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Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
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1

Introduction

Despite changes in military tactics and technology, proficiency in the handling of weapons remains a cornerstone in the training of the modern combat soldier. Modern military forces are trained on one or more small arms, including handguns, shotguns, rifles, and machine guns. Many of the projectiles used in military small arms contain lead. Exposure to lead during weapons training on firing ranges therefore is an important occupational-health concern.

Lead is a ubiquitous metal in the environment, and its adverse effects on human health are well documented. The nervous system is an important target of lead toxicity, which causes adverse cognitive, mood, and psychiatric effects in the central nervous system of adults; causes various peripheral nervous system effects; and has been linked to neurodegenerative diseases. Lead exposure also causes anemia, nephrotoxicity, a variety of adverse reproductive and developmental effects, small increases in blood pressure and an increased risk of hypertension particularly in middle-aged and older people, and various effects in other organ systems, including joint pain and gastrointestinal pain (ATSDR 2007; EPA 2012; NTP 2012).

Various occupations involve lead exposure, including those in lead-smelting, battery-manufacturing, welding, construction, demolition, and firing ranges. Occupational exposure is often the most important source of lead exposure of adults (Shannon 1998). Regulations and guidelines limiting occupational lead exposure have been established by the Occupational Safety and Health Administration (OSHA), the National Institute for Occupational Safety and Health (NIOSH), the American Conference of Governmental Industrial Hygienists (ACGIH®), and other regulatory agencies. Features common to the guidelines include an airborne exposure limit that is used to monitor lead in the workplace and a recommended blood lead level (BLL) to prevent adverse health effects.

OSHA’s lead standard for general industry was established in 1978 (29 CFR 1910.1025). It includes a permissible exposure limit (PEL) of 50 μg/m3 (an 8-hour time-weighted average [TWA]) and an action level of 30 μg/m3 (an 8-hour TWA). If an employee is exposed above the action level for more than 30

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
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days per year, an employer is required to provide a medical surveillance program that includes blood-lead sampling and medical examinations. OSHA also requires that any employee who has a BLL of 60 μg/dL or higher or three consecutive BLLs averaging 50 μg/dL or higher be removed from work that involves lead exposure. The employee may resume work that entails lead exposure only after two BLLs are under 40 μg/dL. The OSHA standard assumes that a population of workers exposed at the PEL of 50 μg/m3 will have an average BLL of 40 μg/dL or lower. It allows workers to have BLLs of up to 40 μg/dL for a working lifetime of 40 years. For workers who wish to plan pregnancies, OSHA recommends a BLL of under 30 μg/dL.

The NIOSH (1978) and ACGIH (2001a, b) guidelines are designed similarly to maintain BLLs below a threshold. NIOSH’s recommended exposure limit of 50 μg/m3 was established in 1978 and was aimed at maintaining the BLL below 60 μg/dL. ACGIH established a biological exposure index (BEI®) in 1995 of 30 μg/dL, and its threshold limit value (TLV®) of 50 μg/m3 was intended to maintain workers’ BLLs below the BEI.

Exposure standards and guidelines for protecting the general public from lead in ambient air, drinking water, soil, and consumer products have been established by such agencies as the US Environmental Protection Agency (EPA), the Agency for Toxic Substances and Disease Registry, the Centers for Disease Control and Prevention, the National Toxicology Program (NTP), and the US Food and Drug Administration. The standard for lead in air is undergoing review by EPA. Lead is one of several criteria pollutants for which EPA has established National Ambient Air Quality Standards (NAAQSs). In February 2012, EPA released an Integrated Science Assessment for Lead (Second External Review Draft), which indicates that the NAAQS for lead will probably be reduced (EPA 2012). In June 2012, the NTP completed an evaluation of the scientific evidence on the potential health effects of low-level lead exposure and concluded that “there is sufficient evidence that [BLLs] <10 μg/dL and <5 μg/dL are associated with adverse health effects in children and adults” (NTP 2012).

Because changes in environmental and occupational guidelines could affect the use of lead by the Department of Defense (DOD), the department asked the National Research Council to conduct a study of potential occupational health risks posed by exposure to lead. Of particular interest was lead exposure on small-arms firing ranges, especially exposure of range workers, who experience it recurrently. In response, the National Research Council convened the Committee on Potential Health Risks from Recurrent Lead Exposure of DOD Firing Range Personnel.

THE COMMITTEE’S TASK

Members of the committee were selected for their expertise in general toxicology, inhalation toxicology, neurotoxicology, reproductive and developmental toxicology, immunotoxicology, toxicokinetics, epidemiology, industrial

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
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hygiene, occupational medicine, exposure assessment, risk assessment, and biostatistics. The committee was specifically asked to accomplish the following task:

An expert committee will assess the potential health risks to Department of Defense firing range instructors and other personnel who experience recurring environmental exposures to lead at small-arms firing ranges. Information will be evaluated on recurrent lead exposures at such firing ranges, and relevant toxicological and epidemiological information on any carcinogenic and non-carcinogenic effects of exposures to lead will be evaluated. The evaluated information will include reviews by the Environmental Protection Agency and the National Toxicology Program. The committee will assess whether current exposure standards used at ranges are protective and will evaluate potential risk assessment options.

