |
4 |
(2.4) |
— |
47 |
State residents |
43 |
(24.7) |
4 |
(2.4) |
— |
47 |
Washington |
||||||
All cases |
273 |
(16.0) |
9 |
(0.6) |
1 |
283 |
State residents |
172 |
(10.1) |
6 |
(0.4) |
— |
178 |
Wisconsin |
||||||
All cases |
640 |
(43.3) |
66 |
(4.8) |
2 |
708 |
State residents |
640 |
(43.3) |
66 |
(4.8) |
2 |
708 |
Wyoming |
||||||
All cases |
46 |
(28.6) |
10 |
(7.7) |
— |
56 |
State residents |
45 |
(28.0) |
10 |
(7.7) |
— |
55 |
* A person aged ≥16 years at the time of blood collection. When an adult had multiple blood lead tests in a given year, only the highest blood lead level for that adult in that year was counted. To calculate rates, CDC estimated the number of employed adults (denominator) by age group and sex on the basis of data obtained from the Current Population Survey, U.S. Census Bureau. † All cases reported by a state. These include cases among adult residents in the reporting state plus cases identified by the reporting state but who reside in another state. § Adults residing in the reporting state. States did not report this variable before 2002. ¶ No cases were reported. |
TABLE 7. (Continued) Number of reported cases and prevalence rate per 100,000 of employed adults* of persons with blood lead levels ≥10 µg/dL — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2010–2012 |
||||||
---|---|---|---|---|---|---|
State |
2010 |
2011 |
2012 |
|||
No. |
(Rate) |
No. |
(Rate) |
No. |
(Rate) |
|
Maine |
||||||
All cases |
120 |
(18.6) |
85 |
(13.1) |
133 |
(20.3) |
State residents |
120 |
(18.6) |
85 |
(13.1) |
133 |
(20.3) |
Maryland |
||||||
All cases |
209 |
(7.4) |
273 |
(9.5) |
273 |
(9.4) |
State residents |
170 |
(6.0) |
265 |
(9.2) |
253 |
(8.7) |
Michigan |
||||||
All cases |
598 |
(14.4) |
625 |
(14.9) |
631 |
(14.9) |
State residents |
590 |
(14.2) |
615 |
(14.7) |
630 |
(14.9) |
Minnesota |
||||||
All cases |
572 |
(20.8) |
428 |
(15.4) |
493 |
(17.6) |
State residents |
572 |
(20.8) |
428 |
(15.4) |
493 |
(17.6) |
Missouri |
||||||
All cases |
2,951 |
(107.3) |
2,988 |
(108.2) |
2,973 |
(106.7) |
State residents |
2,951 |
(107.3) |
2,988 |
(108.2) |
2,973 |
(106.7) |
Montana |
||||||
All cases |
88 |
(19.0) |
34 |
(7.3) |
27 |
(5.7) |
State residents |
26 |
(5.6) |
34 |
(7.3) |
27 |
(5.7) |
Nebraska |
||||||
All cases |
163 |
(17.3) |
141 |
(14.7) |
168 |
(17.2) |
State residents |
163 |
(17.3) |
141 |
(14.7) |
168 |
(17.2) |
New Hampshire |
||||||
All cases |
225 |
(32.4) |
214 |
(30.7) |
155 |
(22.1) |
State residents |
225 |
(32.4) |
214 |
(30.7) |
155 |
(22.1) |
New Jersey |
||||||
All cases |
1,187 |
(28.9) |
1,261 |
(30.7) |
1,102 |
(26.6) |
State residents |
1,119 |
(27.2) |
1,146 |
(27.9) |
1,085 |
(26.2) |
New Mexico |
||||||
All cases |
63 |
(7.4) |
61 |
(7.1) |
50 |
(5.8) |
State residents |
57 |
(6.7) |
61 |
(7.1) |
50 |
(5.8) |
New York |
||||||
All cases |
2,552 |
(29.1) |
2,376 |
(27.1) |
2,149 |
(24.4) |
State residents |
2,222 |
(25.4) |
2,136 |
(24.4) |
1,924 |
(21.9) |
North Carolina |
||||||
All cases |
484 |
(11.7) |
395 |
(9.4) |
277 |
(6.5) |
State residents |
482 |
(11.7) |
391 |
(9.4) |
274 |
(6.4) |
Ohio |
||||||
All cases |
3,002 |
(57.1) |
2,049 |
(38.8) |
2,323 |
(43.7) |
State residents |
2,880 |
(54.8) |
1,988 |
(37.6) |
2,167 |
(40.8) |
Oklahoma |
||||||
All cases |
— |
(—) |
65 |
(3.9) |
175 |
(10.3) |
State residents |
— |
(—) |
54 |
(3.2) |
117 |
(6.9) |
TABLE 7. (Continued) Number of reported cases and prevalence rate per 100,000 of employed adults* of persons with blood lead levels ≥10 µg/dL — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2010–2012 |
