Take-home lead exposure among children with relatives employed at a battery recycling facility - Puerto Rico, 2011.

The recycling of lead has increased during the past 20 years, with more workers and their families potentially being exposed to lead from recycling facilities, including facilities that recycle lead-acid batteries. During November 2010-May 2011, four voluntary blood lead screening clinics for children of employees of a battery recycling facility in Puerto Rico were conducted. A total of 227 persons from 78 families had blood lead tests. Among 68 children aged <6 years, 11 (16%) had confirmed blood lead levels (BLLs) ≥10 µg/dL, the BLL at which CDC recommended individual intervention to reduce BLLs in 2010, and 39 (57%) children aged <6 years had venous or capillary BLLs ≥5 µg/dL, the reference value for elevated BLLs in children established by CDC in 2012. To determine whether take-home lead exposure contributed to the children's BLLs of ≥10 µg/dL, vehicle and household environmental samples were collected and analyzed. Eighty-five percent of vehicle dust samples and 49% of home dust samples exceeded the U.S. Environmental Protection Agency (EPA) level of concern of ≥40 µg/ft² (430.6 µg/m²) [corrected]. EPA began clean-up of employee homes and vehicles, focusing first on homes with children with BLLs ≥10 µg/dL. EPA also required that the company set up shower facilities, shoe washes, and clean changing areas at the battery recycling facility. Lastly, CDC assigned a case manager to provide education, environmental follow-up, and case management of all children with BLLs ≥5 µg/dL. On average, children's BLLs have decreased 9.9 µg/dL since being enrolled in case management.