APPROACH TO THE STUDY

There is a large amount of scientific literature on lead. To manage the amount of data that it had to review and to structure its analysis to address its task in a timely manner, the committee established the following boundaries for its review:

•  Evaluation of health effects. The committee did not conduct a systematic review of the lead literature or conduct a formal risk assessment, but it took advantage of the recent compilations of the toxicologic and epidemiologic studies of lead by the NTP, EPA, and the International Agency for Research on Cancer. Those reviews were used as a basis for identifying the primary health end points that would be of concern for firing-range personnel. The committee supplemented the reviews by evaluating relevant new studies related to those health effects and by determining what exposures would be of greatest concern. The following considerations were used to focus the committee’s review further:

image  Human studies were the primary source of data, and animal studies and mechanistic information were used when appropriate. Few epidemiologic studies of firing-range personnel were found; therefore, occupational and other studies involving lead exposure were sought. Studies that considered potential covariates in their statistical analyses were favored.

image  Acute, chronic, and latent health effects of lead exposure were considered. Data on clinical disease outcomes were believed to be more relevant to the committee’s charge than data on early biologic effects.

image  The preferred measures of exposure were the BLL as a measure of recent exposure and the cumulative blood lead index (CBLI) or bone lead concentrations as a measure of cumulative dose.

image  Health-effects data on BLLs under 40 μg/dL were considered primarily, because the current OSHA standard aims to maintain BLLs below

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

that. Evidence on health effects at corresponding estimates of CBLI of 1,600 μg-years/dL (40 years at 40 μg/dL) and tibia lead levels of 40-80 μg/g (2.5-5% of the CBLI) was also sought. The committee decided that if it found evidence to suggest that health effects occur below those BLLs, CBLIs, or bone lead values, it would have to conclude that the OSHA exposure standard is inadequate.

•  Population characteristics. Firing-range workers may be active-duty military or civilians. The health of the population of firing-range workers is probably similar to that of the general working population. Special consideration was given to women who might be pregnant or nursing or might become pregnant, because of the well-known effects of lead on obstetric outcomes.

•  Characterization of exposure on firing ranges. The committee focused its attention on airborne lead exposures that are most likely to occur on DOD firing ranges. Measurements and evaluations conducted at DOD ranges were used primarily and were supplemented with information on other types of firing ranges.

In addressing the statement of task, the committee focused on answering the following questions:

1. Are OSHA’s guidelines for using BLLs adequate to protect DOD firing-range personnel?

2. Is the current OSHA PEL sufficiently protective of DOD firing-range personnel?

3. Is the current OSHA action level for medical surveillance appropriate?

4. Were data gaps identified in answering the above questions? Is research needed to fill those gaps?

FIRING-RANGE ENVIRONMENTS

Military firing ranges are specialized facilities designed for small-arms practice. Firearms can be fired inside a closed firing range or on an outdoor range. Both configurations have the potential for contamination with products of combustion (primer) or with a lead-based projectile (bullet). Depending on the weapon and the application, various specialized types of projectiles may be used. For example, jacketed bullets often consist of a soft lead core that is partially or fully encased in a shell of harder metal (such as copper). Jacketed bullets can minimize lead vaporization and particle generation. Other types of ammunition include fragmentation bullets and frangible bullets (projectiles that are designed to disintegrate on contact with a surface harder than the bullets themselves). The increasing use of full-jacketed bullets, alternative metal projectiles, and non-lead-containing primers should reduce airborne lead exposure during live-fire exercises.

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
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Generation of Atmospheric Lead on Firing Ranges

The committee sought but did not find data on chemical speciation of airborne lead particles on firing ranges. The following discussion therefore is a general characterization of atmospheric lead on ranges and applies primarily to nonjacketed lead-based ammunition with lead-containing primers. As a shooter pulls the trigger, the firing pin causes the primer, which contains lead styphnate (an explosive compound), to initiate the combustion of the gunpowder in the cartridge (Valway et al. 1989). The propellant burns at temperatures up to 1,000°C and can generate pressures of up to 1,400 kg/cm2 (20,000 lb/in2 [psi]), which propel the bullet down the barrel and toward the target (NEHC 2002). At 1,000°C, lead is vaporized at the base of the bullet and is released at the muzzle, and probably at the chamber when the shell casing is ejected, as lead fume, possibly as lead oxide fume as the lead fume reacts with atmospheric oxygen. As the bullet passes through the barrel, the barrel’s rifling may generate additional particles that are released at the muzzle. Misalignment as the bullet enters the chamber from the magazine or revolver cylinder may also generate particles (Anania and Seta 1975; Fischbein et al. 1979). Large lead particles settle out quickly and deposit on the floor and other surfaces (Jones 1999; NEHC 2002). The bullets will fragment on striking the target or backstop, and this contributes to the airborne particles (Anania and Seta 1975; Fischbein et al. 1979); this source will be close to the target or backstop. Lead dust can contaminate the shooter’s hands, face, and clothing. Dermal or oral exposure can also occur during weapon cleaning or during handling of empty casings.