||||||
---|---|---|---|---|---|---|
State |
2010 |
2011 |
2012 |
|||
No. |
(Rate) |
No. |
(Rate) |
No. |
(Rate) |
|
Oregon |
||||||
All cases |
355 |
(20.2) |
312 |
(17.6) |
344 |
(19.4) |
State residents |
340 |
(19.4) |
295 |
(16.6) |
226 |
(12.7) |
Pennsylvania |
||||||
All cases |
3,904 |
(66.7) |
4,042 |
(68.7) |
3,138 |
(52.7) |
State residents |
3,895 |
(66.6) |
4,030 |
(68.5) |
3,137 |
(52.7) |
Rhode Island |
||||||
All cases |
159 |
(31.5) |
134 |
(26.8) |
104 |
(20.7) |
State residents |
159 |
(31.5) |
134 |
(26.8) |
104 |
(20.7) |
South Carolina |
||||||
All cases |
240 |
(12.5) |
216 |
(11.1) |
291 |
(14.6) |
State residents |
102 |
(5.3) |
216 |
(11.1) |
290 |
(14.6) |
Tennessee |
||||||
All cases |
967 |
(34.8) |
1,189 |
(42.0) |
985 |
(34.6) |
State residents |
632 |
(22.7) |
942 |
(33.3) |
838 |
(29.4) |
Texas |
||||||
All cases |
1,203 |
(10.7) |
1,156 |
(10.1) |
1,149 |
(9.8) |
State residents |
1,157 |
(10.3) |
1,149 |
(10.0) |
1,144 |
(9.7) |
Utah |
||||||
All cases |
170 |
(13.6) |
129 |
(10.2) |
164 |
(12.6) |
State residents |
75 |
(6.0) |
56 |
(4.4) |
56 |
(4.3) |
Vermont |
||||||
All cases |
57 |
(16.9) |
63 |
(18.6) |
47 |
(13.9) |
State residents |
57 |
(16.9) |
63 |
(18.6) |
47 |
(13.9) |
Washington |
||||||
All cases |
332 |
(10.5) |
278 |
(8.8) |
283 |
(8.8) |
State residents |
159 |
(5.0) |
187 |
(5.9) |
178 |
(5.6) |
Wisconsin |
||||||
All cases |
831 |
(29.4) |
782 |
(27.6) |
708 |
(24.8) |
State residents |
830 |
(29.4) |
781 |
(27.5) |
708 |
(24.8) |
Wyoming |
||||||
All cases |
48 |
(17.1) |
56 |
(19.7) |
56 |
(19.4) |
State residents |
48 |
(17.1) |
55 |
(19.3) |
55 |
(19.0) |
* A person aged ≥16 years at the time of blood collection. When an adult had multiple blood lead tests in a given year, only the highest blood lead level for that adult in that year was counted. Rates were calculated on the basis of data on the number of employed adults (denominator), which were obtained from the Local Area Unemployment Statistics (LAUS) program, Bureau of labor Statistics, U.S. Department of Labor. † All cases reported by a state. These include cases among adults residing in the reporting state plus cases identified by the reporting state but who reside in another state. § Adults residing in the reporting state. States did not report this variable before 2002. ¶ Data unavailable. |
TABLE 8. (Continued) Reported prevalence rate per 100,000 employed adults of adults* with blood lead levels ≥25 µg/dL — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2002–2012 |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
State |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
2008 |
2009 |
2010 |
2011 |
2012 |
Maine |
|||||||||||
All cases |
7.1 |
6.9 |
6.6 |
4.0 |
4.8 |
3.0 |
3.8 |
2.2 |
4.2 |
2.2 |
2.7 |
State residents |
7.1 |
6.9 |
4.7 |
4.0 |
4.8 |
3.0 |
3.8 |
2.2 |
4.2 |
2.2 |
2.7 |
Maryland |
|||||||||||
All cases |
4.8 |
4.6 |
3.1 |
2.7 |
2.3 |
3.9 |
3.9 |
3.7 |
3.7 |
2.0 |
2.2 |
State residents |
4.7 |
3.4 |
2.2 |
1.5 |
1.8 |
3.3 |
3.1 |
2.8 |
2.9 |
1.9 |
2.1 |
Massachusetts |
|||||||||||
All cases |
9.1 |
7.6 |
7.8 |
6.3 |
7.1 |
5.6 |
5.3 |
5.3 |
5.4 |
6.1 |
3.8 |
State residents |
7.3 |
6.9 |
7.2 |
5.8 |
6.1 |
5.0 |
4.9 |
4.7 |
4.5 |
5.5 |
3.6 |
Michigan |
|||||||||||
All cases |
4.1 |
3.7 |
3.4 |
2.8 |
2.3 |
2.8 |
2.8 |
2.5 |
2.5 |
2.8 |
3.1 |
State residents |
4.1 |
3.5 |
3.2 |
2.7 |
2.3 |
2.8 |
2.8 |
2.4 |
2.4 |
2.7 |
3.1 |
Minnesota |
|||||||||||
All cases |
6.0 |
6.7 |
5.2 |
4.8 |
4.8 |
5.6 |
4.5 |
3.5 |
4.1 |
3.2 |
4.4 |
State residents |
6.0 |
6.7 |
5.2 |
