A multiagency response to a lead poisoning outbreak during construction and renovation at an indoor firing range

Beginning in October 2012, multiple agencies in Washington State responded to reports of elevated blood lead levels (BLLs) at an indoor firing range identified by Washington State's Adult Blood Lead Epidemiology and Surveillance (ABLES) program. Worker interviews revealed deficiencies in lead exposure controls and potential violations of occupational health & safety standards during construction and remodeling. The ABLES program then referred the firing range to the Washington State Division of Occupational Safety & Health (DOSH) for regulatory action. DOSH was concerned that the temporary ventilation system was inadequate to protect customers from lead exposure, but was unable to compel the range to close. Consequently, DOSH contacted Public Health-Seattle & King County (PHSKC) to work in partnership to assess the extent of the health risks posed to employees and the public, and compel the facility to mitigate those risks. A joint lead-poisoning cluster investigation conducted by the ABLES program and PHSKC revealed that 117 construction workers and 42 range employees were on-site during the critical lead exposure period (i.e., October-November 2012). Of these, 26 (36%) construction workers and 20 (77%) range employees had BLLs in excess of 10 ug/dl, (highest BLL: 153 ug/dl). Testing of household members revealed three children and two adults from four households with BLLs ≥5 µg/dl. In the absence of clear environmental standards to protect the general public from lead exposures in firing ranges, PHSKC consulted with the Agency for Toxic Substances and Disease Registry (ATSDR) to conduct a health assessment. The absence of a public exposure standard calls for the development of a policy on firing range safety that considers the potential for public exposure to lead.