US Military Firing Ranges

Military firing ranges can be indoor or outdoor and may be restricted to particular weapons (such as pistols, rifles, grenade launchers, and machine guns). A firing range typically is overseen by supervisory personnel (such as a range master or a range safety officer) who are responsible for ensuring that all safety rules are followed. Modern firing ranges are designed to prevent injury and property damage caused by misdirected or accidental firing and ricochets. They are also designed to direct ricochets away from the firing line (DOE 2012). Various materials are commonly used for that purpose, including concrete, gravel-filled concrete-masonry units, sand, stone logs, and earth. Some surfaces (such as baffles, wing walls, and metal connectors) may be covered with plywood to prevent back splatter.

Indoor ranges typically have specially constructed back walls or bullet traps, roofs, and side walls. Outdoor ranges may have concrete tubes to prevent stray shots (such as 10-m machine gun ranges), may lack a backstop to allow rounds to travel to their maximum range, or may be designed as fully or partially contained ranges (combination of side walls, bullet trap, canopy baffle, and

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

overhead baffles). Proper firing-range ventilation systems push and pull smoke and lead particles away from the shooting line to reduce lead exposure. However, because of the high noise levels produced at firing ranges (over 140 dB), many ranges have an air-locked corridor for soundproofing with doors at opposite ends of the egress corridor; most indoor ranges therefore have more lead-dust contamination than outdoor ranges because of their semiclosed (air) environment. Lead exposure in indoor ranges occurs at the firing line (for example, from primer ignition and muzzle blast) and at the bullet trap from projectiles’ striking of the trap (Jones 1999).

Outdoor facilities are often used for longer-distance shooting (up to 1,000 m) under ambient environmental conditions (US Department of the Army 2010). High retaining walls, earth mounds, sandbag barriers, or specially designed traps are used on outdoor ranges to prevent bullets or shots from ricocheting outside the bounds of the range.

Firing-range environments that resemble common combat scenarios (for example, urban combat in Middle East operations) are increasingly used in the training of US armed forces. Mock facilities can include “shoot houses”, method-of-entry buildings, maritime counterterrorism facilities, partition ranges that can be reconfigured to rooms of different sizes, combat ranges, combat villages, vehicle ranges (for land and air vehicles), and other full-size mockups (such as mockups of aircraft, shipside, and oil rigs). One subclass of specialized range mimics urban terrain, for example, Military Operations on Urbanized Terrain (MOUT). Each range can pose different risks of lead exposure. For example, MOUT training increases the possible contribution from fragmentation of bullets that strike targets inasmuch as it involves moving through mock buildings and firing at targets as close as 5 m away, a much shorter distance than the 25 m or more used on static target ranges (Mancuso et al. 2008). Resuspension and later inhalation of settled lead dust is another source of exposure as shooters move down range after firing; this could be an important contributor to lead exposure in MOUT training as shooters move through hallways, down lanes, and past targets at which they recently fired. Resuspension of settled lead dust is a major source of exposure during range maintenance and cleaning.

DEPARTMENT OF DEFENSE FIRING-RANGE PERSONNEL

The committee asked DOD to provide information about the range personnel in each service, including the number of personnel working on firing ranges, demographics, eligibility requirements, typical workday, requirements for physicals, and whether there are special considerations for pregnant range personnel. Little information was provided on the number of DOD ranges or on the number or demographics of range personnel. Below is a summary of information provided to DOD by each service and information located by the committee through its own literature searches.

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

US Army

The US Army has about 95 live-fire shoot houses at active installations and about 14 more that belong to reserve units. No information on the number indoor or outdoor ranges was provided. Firing-range personnel may have the following job classifications: range manager, range operations specialist, range technician, training technician, small-arms range lead, and live-fire range operations specialist (personal communication, J. Seibert, Office of the Deputy Under Secretary of Defense for Installations and Environment, July 2, 2012).

