From Efficacy to Effectiveness of Masks for the Prevention of Lead Uptake in Workers Exposed to Environmental Lead - A Review

Lead is an element which enters the human body by inhalation and ingestion.Occupational Safety and Health Administration, California (Cal/OSHA) requires that employers reduce high air lead levels (50g/m 3 or higher) in industries.But, the high levels of environmental contamination, often, found in work environments make it highly desirable to use masks and overalls to prevent lead from entering the body.Studies often prove that the straight application of assigned lead protection factors of mask respirators to actual workplace situations may not always be appropriate.This review attempts to synthesize and discuss the best available evidence on the effectiveness of masks, in terms of the interventions aimed at promoting its use, as compared to similar workplace interventions in preventing the absorption and assimilation of lead in adults employed in industries with high lead exposure.On the whole, this review seems to support the impression that if masks are specifically enforced through education then the fall in blood lead seems to be higher than education alone (31.5% for education with mask vs. 15 -24% for education without mask).In conclusion, however, there is no solid ground on which to recommend masks alone to protect workers against lead exposure.Interventions such as respiratory masks with worker education and, more importantly, respiratory protection with surveillance based on reliable markers need to be tested in controlled conditions to formulate effective recommendations to prevent and limit lead poisoning in high risk industries.