4.7 |
4.8 |
5.6 |
4.5 |
3.5 |
4.1 |
3.2 |
4.4 |
Missouri |
|||||||||||
All cases |
32.9 |
33.1 |
26.8 |
30.9 |
32.1 |
37.2 |
35.3 |
26.5 |
30.7 |
28.2 |
24.0 |
State residents |
15.1 |
24.7 |
26.3 |
29.0 |
30.6 |
36.0 |
34.4 |
26.4 |
30.7 |
28.2 |
24.0 |
Montana |
|||||||||||
All cases |
0.9 |
1.1 |
1.8 |
0.9 |
1.5 |
1.0 |
2.1 |
3.0 |
2.6 |
0.6 |
0.4 |
State residents |
0.9 |
1.1 |
1.8 |
0.9 |
0.2 |
** |
1.2 |
2.4 |
1.1 |
0.6 |
0.4 |
Nebraska |
|||||||||||
All cases |
4.8 |
6.3 |
5.5 |
4.5 |
3.3 |
5.4 |
5.0 |
5.1 |
5.0 |
4.1 |
5.2 |
State residents |
4.8 |
6.3 |
5.5 |
4.5 |
3.3 |
5.4 |
5.0 |
5.1 |
5.0 |
4.1 |
5.2 |
New Hampshire |
|||||||||||
All cases |
9.1 |
8.4 |
7.6 |
7.6 |
6.4 |
5.5 |
7.0 |
4.2 |
4.3 |
3.9 |
2.3 |
State residents |
8.4 |
8.4 |
7.6 |
7.6 |
6.4 |
5.5 |
7.0 |
4.2 |
4.3 |
3.9 |
2.3 |
New Jersey |
|||||||||||
All cases |
10.4 |
10.2 |
9.5 |
9.5 |
7.8 |
3.3 |
4.7 |
4.9 |
5.8 |
5.1 |
4.3 |
State residents |
10.4 |
8.7 |
7.8 |
8.7 |
7.3 |
3.1 |
4.5 |
4.7 |
5.5 |
4.5 |
4.3 |
New Mexico |
|||||||||||
All cases |
1.8 |
1.1 |
1.3 |
0.6 |
0.8 |
0.8 |
1.1 |
1.0 |
0.8 |
1.9 |
0.8 |
State residents |
1.8 |
1.1 |
1.3 |
0.6 |
0.8 |
0.8 |
1.0 |
1.0 |
0.7 |
1.9 |
0.8 |
New York |
|||||||||||
All cases |
9.2 |
7.3 |
7.8 |
6.2 |
5.6 |
3.6 |
3.8 |
3.2 |
4.6 |
3.8 |
3.2 |
State residents |
8.4 |
6.8 |
7.2 |
5.6 |
5.3 |
3.3 |
3.5 |
2.8 |
3.9 |
3.5 |
3.0 |
North Carolina |
|||||||||||
All cases |
5.5 |
5.6 |
4.5 |
3.2 |
3.7 |
4.8 |
3.9 |
3.5 |
5.6 |
3.5 |
2.6 |
State residents |
5.5 |
5.6 |
4.4 |
3.1 |
3.7 |
4.7 |
3.8 |
3.4 |
5.6 |
3.5 |
2.6 |
Ohio |
|||||||||||
All cases |
16.5 |
13.0 |
12.4 |
13.2 |
10.9 |
10.9 |
10.8 |
10.2 |
13.1 |
10.4 |
9.7 |
State residents |
16.5 |
13.0 |
12.3 |
13.1 |
10.9 |
10.9 |
10.7 |
10.2 |
13.0 |
10.2 |
9.3 |
Oklahoma |
|||||||||||
All cases |
3.9 |
6.1 |
5.1 |
3.0 |
4.0 |
1.9 |
2.3 |
2.0 |
— |
2.5 |
4.7 |
State residents |
3.9 |
5.3 |
4.6 |
3.0 |
3.6 |
1.3 |
1.6 |
2.0 |
— |
2.1 |
3.8 |
TABLE 8. (Continued) Reported prevalence rate per 100,000 employed adults of adults* with blood lead levels ≥25 µg/dL — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2002–2012 |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
State |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
2008 |
2009 |
2010 |
2011 |
2012 |
Oregon |
|||||||||||
All cases |
4.1 |
4.5 |
4.8 |
3.5 |
2.7 |
3.4 |
3.9 |
2.7 |
2.2 |
3.0 |
3.0 |
State residents |
4.1 |
4.2 |
4.1 |
3.3 |
2.7 |
3.4 |
3.9 |
2.0 |
1.9 |
2.7 |
2.1 |
Pennsylvania |
|||||||||||
All cases |
26.0 |
31.3 |
30.2 |
20.9 |
32.2 |
34.3 |
37.6 |
32.2 |
35.7 |
39.3 |
28.7 |
State residents |
25.8 |
31.3 |
30.2 |
20.9 |
32.2 |
34.0 |
37.3 |
32.0 |
35.6 |
39.2 |
28.7 |
Rhode Island |
|||||||||||
All cases |
20.4 |
8.3 |
7.0 |
7.7 |
7.2 |
6.1 |
4.9 |
5.4 |
5.9 |
6.4 |
4.4 |
State residents |
20.4 |
7.7 |
7.0 |
7.7 |
7.2 |
6.1 |
4.9 |
5.4 |
5.9 |
6.4 |
4.4 |
South Carolina |
|||||||||||
All cases |
6.7 |
4.2 |
6.1 |
12.1 |
6.9 |
5.6 |
3.7 |
1.6 |
3.7 |
2.1 |
3.3 |
State residents |
6.7 |
4.2 |
5.4 |
12.1 |
6.9 |
5.6 |
3.6 |
0.6 |
1.5 |
2.1 |
3.3 |
Tennessee |
|||||||||||
All cases |
— |
— |
— |
— |
19.8 |
21.2 |
19.5 |
9.7 |
9.4 |
9.4 |
7.5 |
State residents |
— |
— |
— |
— |
19.5 |
19.1 |
17.3 |
7.7 |
6.3 |
8.2 |
6.9 |
Texas |
|||||||||||
All cases |
3.4 |
2.4 |
2.0 |
2.3 |
2.4 |
2.3 |
2.9 |
2.9 |
2.5 |
2.5 |
2.2 |
State residents |
3.4 |
2.4 |
2.0 |
2.3 |
2.4 |
2.3 |
2.5 |
2.7 |
2.5 |
2.4 |
2.2 |
Utah |
|||||||||||
All cases |
4.0 |
5.2 |
3.0 |
4.3 |
3.0 |
2.6 |
2.6 |
2.6 |
1.9 |
1.6 |
2.0 |
State residents |
4.0 |
5.1 |
2.8 |
4.0 |
2.5 |
2.4 |
2.3 |
2.4 |