Some Army firing ranges have adopted lead-exposure guidelines more stringent than OSHA’s. For example, the John F. Kennedy Special Warfare Center and School in Fort Bragg, North Carolina, has adopted medical removal-guidelines that are consistent with the recommendations of the American College of Occupational and Environmental Medicine. Instructors are removed if they have a single BLL over 30 μg/dL or two consecutive BLLs over 20 μg/dL (personal communication, J. Seibert, July 2, 2012). Army policy for pregnant range personnel is to follow DOD’s Occupational Medical Examinations and Surveillance Manual (DOD 2007). The guidance is to maintain pregnant women or women who may be pregnant at BLLs under 5 μg/dL.

US Air Force

Air Force security forces combat-arms personnel operate 193 small-arms ranges (personal communication, J. Seibert, May 21, 2012). The Air Force has about 1,220 authorized range personnel. Personnel with this specialty (Air Force specialty code P0X1B and special experience identifier 312) are trained in combat-arms operation, facility maintenance, firearms instruction, occupational safety and health, and related subjects (US Department of the Air Force 2010). Combat-arms personnel must meet minimum physical requirements specified in the Air Force Enlisted Classification Directory related to physical condition, mobility and strength of upper and lower extremities, hearing, vision, and psychiatric health. Range workers typically get physicals twice a year. Potential medical reasons for exclusion from range work include those specified by OSHA. Other medical conditions that could require exclusion are assessed case by case. Workers may also be excluded if they are unable to wear required respirators. Duration of work on ranges varies with the weapon and course of instruction, but range workers typically work 8-10 hours per day 5 days per week. The daily average of work during live firing is estimated to be about 2.5-3 hours (personal communication, J. Seibert, May 21, 2012).

Pregnant military workers are required to undergo an evaluation for recommended modification of work activities. The Air Force Combat Arms Program (U.S. Department of the Air Force 2009) requires the local medical treatment facility to provide medical assessment of and line-of-duty determination on pregnant women who are working in and around firing-range operations or weapons maintenance. Civilian workers may also elect to undergo evaluation

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

with an assessment in the interest of fetal health and the possibility of recommended modification of work activities. Modifications of work activities are site-specific and worker-specific (personal communication, J. Seibert, May 21, 2012).

US Navy and Marine Corps

No information on the number and types of ranges in the Navy or Marine Corps was provided. The Navy has small-arms marksmanship instructors (GM-0812), who conduct training in all phases of basic marksmanship. Duties include firearms safety, mechanical training on small arms, instructional and qualification firing, and basic range operations (US Department of the Navy 2011a). Firing-range personnel typically work 8 hours per day 5 days per week (personal communication, J. Seibert, May 2, 2012).

Firing-range occupational specialties in the Marine Corps include range officers (MOS 0930), marksmanship instructors (MOS 0931), small-arms weapons instructors (MOS 0932), and marksmanship coaches (MOS 0933). Range officers supervise marksmanship-training programs and develop marksmanship training doctrine and techniques. Duties may include planning range layout, organizing courses of instruction, interpretation and enforcement of regulation, inspecting weapons and ammunition, and supervising test firing of weapons. Marksmanship instructors teach in all phases of the Marine Corps marksmanship program on qualification and requalification on small-arms use, and small-arms weapons instructors conduct and supervise all small-arms marksmanship training. Marksmanship coaches analyze the performance of shooters during dry- and live-fire exercises for qualification and requalification. Weapons instructors and marksmanship coaches also assist in the operation of firing ranges (US Department of the Navy 2008).

Workers who may be exposed at or above the OSHA action level of 30 μg/m3 for 30 days per year are included in the surveillance program. Medical examinations are conducted annually for each person who is found to have a BLL of 30 μg/dL or higher (NMCPHC 2011; US Department of the Navy 2011b). Clinicians may counsel workers who want to plan pregnancies to achieve BLLs lower than those specified by OSHA (30 μg/dL). Navy guidance indicates that it may be advisable for BLLs to be under 20 μg/dL preceding conception and during pregnancy. Women who have BLLs over 20 μg/dL might be advised to avoid uncontrolled lead exposure for 1-2 years before attempting to conceive (NMCPHC 2010).

LEAD EXPOSURE ON DEPARTMENT OF DEFENSE FIRING RANGES

DOD was asked to provide the committee with air-sampling data on lead and BLLs collected over the last 5 years for range personnel, if possible according to job classification. In response to the request, the US Army submitted data extracted from the Defense Occupational and Environmental Health Readiness

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

System—Industrial Hygiene (personal communication, J. Seibert, July 2, 2012). Information was available on only a few small-arms firing ranges. Table 1-1 shows that mean airborne concentrations of lead ranged from 0.7 to 238 μg/m3 and that the current OSHA PEL of 50 μg/m3 was exceeded to some degree in almost all duties. The greatest percentage of samples that were above the PEL were collected during weapons handling at shoot houses (60%) and during range maintenance and cleaning activities (50%). The Army’s industrial-hygiene program offices use the concept of similar exposure groups. A person who has a given job classification may perform many duties, and a sample and its TWA may have been determined to be valid for many processes that a worker has been performing during the time when the sample was taken. Data provided by the Army show overlap in job duties, so it was difficult to distinguish which tasks might have accounted for the highest exposures. For example, a maximum airborne concentration of 4,386 μg/m3 was reported for several duties in the categories of supervision, cleaning and maintenance, weapons handling and firing, fire services, and ambulance drivers. The available BLL data from 2007-2011 obtained from the Army’s Occupational Health Program Surveillance Reports indicated that the percentage of screened employees who had “abnormal” results ranged from less than 1% to 5%. However, the reports did not identify the sources of lead exposure—for example, shoot houses, indoor ranges, or other occupationally related exposures, such as exposure to plumbing, pipefitting, or handling of cable sheaths—or indicate the magnitude of the abnormalities.

The Navy provided the committee with results of personal air monitoring at its firing ranges (personal communication, J. Seibert, May 2, 2012). Personal air breathing-zone monitoring was performed during the period January 2008-April 2012 for a variety of firing-range tasks (Table 1-2). Air samples were collected in accordance with the US Navy’s standard operating procedures (US Navy Industrial Hygiene Field Operations Manual) (NEHC 2012). In general, nearly full-shift samples (for example, 7 hours of an 8-hour work shift or 11 hours of a 12-hour work shift) are used to evaluate TWA exposures. Sampling during the period of greatest exposure during an operation is also stressed. Data presented in Table 1-2 confirm that air lead concentrations can vary widely between job categories and the type of firing range. Concentrations were highest in the cleaning of ranges; 58% of the samples were above the PEL, and the mean concentration was 190 μg/m3. Air measurements in other job categories were also well above the current OSHA PEL of 50 μg/m3 (see Table 1-2). BLLs of firing-range personnel during that time were unavailable to the committee because the central Navy electronic medical-records data system does not include information about personnel by job classification.

The Air Force also provided the committee with air-monitoring data from 2007-2012 and was the only service1 to provide data on BLLs of range instructors

___________________

1After the committee completed its evaluation and released the prepublication draft of this report, the Army submitted data on BLLs for Department of the Army civilian personnel working at shoot houses. The Army’s submission can be obtained by contacting

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

(Table 1-3). With the exception of data from 2011, it can be seen that mean air lead concentrations over the 6-year sampling time were well above the current OSHA PEL of 50 μg/m3. It can also be seen that individual ranges can have appreciably higher air lead concentrations that are several orders of magnitude higher than the PEL (maximum values ranged from 247 to 386,000 μg/m3). The Air Force began substituting lead-free ammunition for small-arms training in 2004 (AFIOH 2008), but no distinction was made about whether the data in Table 1-3 included measurements taken on ranges where the substitution was implemented. The maximum BLLs of Air Force range instructors in 2008-2012 were below the current OSHA standard of 40 μg/dL.

In addition to the data provided by DOD, the committee reviewed published data on BLLs and air concentrations of lead reported in connection with civilian and military firing ranges (IARC 2006). Table 1-4 shows the large variability in air lead concentrations and BLLs measured within and between firing ranges. No clear relationship between air lead concentrations and BLLs is apparent; the table has examples of higher mean BLLs at firing ranges that have lower mean air lead concentrations and examples of lower BLLs at ranges that have higher mean air lead concentrations. The latter observation was particularly relevant to the committee’s work because it suggests that there are limitations on the use of air lead monitoring to protect personnel in this setting, especially at lower air lead concentrations. Differences in air lead concentrations and BLLs on firing ranges may reflect differences in the use of personal protective equipment; range hygiene and ventilation; personal hygiene; hand-to-mouth behaviors; smoking, eating, and drinking policies and practices; and policies and practices concerning hand-washing and clothes-laundering.

ORGANIZATION OF THE REPORT

The committee organized its review into three major components: understanding the basis of occupational standards and guidelines for lead, exposure considerations for lead on DOD firing ranges, and health effects of lead exposure. Chapter 2 provides an overview of different occupational standards and guidelines for lead and their bases. In addition to US guidelines, the guidelines of relevant organizations of other countries are considered. Chapter 3 presents exposure considerations for lead, including an overview of routes of exposure, biomarkers, toxicokinetics and toxicodynamics, and exposure factors that influence health outcomes. Health effects of exposure to lead are discussed in Chapter 4 (noncancer effects) and Chapter 5 (cancer effects), with a focus on studies relevant to DOD firing-range personnel. Chapter 6 presents a summary of the committee’s findings.


the National Research Council’s Public Access Records Office at (202) 334-3543 or paro@nas.edu.