1.2 |
0.7 |
0.6 |
Vermont |
|||||||||||
All cases |
— |
— |
— |
— |
— |
— |
5.6 |
4.2 |
3.3 |
5.0 |
2.4 |
State residents |
— |
— |
— |
— |
— |
— |
5.6 |
4.2 |
3.3 |
5.0 |
2.4 |
Washington |
|||||||||||
All cases |
2.8 |
3.6 |
2.3 |
2.0 |
2.5 |
2.3 |
1.7 |
2.6 |
2.7 |
2.3 |
2.7 |
State residents |
2.7 |
2.7 |
2.1 |
1.6 |
2.0 |
1.8 |
1.5 |
2.1 |
2.1 |
2.0 |
2.4 |
Wisconsin |
|||||||||||
All cases |
9.0 |
7.4 |
7.0 |
6.0 |
5.2 |
7.9 |
6.5 |
5.6 |
4.2 |
4.2 |
3.5 |
State residents |
9.0 |
7.4 |
7.0 |
6.0 |
5.2 |
7.9 |
6.5 |
5.6 |
4.2 |
4.1 |
3.5 |
Wyoming |
|||||||||||
All cases |
4.3 |
5.0 |
10.7 |
15.7 |
10.1 |
9.6 |
6.6 |
5.0 |
2.1 |
4.6 |
4.2 |
State residents |
4.3 |
5.0 |
10.7 |
15.7 |
10.1 |
9.2 |
6.3 |
5.0 |
2.1 |
4.6 |
4.2 |
Abbreviation: NA = not available; program did not report state resident data this year. * A person aged ≥16 years at the time of blood collection. When an adult had multiple blood lead tests in a given year, only the highest blood lead level for that adult in that year was counted. † All cases reported by a state. These include cases among adults residing in the reporting state plus cases identified by the reporting state but who reside in another state. § Adults residing in the reporting state. States did not report this variable before 2002. ¶ Data were unavailable because the state did not participate in the program for this year. ** Reported zero cases of state residents with elevated BLLs for this year. |
TABLE 9. (Continued) Number of reported cases of adults* with blood lead levels ≥25 µg/dL — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2002–2012 |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
State |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
2008 |
2009 |
2010 |
2011 |
2012 |
Maine |
|||||||||||
All cases |
46 |
45 |
43 |
26 |
32 |
20 |
25 |
14 |
27 |
14 |
18 |
State residents |
46 |
45 |
31 |
26 |
32 |
20 |
25 |
14 |
27 |
14 |
18 |
Maryland |
|||||||||||
All cases |
132 |
126 |
85 |
75 |
66 |
113 |
114 |
103 |
106 |
56 |
63 |
State residents |
128 |
93 |
60 |
42 |
51 |
96 |
89 |
80 |
82 |
54 |
61 |
Massachusetts |
|||||||||||
All cases |
296 |
245 |
249 |
203 |
232 |
183 |
174 |
168 |
173 |
196 |
124 |
State residents |
237 |
222 |
230 |
186 |
198 |
165 |
160 |
151 |
142 |
176 |
117 |
Michigan |
|||||||||||
All cases |
195 |
173 |
157 |
133 |
108 |
132 |
128 |
103 |
102 |
116 |
132 |
State residents |
194 |
162 |
149 |
129 |
107 |
132 |
127 |
102 |
101 |
115 |
132 |
Minnesota |
|||||||||||
All cases |
164 |
185 |
143 |
131 |
134 |
156 |
125 |
96 |
113 |
88 |
123 |
State residents |
164 |
185 |
143 |
130 |
134 |
156 |
125 |
96 |
113 |
88 |
123 |
Missouri |
|||||||||||
All cases |
932 |
931 |
755 |
881 |
928 |
1,078 |
1,014 |
736 |
845 |
780 |
669 |
State residents |
427 |
695 |
740 |
826 |
885 |
1,042 |
987 |
734 |
845 |
780 |
669 |
Montana |
|||||||||||
All cases |
4 |
5 |
8 |
4 |
7 |
5 |
10 |
14 |
12 |
3 |
2 |
State residents |
4 |
5 |
8 |
4 |
1 |
** |
6 |
11 |
5 |
3 |
2 |
Nebraska |
|||||||||||
All cases |
44 |
59 |
52 |
42 |
31 |
51 |
48 |
48 |
47 |
39 |
51 |
State residents |
44 |
59 |
52 |
42 |
31 |
51 |
48 |
48 |
47 |
39 |
51 |
New Hampshire |
|||||||||||
All cases |
62 |
57 |
52 |
53 |
45 |
39 |
50 |
29 |
30 |
27 |
16 |
State residents |
57 |
57 |
52 |
53 |
45 |
39 |
50 |
29 |
30 |
27 |
16 |
New Jersey |
|||||||||||
All cases |
430 |
417 |
392 |
401 |
331 |
141 |
199 |
202 |
239 |
210 |
178 |
State residents |
430 |
358 |
325 |
367 |
309 |
131 |
193 |
196 |
227 |
186 |
176 |
New Mexico |
|||||||||||
All cases |
15 |
9 |
11 |
5 |
7 |
7 |
10 |
9 |
7 |
16 |
7 |
State residents |
15 |
9 |
11 |
5 |
7 |
7 |
9 |
9 |
6 |
16 |
7 |
New York |
|||||||||||
All cases |
801 |
639 |
683 |
552 |
511 |
330 |
350 |
285 |
402 |
331 |
285 |
State residents |
728 |
593 |
631 |
503 |
480 |
299 |
318 |
246 |
342 |
308 |
260 |
North Carolina |
|||||||||||
All cases |
217 |
221 |
183 |
132 |
157 |
205 |
168 |
142 |
230 |
147 |
112 |
State residents |
217 |
221 |
176 |
129 |
157 |
200 |
161 |
140 |
230 |
147 |
112 |
Ohio |
|||||||||||
All cases |
910 |
716 |
680 |
730 |
608 |
611 |
601 |
544 |
689 |
548 |
517 |
State residents |
910 |
715 |
676 |
723 |
608 |
611 |
594 |
544 |
684 |
539 |
495 |
TABLE 9. (Continued) Number of reported cases of adults* with blood lead levels ≥25 µg/dL — State Adult Blood Lead Epidemiology and Surveillance programs, United States, 2002–2012 |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
State |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
2008 |
2009 |
2010 |
2011 |
2012 |
Oklahoma |
|||||||||||
All cases |
62 |
97 |
82 |
49 |
66 |
31 |
39 |
33 |
— |
41 |
80 |
State residents |
62 |
85 |
74 |
48 |
59 |
22 |
27 |
33 |
— |
35 |
65 |
Oregon |
|||||||||||
All cases |
70 |
77 |
82 |
60 |
49 |
62 |
71 |
47 |
39 |
54 |
53 |
State residents |
69 |
71 |
70 |
58 |
48 |
62 |
71 |
35 |
34 |
48 |
38 |
Pennsylvania |
|||||||||||
All cases |
1,526 |
1,816 |
1,770 |
1,244 |
1,937 |
2,074 |
2,296 |
1,897 |
2,087 |
2,312 |
1,708 |
State residents |
1,512 |
1,816 |
1,770 |
1,244 |
1,937 |
2,058 |
2,276 |
1,886 |
2,084 |
2,309 |
1,708 |
Rhode Island |
|||||||||||
All cases |
107 |
44 |
37 |
41 |
39 |
33 |
26 |
27 |
30 |
32 |
22 |
State residents |
107 |
41 |
37 |
41 |
39 |
33 |
26 |
27 |
30 |
32 |
22 |
South Carolina |
|||||||||||
All cases |
123 |
78 |
115 |
233 |
136 |
112 |
73 |
31 |
72 |
41 |
66 |
State residents |
123 |
78 |
102 |
233 |
136 |
112 |
71 |
11 |
29 |
41 |
66 |
Tennessee |
|||||||||||
All cases |
— |
— |
— |
— |
564 |
614 |
555 |
264 |
260 |
267 |
214 |
State residents |
— |
— |
— |
— |
557 |
554 |
493 |
210 |
176 |
232 |
195 |
Texas |
|||||||||||
All cases |
344 |
246 |
202 |
241 |
254 |
255 |
321 |
318 |
287 |
282 |
261 |
State residents |
344 |
246 |
202 |
241 |
254 |
251 |
281 |
295 |
279 |
279 |
260 |
Utah |
|||||||||||
All cases |
44 |
59 |
35 |
53 |
38 |
35 |
35 |
33 |
24 |
20 |
26 |
State residents |
44 |
58 |
33 |
49 |
32 |
32 |
31 |
30 |
15 |
9 |
8 |
Vermont |
|||||||||||
All cases |
— |
— |
— |
— |
— |
— |
19 |
14 |
11 |
17 |
8 |
State residents |
— |
— |
— |
— |
— |
— |
19 |
14 |
11 |
17 |
8 |
Washington |
|||||||||||
All cases |
79 |
105 |
69 |
62 |
78 |
73 |
57 |
83 |
84 |
72 |
87 |
State residents |
77 |
78 |
63 |
49 |
63 |
57 |
48 |
66 |
67 |
62 |
78 |
Wisconsin |
|||||||||||
All cases |
257 |
213 |
202 |
173 |
153 |
233 |
190 |
159 |
119 |
118 |
100 |
State residents |
257 |
213 |
202 |
173 |
153 |
233 |
190 |
159 |
119 |
117 |
100 |
Wyoming |
|||||||||||
All cases |
11 |
13 |
28 |
42 |
28 |
27 |
19 |
14 |
6 |
13 |
12 |
State residents |
11 |
13 |
28 |
42 |
28 |
26 |
18 |
14 |
6 |
13 |
12 |
Abbreviation: NA = not available; program did not report state resident data this year. * A person aged ≥16 years at the time of blood collection. When an adult had multiple blood lead tests in a given year, only the highest blood lead level for that adult in that year was counted. † All cases reported by a state. These include cases among adults residing in the reporting state plus cases identified by the reporting state but who reside in another state. § Adults residing in the reporting state. States did not report this variable before 2002. ¶ Data were unavailable because the state did not participate in the program in this year. ** Reported zero cases of state residents with elevated BLLs for this year. |