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

TABLE 1-1 Airborne Lead Concentration During Performance of Different Job Duties on US Army Weapons and Small-Arms Firing Rangesa

Duty No. Sites No. Samples Mean (μg/m3) Geometric Mean (μg/m3) Geometric Standard Deviation (μg/m3) Samples Above the PEL
Supervision
Firing-range supervision, protective services 3 84 103 7 6,730 13.1%
Range supervision, monitor 1 58 239 11.2 6,340 6.9%
Range supervision 1 29 239 11.2 6,440 6.9%
Range support, range instructor 1 29 239 11.2 6.440 6.9%
Weapons or small arms, range supervision 5 106 74 12.3 4,580 11.3%
Cleaning and Maintenance
Range, equipment repair, preventive maintenance, NOCb 1 5 0.7 0.7 1,150 0%
Range maintenance, cleaning, other 1 2 89.4 76.7 2,230 50%
Firing-range cleaning, protective services 3 39 26.6 8.1 5,570 17.9%
Range cleaning, scraping 1 2 89.4 76.7 2,230 50%
Firing-range pit cleaning, protective services 1 11 35.9 3.1 8,050 9.1%
Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×
Range or ground maintenance, heavy-equipment operator 1 29 239 11.2 6,440 6.9%
Range or ground maintenance 2 44 191 16.3 6,900 25%
Maintenance-structures ranges, multiple operations 4 6 0.8 0.4 3,510 0%
Range cleaning 1 22 24.3 13.3 3,710 27.3%
Weapons or small arms, backstop or pit cleanup 1 4 114 14.4 25,420 50%
Weapons or small arms, range cleaning 6 116 85.2 10.2 5,830 13.8%
Disposition of range residue, HM/HW hand cleanup 1 22 24.3 13.3 3,710 27.3%
Weapons Handling or Firing
Firing range, testing NOCb 1 22 24.3 13.3 3,710 27.3%
Indoor range, small-arms firing 6 100 30.6 2.9 9,570 19%
Indoor firing range, ordnance testing 1 22 24.3 13.3 3,710 27.3%
Outdoors, weapons or small-arms firing 7 114 84.8 4.8 9,390 16.7%
Shoot house, weapons or small-arms firing, NOCb 1 15 97.7 33.8 6,750 60%
Shoot house, small-arms handling 3 48 37.2 2.4 12,030 20.8%
Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×
Operations or Services
Range operations, weapons and ordnance 1 4 114 14.4 25,420 50%
Skeet and trap range, recreational services 1 4 1.9 0.5 6,760 0%
Fire services, ranges
1 29 239 11.2 6,440 6.9%
Other
Ambulance drivers or EMT, range 1 29 239 11.2 6,440 6.9%

aData extracted from the Defense Occupational and Environmental Health Readiness System—Industrial Hygiene. Army industrial hygiene program offices use the concept of similar exposure groups. A person who has a given job classification may perform many duties. A sample and its TWA may have been determined to be valid for many processes that a worker may have been performing during the time when the sample was taken.

bNot otherwise classified.

Source: Personal communication, J. Seibert, Office of the Deputy Under Secretary of Defense for Installations and Environment, July 2, 2012.

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

TABLE 1-2 Airborne Lead Concentration During Performance of Different Job Duties on US Navy Weapons and Small-arms Firing Ranges

Range Cleaning Ammunition Handling NOCa Outdoor Range Firing Indoor Range Firing Range Supervision Backstop Pit Cleanup Breeching Lead Indoor Simulated Marksmanship Trainer Weapons and Ordnance NOCa
No. samples 19 3 138 9 50 106 19 14 11 4
Maximum, μg/m3 848 78.4 482 558 442 342 29.6 18.7 40.6 0.92
Minimum, μg/m3 2.12 25.5 0.46 4 0.71 0.71 0.71 3.5 0.8 0.71
Mean, μg/m3 190 44 48 22 46 23 9 9 13 1
Geometric mean, μg/m3 50 39 13 15 11 8 5 7 8 1
Geometric standard deviation, μg/m3 8,169 1,849 5,980 2,669 4,730 4,274 3,669 1,940 3,476 1,140
Samples above PEL, % 58 33 31.9 22.2 16 14.2 0 0 0 0
95th percentileb, μg/m3 1,583 1,060 2,400 76 148 83 39 21 61 1

aNot otherwise classified. Not a specific operation that can be further classified.

bLognormal distribution.

Source: Personal communication, J. Seibert, Office of the Deputy Under Secretary of Defense for Installations and Environment, May 2, 2012.

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

TABLE 1-3 Lead Exposure on US Air Force Firing Ranges (2007-2012)—Air Lead Concentrations on Weapons and Small-Arms Firing Ranges and Blood Lead Levels of Combat-Arms Training and Maintenance Instructors

2007 2008 2009 2010 2011 2012
Air Sampling Data
No. samples 81 139 307 154 303 100
No. locations 12 18 23 24 27 16
Maximum, μg/m3 386,000 1,650 14,900 7,820 247 19,500
Minimum, μg/m3 0.21 ND 0.03 ND ND ND
Mean (± SD), μg/m3 9,120 ± 51,081 82.3 ± 209 80.3 ± 850 82.8 ± 652 19.7 ± 31 267 ± 218
Blood Lead Levels
No. samples 37 41 57 93 69
Maximum, μg/dL 31 16 23 26 21
Minimum, μg/dL 1 1 1 1 1
Mean (± SD), μg/dL 5.0 ± 5.7 4.6 ± 4.0 4.1 ± 4.4 5.4 ± 4.6 5.2 ± 4.4

Abbreviations: ND, not detected; SD, standard deviation.

Source: Personal communication, J. Seibert, Office of the Deputy Under Secretary of Defense for Installations and Environment, May 21, 2012.

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

TABLE 1-4 Air and Blood Lead Concentrations Measured on Indoor and Outdoor Firing Ranges

Blood Lead (μg/dL) Lead in Air (μg/m3)
Country Settings or Tasks Job History (years) Mean Range Mean Range Reference
China (Province of Taiwan) Employees in indoor range 4-21 37.2 22.4-59.6 GA: 134 PBZ: 413 NR Chau et al. 1995
New Zealand Indoor small-bore rifle range Recreational shooters End of season: 55.0; start of season 33.3 GA: 140-210 PBZ: 120 George et al. 1993
Sweden Indoor range Svensson et al. 1992
  Powder gun 10.2 13.8a 6.9-22.8 660 112-2,238
  Air gun 13.7 8.4a 2.0-22.2 4.6 1.8-7.2
On-duty and off-duty police officers NR 5.0 1.0-18.2 NR Löfstedt et al. 1999
>9 3.7
United Kingdom Indoor range for police officers NR 30-59 30-160 Smith 1976
Soldiers 4.2 19.25 9.6-30.1 TWA: 190 Brown 1983
United States Indoor range
Full-time employee NR 30-77 Showroom: 2.7 Novotny et al. 1987
Part-time employee NR 17-49 Firing line: 13.6
Midway to target: 57.4
Target: 90.5
Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×
Covered outdoor range NR 5.6 (pre-exposure) GA: 68.4 PBZ: 128.5 3.8-298.6 34.7-314.3 Tripathi et al. 1989
10.7 (day 2)
14.9 (day 5)
8.7 (day 69)
Indoor range with training February 3-April 28 Trainees Valway et al. 1989
6.45 <5-23.1 1,483-1,860 304-2,688
51.4 31.2-73.3 2,906-3,226 994-5,589
44.6 27.1-62.3 1,231 553-2,567b
39.8 23.1-51.2
Lead bullet 1,410
Nylon-coated 78.3
Copper-jacketed 43.1
Covered outdoor range using copperjacketed bullets NR Before shooting: 6.0 ± 1.7 After shooting: 6.5 ± 1.5 GA: 9.53 PBZ: 5.88 5.50-14.56 0.42-7.66 Tripathi et al. 1990
Uncovered outdoor range Goldberg et al. 1991
NR 28-66
NR 460-510 (3-h TWA)
NR 25-70
Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×
NR 100-170 (3-h TWA)
28-38
Covered outdoor range Tripathi et al. 1991
Nonjacketed bullets Instructors 14.2-24.2c 10-27 67.1-211.1 36.7-431.5
Jacketed bullets Instructors 13.1-22.1 5.4-8.7
University rifle range Recreational shooters Prince and Horstman 1993
Old ventilation 11.8-16.4 5-21 176 24-239
New ventilation 13.2-13.6 8-23 129 67-211

aMedian value.

bNew ventilation system installed.

cRange on three sampling dates.

Abbreviations: GA, general area; NA, not applicable; NR, not reported; PBZ, personal breathing zone; TWA, time-weighted average.

Source: Adapted from IARC 2006.

Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

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AFIOH (Air Force Institute for Occupational Health). 2008. Lead Free Frangible Ammunition Exposure at United States Air Force Small Arms Firing Ranges, 2005-2007. IOH-RS-BR-TR-2008-0002. Air Force Institute for Occupational Health, Brooks City-Base, TX [online]. Available: http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA487506 [accessed Dec. 19, 2011].

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Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
×

IARC (International Agency for Research on Cancer). 2006. Inorganic and Organic Lead Compounds. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans Vol. 87. Lyon, France: World Health Organization [online]. Available: http://monographs.iarc.fr/ENG/Monographs/vol87/mono87.pdf [accessed Sept. 20, 2012].

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Mancuso, J.D., J. McCoy, B. Pelka, P.J. Kahn, and J.C. Gaydos. 2008. The challenge of controlling lead and silica exposures from firing ranges in a special operations force. Mil. Med. 173(2):182-186.