TABLE 11. Total number (in 1000s) of state-resident employed adults* (denominators), by state and year — United States, 2002–2012† |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
State |
2002 |
2003 |
2004 |
2005 |
2006 |
2007 |
2008 |
2009 |
2010 |
2011 |
2012 |
Alabama |
1,995 |
1,990 |
2,007 |
2,052 |
2,098 |
2,104 |
2,054 |
1,937 |
1,978 |
2,004 |
2,010 |
Alaska |
—† |
311 |
315 |
321 |
326 |
330 |
333 |
331 |
333 |
337 |
340 |
Arizona |
2,513 |
2,573 |
2,650 |
2,725 |
2,837 |
2,898 |
2,913 |
2,822 |
2,782 |
2,761 |
2,774 |
California |
16,181 |
16,200 |
16,355 |
16,592 |
16,821 |
16,961 |
16,894 |
16,155 |
16,068 |
16,250 |
16,590 |
Colorado |
— |
— |
— |
— |
— |
— |
— |
— |
— |
2,493 |
2,531 |
Connecticut |
1,701 |
1,697 |
1,704 |
1,719 |
1,746 |
1,761 |
1,769 |
1,741 |
1,737 |
1,737 |
1,731 |
Florida |
7,663 |
7,786 |
7,998 |
8,305 |
8,584 |
8,839 |
8,637 |
8,140 |
8,131 |
8,311 |
8,547 |
Georgia |
4,135 |
4,174 |
4,249 |
4,375 |
4,500 |
4,588 |
4,541 |
4,295 |
4,235 |
4,280 |
4,342 |
Hawaii |
584 |
— |
598 |
610 |
618 |
— |
617 |
593 |
604 |
614 |
612 |
Illinois |
5,969 |
5,917 |
5,969 |
6,033 |
6,225 |
6,322 |
6,248 |
5,938 |
5,925 |
5,937 |
5,982 |
Indiana |
— |
2,998 |
2,998 |
3,032 |
3,080 |
3,082 |
3,057 |
2,873 |
2,851 |
2,890 |
2,912 |
Iowa |
1,568 |
1,537 |
1,535 |
1,558 |
1,595 |
1,604 |
1,609 |
1,571 |
1,566 |
1,569 |
1,577 |
Kansas |
1,351 |
1,365 |
1,381 |
1,390 |
1,404 |
1,411 |
1,416 |
1,400 |
1,397 |
1,399 |
1,401 |
Kentucky |
1,838 |
1,848 |
1,855 |
1,876 |
1,904 |
1,924 |
1,907 |
1,850 |
1,857 |
1,879 |
1,900 |
Louisiana |
— |
— |
— |
— |
— |
1,934 |
1,965 |
1,916 |
1,919 |
1,917 |
1,944 |
Maine |
651 |
650 |
654 |
659 |
666 |
666 |
665 |
643 |
645 |
651 |
656 |
Maryland |
2,733 |
2,741 |
2,762 |
2,825 |
2,893 |
2,885 |
2,893 |
2,814 |
2,833 |
2,871 |
2,910 |
Massachusetts |
3,243 |
3,209 |
3,204 |
3,220 |
3,256 |
3,277 |
3,278 |
3,188 |
3,187 |
3,212 |
3,235 |
Michigan |
4,725 |
4,676 |
4,687 |
4,717 |
4,723 |
4,678 |
4,551 |
4,204 |
4,151 |
4,192 |
4,244 |
Minnesota |
2,750 |
2,751 |
2,752 |
2,757 |
2,775 |
2,768 |
2,772 |
2,714 |
2,744 |
2,776 |
2,795 |
Missouri |
2,830 |
2,814 |
2,816 |
2,850 |
2,889 |
2,895 |
2,870 |
2,776 |
2,751 |
2,762 |
2,787 |
Montana |
445 |
450 |
456 |
463 |
476 |
486 |
487 |
466 |
463 |
467 |
477 |
Nebraska |
921 |
932 |
938 |
935 |
943 |
953 |
962 |
939 |
944 |
960 |
979 |
New Hampshire |
680 |
679 |
688 |
697 |
709 |
714 |
714 |
696 |
694 |
698 |
702 |
New Jersey |
4,117 |
4,108 |
4,144 |
4,208 |
4,258 |
4,265 |
4,262 |
4,136 |
4,109 |
4,112 |
4,137 |
New Mexico |
823 |
836 |
850 |
866 |
887 |
904 |
905 |
870 |
856 |
854 |
860 |
New York |
8,721 |
8,704 |
8,816 |
8,947 |
9,062 |
9,098 |
9,111 |
8,834 |
8,767 |
8,755 |
8,806 |
North Carolina |
3,931 |
3,974 |
4,031 |
4,124 |
4,261 |
4,284 |
4,280 |
4,108 |
4,138 |
4,183 |
4,271 |
Ohio |
5,503 |
5,499 |
5,503 |
5,537 |
5,603 |
5,611 |
5,550 |
5,312 |
5,260 |
5,287 |
5,317 |
Oklahoma |
1,602 |
1,599 |
1,606 |
1,629 |
1,650 |
1,664 |
1,676 |
1,647 |
— |
1,671 |
1,698 |
Oregon |
1,704 |
1,700 |
1,714 |
1,741 |
1,792 |
1,822 |
1,827 |
1,751 |
1,757 |
1,777 |
1,777 |
Pennsylvania |
5,869 |
5,796 |
5,860 |
5,958 |
6,021 |
6,054 |
6,105 |
5,898 |
5,851 |
5,885 |
5,954 |
Rhode Island |
526 |
533 |
526 |
533 |
544 |
544 |
528 |
504 |
505 |
499 |
501 |
South Carolina |
1,826 |
1,854 |
1,888 |
1,922 |
1,971 |
2,010 |
1,998 |
1,912 |
1,925 |
1,955 |
1,989 |
Tennessee |
— |
— |
— |
— |
2,853 |
2,902 |
2,854 |
2,715 |
2,779 |
2,828 |
2,846 |
Texas |
10,115 |
10,229 |
10,385 |
10,552 |
10,758 |
10,914 |
11,076 |
11,074 |
11,281 |
11,506 |
11,762 |
Utah |
1,114 |
1,139 |
1,179 |
1,230 |
1,285 |
1,329 |
1,330 |
1,273 |
1,253 |
1,262 |
1,303 |
Vermont |
— |
— |
— |
— |
— |
— |
342 |
335 |
337 |
338 |
338 |
Washington |
2,877 |
2,913 |
3,000 |
3,076 |
3,155 |
3,233 |
3,285 |
3,194 |
3,167 |
3,154 |
3,203 |
Wisconsin |
2,861 |
2,863 |
2,868 |
2,890 |
2,932 |
2,949 |
2,941 |
2,845 |
2,823 |
2,838 |
2,850 |
Wyoming |
258 |
259 |
262 |
268 |
277 |
282 |
287 |
281 |
281 |
285 |
289 |
* Persons aged ≥16 years in the civilian noninstitutionalizedpopulation who, during the reference week (the week including the 12th day of the month), either 1) did any work as paid employees, worked in their own business or profession or on their own farm, or worked 15 hours or more as unpaid workers in an enterprise operated by a member of their family, or 2) were not working but who had jobs from which they were temporarily absent because of vacation, illness, bad weather, childcare problems, maternity or paternity leave, labor-management dispute job training, or other family or personal reasons, whether or not they were paid for the time off or were seeking other jobs. Each employed person is counted only once, even if he or she holds more than one job. Source: US Department of Labor, Bureau of Labor Statistics. Local Area Unemployment Statistics (LAUS) program. Washington, DC: Department of Labor, Bureau of Labor Statistics; 2014. Available at http://www.bls.gov/lau/staadata.txt. † No denominator data were provided because the state did not participate in the ABLES program in these years. |
TABLE 12. Total number (in 1,000s) of state-resident employed adults* (denominators) by state and year — United States, 1994–2001 |
||||||||
---|---|---|---|---|---|---|---|---|
State |
1994 |
1995 |
1996 |
1997 |
1998 |
1999 |
2000 |
2001 |
Alabama |
1,910 |
—† |
1,993 |
2,035 |
2,059 |
2,070 |
2,073 |
2,033 |
Arizona |
1,977 |
2,096 |
2,146 |
2,197 |
2,279 |
2,355 |
2,406 |
2,453 |
California |
13,954 |
14,062 |
14,304 |
14,781 |
15,204 |
15,567 |
16,034 |
16,217 |
Connecticut |
1,670 |
1,658 |
1,660 |
1,675 |
1,685 |
1,695 |
1,698 |
1,698 |
Iowa |
— |
1,528 |
1,551 |
1,556 |
1,556 |
1,561 |
1,561 |
1,570 |
Maryland |
2,545 |
2,573 |
2,616 |
2,646 |
2,661 |
2,688 |
2,703 |
2,719 |
Massachusetts |
2,989 |
3,029 |
3,083 |
3,159 |
3,209 |
3,246 |
3,277 |
3,275 |
Michigan |
— |
— |
— |
4,749 |
4,810 |
4,897 |
4,967 |
4,865 |
Minnesota |
— |
2,529 |
2,566 |
2,606 |
2,657 |
2,687 |
2,733 |
2,764 |
Nebraska |
— |
— |
— |
— |
— |
916 |
926 |
— |
New Hampshire |
— |
— |
— |
635 |
651 |
666 |
677 |
681 |
New Jersey |
3,790 |
3,846 |
3,926 |
4,031 |
4,047 |
4,093 |
4,129 |
4,112 |
New York |
8,080 |
8,126 |
8,229 |
8,417 |
8,547 |
8,657 |
8,764 |
8,730 |
North Carolina |
3,511 |
3,583 |
3,704 |
3,810 |
3,845 |
3,921 |
3,959 |
3,949 |
Ohio |
— |
— |
5,378 |
5,448 |
5,489 |
5,534 |
5,571 |
5,570 |
Oklahoma |
1,469 |
1,491 |
1,515 |
1,543 |
1,569 |
1,591 |
1,608 |
1,615 |
Oregon |
1,547 |
1,583 |
1,619 |
1,653 |
1,678 |
1,697 |
1,721 |
1,709 |
Pennsylvania |
5,530 |
5,554 |
5,662 |
5,775 |
5,788 |
5,810 |
5,832 |
5,870 |
Rhode Island |
— |
— |
— |
504 |
510 |
519 |
521 |
520 |
South Carolina |
1,729 |
1,755 |
1,786 |
1,820 |
1,849 |
1,877 |
1,896 |
— |
Texas |
8,779 |
8,986 |
9,176 |
9,395 |
9,601 |
9,766 |
9,913 |
10,004 |
Utah |
945 |
979 |
1,004 |
1,034 |
1,061 |
1,080 |
1,096 |
1,103 |
Washington |