NEHC (Navy Environmental Health Center). 2002. Indoor Firing Ranges, Industrial Hygiene Technical Guide, Technical Manual HEHC-TM6290.99-10 Rev. 1. Navy Environmental Health Center, Bureau of Medicine and Surgery. May 2002 [online]. Available: http://www.nmcphc.med.navy.mil/downloads/IH/indoor_firing_range.pdf [accessed Dec. 19, 2011].

NEHC (Navy Environmental Health Center). 2012. Industrial Hygiene Field Operations Manual. Technical Manual NEHC-TM6290.91-2 Rev. B. Navy Environmental Health Center, Bureau of Medicine and Surgery [online]. Available: http://www.nmcphc.med.navy.mil/Occupational_Health/Industrial_Hygiene/ih_fieldops_manual.aspx [accessed Oct. 31, 2012].

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NMCPHC (Navy and Marine Corps Public Health Center). 2011. Medical Surveillance Procedures Manual and Medical Matrix (Edition 11). Technical Manual NMCPHCTM OM 6260. Navy and Marine Corps Public Health Center, Occupational and Environmental Medicine (OEM) Directorate, Portsmouth, VA. July 2011 [online]. Available: http://www.nmcphc.med.navy.mil/downloads/occmed/MedicalMatrix11.pdf [accessed June 13, 2012].

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NTP (National Toxicology Program). 2012. NTP Monograph on Health Effects of Low-Level Lead. Prepublication Copy. U.S. Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health. June 13, 2012 [online]. Available: http://ntp.niehs.nih.gov/?objectid=4F04B8EA-B187-9EF2-9F9413C68E76458E [accessed June 14, 2012].

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×

Prince, T.S., and S.W. Horstman. 1993. Case study at a college rifle range: The effect of a new ventilation system on air and blood lead levels. Appl. Occup. Environ. Hyg. 8(11):909-911.

Shannon, M.W. 1998. Lead. Pp. 767-783 in Clinical Management of Poisoning and Drug Overdose, 3rd Ed., L.M. Haddad, M.W. Shannon, and J.F. Winchester, eds. Philadelphia: W.B. Saunders.

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Tripathi, R.K., P.C. Sherertz, G.C. Llewellyn, C.W. Armstrong, and S.L. Ramsey. 1990. Reducing exposures to airborne lead in a covered, outdoor firing range by using totally copper-jacketed bullets. Am. Ind. Hyg. Assoc. J. 51(1):28-31.

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Suggested Citation:"1 Introduction." National Research Council. 2013. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure. Washington, DC: The National Academies Press. doi: 10.17226/18249.
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Lead is a ubiquitous metal in the environment, and its adverse effects on human health are well documented. Lead interacts at multiple cellular sites and can alter protein function in part through binding to amino acid sulfhydryl and carboxyl groups on a wide variety of structural and functional proteins. In addition, lead mimics calcium and other divalent cations, and it induces the increased production of cytotoxic reactive oxygen species. Adverse effects associated with lead exposure can be observed in multiple body systems, including the nervous, cardiovascular, renal, hematologic, immunologic, and reproductive systems. Lead exposure is also known to induce adverse developmental effects in utero and in the developing neonate.

Lead poses an occupational health hazard, and the Occupational Safety and Health Administration (OSHA) developed a lead standard for general industry that regulates many workplace exposures to this metal. The standard was promulgated in 1978 and encompasses several approaches for reducing exposure to lead, including the establishment of a permissible exposure limit (PEL) of 50 μg/m3 in air (an 8-hour time-weighted average [TWA]), exposure guidelines for instituting medical surveillance, guidelines for removal from and return to work, and other risk-management strategies. An action level of 30 μg/m3 (an 8-hour TWA) for lead was established to trigger medical surveillance in employees exposed above that level for more than 30 days per year. Another provision is that any employee who has a blood lead level (BLL) of 60 μg/dL or higher or three consecutive BLLs averaging 50 μg/dL or higher must be removed from work involving lead exposure. An employee may resume work associated with lead exposure only after two BLLs are lower than 40 μg/dL. Thus, maintaining BLLs lower than 40 μg/dL was judged by OSHA to protect workers from adverse health effects. The OSHA standard also includes a recommendation that BLLs of workers who are planning a pregnancy be under 30μg/dL.

In light of knowledge about the hazards posed by occupational lead exposure, the Department of Defense (DOD) asked the National Research Council to evaluate potential health risks from recurrent lead exposure of firing-range personnel. Specifically, DOD asked the National Research Council to determine whether current exposure standards for lead on DOD firing ranges protect its workers adequately.The committee also considered measures of cumulative lead dose. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure will help to inform decisions about setting new air exposure limits for lead on firing ranges, about whether to implement limits for surface contamination, and about how to design lead-surveillance programs for range personnel appropriately.

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