2,567 |
2,636 |
2,712 |
2,822 |
2,887 |
2,918 |
2,899 |
2,861 |
Wisconsin |
2,713 |
2,774 |
2,816 |
2,856 |
2,870 |
2,879 |
2,891 |
2,899 |
Wyoming |
— |
— |
— |
244 |
248 |
252 |
257 |
260 |
* Persons aged ≥16 years in the civilian noninstitutionalized population who were employed during the reference week. Source: US Department of Labor, Bureau of Labor Statistics. 2003 Local Area Unemployment Statistics (LAUS) program. Washington, DC: Department of Labor, Bureau of Labor Statistics; 2004. Available at http://www.bls.gov/lau/staadata.txt. † No denominator data were provided because the state did not participate in the ABLES program in these years. |
State Adult Blood Lead Epidemiology and Surveillance (ABLES) Program Investigators
(All ABLES program investigators meet the CDC and MMWR criteria for contributors)
Sherri Davidson, MPH, Martha L. Sanchez, MD, Alabama Department of Public Health; Sandrine E. Deglin, PhD, Alaska Department of Health and Social Services; Diane Eckles, Arizona Department of Health Services; Susan F. Payne, MA, California Department of Public Health; Albert L. DeLoreto, MPH, Thomas St. Louis, MSPH, Connecticut Department of Public Health; Christy Kuriatnyk, MSPH, Georgia Department of Public Health; Barbara Brooks, PhD, Hawaii Department of Health; Van Nguyen, MS, Tiefu Shen, MD, Illinois Department of Public Health; Jeffery M. Turner, Indiana State Department of Health; Kathy Leinenkugel, MPA, Iowa Department of Public Health; Alisha Langham, Kansas Department of Health and Environment; Monica L. Clouse, MPH, Kentucky Department for Public Health; Michelle Lackovic, MPH, Jocelyn Lewis, PhD, Louisiana Department of Health and Hospitals; Ezattolah Keyvan, MD, Maryland Department of the Environment; Robert J. Nicotera, DJ, Massachusetts Department of Labor Standards; Joanna Kica, MPA, Michigan State University; Stephanie Yendell, DVM, Minnesota Department of Health; Carol R. Braun, Missouri Department of Health and Senior Services; Doug Gillespie, Derry Stover, MPH, Nebraska Department of Health and Human Services; Karla R. Armenti, ScD, Paul L. Lakevicius, MBA, New Hampshire Department of Health and Human Services; Marija Borjan, PhD, Margaret E. Lumia, PhD, Devendra Singh, New Jersey Department of Health; Leilani Schwarcz, MPH, New Mexico Department of Health; Alicia M. Fletcher, MPH, New York State Department of Health; Sheila Higgins, MPH, North Carolina Department of Health and Human Services; Chris Alexander, MS, Tyler Serafini, MPH, Ohio Department of Health; Susan J. Quigley, Christin T. Benner, MPH, Oklahoma State Health Department; Daniel Cain, MA, Oregon Health Authority; Sasidevi Arunachalam, Pennsylvania Department of Health; James Bruckshaw, Rhode Island Department of Health; H. Reed Corley, MPH, South Carolina Department of Health and Environmental Control; Jennifer Karnik, MPH, Teresa Willis, Texas Department of State Health Services; Bonnie Hinds, Martha Keel, PhD, Morey Parang, Phillip Woodard, University of Tennessee; Mark E. Jones, Sam Lefevre, Utah Department of Health; Mike Sullivan, MBA, Vermont Department of Health; Todd M. Schoonover, PhD, Washington Department of Labor and Industries; Carrie Tomasallo, PhD, Wisconsin Department of Health Services; Steve Melia, MSPH, Wyoming Department of Health; ABLES Programs coordinators in Colorado Department of Public Health and Environment, Florida Department of Health, Maine Department of Health and Human Services, and Montana Department of Public Health and Human Services.
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