Potential Health Risks to DOD
FIRING-RANGE PERSONNEL
from Recurrent Lead Exposure
Committee on Potential Health Risks from Recurrent
Lead Exposure of DOD Firing Range Personnel
Committee on Toxicology
Board on Environmental Studies and Toxicology
Division on Earth and Life Studies
NATIONAL RESEARCH COUNCIL
OF THE NATIONAL ACADEMIES
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This project was supported by Contract W81K04-11-D-0017 between the National Academy of Sciences and the Department of Defense. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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COMMITTEE ON POTENTIAL HEALTH RISKS FROM RECURRENT LEAD EXPOSURE OF DOD FIRING RANGE PERSONNEL
Members
DAVID C. DORMAN (Chair), North Carolina State University, Raleigh, NC
SUSAN H. BENOFF, Feinstein Institute for Medical Research (retired), Riverdale, NY
EDWARD C. BISHOP, Parsons Government Services (retired), Council Bluffs, IA
MARGIT L. BLEECKER, Center for Occupational and Environmental Neurology, Baltimore, MD
LISA M. BROSSEAU, University of Minnesota School of Public Health, Minneapolis, MN
ROSE H. GOLDMAN, Harvard Medical School and Harvard School of Public Health, Boston, MA
JOSEPH H. GRAZIANO, Columbia University Mailman School of Public Health, New York, NY
SHERYL A. MILZ, University of Toledo, Toledo, OH
SUNG KYUN PARK, University of Michigan School of Public Health, Ann Arbor, MI
MARK A. ROBERTS, Exponent, Chicago, IL
BRISA N. SANCHEZ, University of Michigan, Ann Arbor, MI
BRIAN S. SCHWARTZ, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
LAUREN ZEISE, California Environmental Protection Agency, Oakland, CA
JUDITH T. ZELIKOFF, New York University School of Medical, Tuxedo, NY
Staff
SUSAN N.J. MARTEL, Project Director
KERI STOEVER, Research Associate
NORMAN GROSSBLATT, Senior Editor
MIRSADA KARALIC-LONCAREVIC, Manager, Technical Information Center
RADIAH ROSE, Manager, Editorial Projects
TAMARA DAWSON, Program Associate
Sponsor
US Department of Defense
Members
GARY P. CARLSON (Chair), Purdue University (retired), West Lafayette, IN
LAWRENCE S. BETTS, Eastern Virginia Medical School, Norfolk
DEEPAK K. BHALLA, Wayne State University, Detroit, MI
DEBORAH A. CORY-SLECHTA, University of Rochester School of Medicine and Dentistry, Rochester, NY
MARY E. DAVIS, West Virginia University, Morgantown
DAVID C. DORMAN, North Carolina State University, Raleigh
MARGARET M. MACDONELL, Argonne National Laboratory, Argonne, IL
IVAN RUSYN, University of North Carolina, Chapel Hill, NC
KENNETH R. STILL, Portland State University, Portland, OR
JOYCE S. TSUJI, Exponent, Inc., Bellevue, WA
Staff
SUSAN N.J. MARTEL, Senior Program Officer for Toxicology
MIRSADA KARALIC-LONCAREVIC, Manager, Technical Information Center
RADIAH ROSE, Manager, Editorial Projects
TAMARA DAWSON, Program Associate
BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY
Members
ROGENE F. HENDERSON (Chair), Lovelace Respiratory Research Institute, Albuquerque, NM
PRAVEEN AMAR, Clean Air Task Force, Boston, MA
MICHAEL J. BRADLEY, M.J. Bradley & Associates, Concord, MA
JONATHAN Z. CANNON, University of Virginia, Charlottesville
GAIL CHARNLEY, HealthRisk Strategies, Washington, DC
FRANK W. DAVIS, University of California, Santa Barbara
CHARLES T. DRISCOLL, JR., Syracuse University, New York
LYNN R. GOLDMAN, George Washington University, Washington, DC
LINDA E. GREER, Natural Resources Defense Council, Washington, DC
WILLIAM E. HALPERIN, University of Medicine and Dentistry of New Jersey, Newark
STEVEN P. HAMBURG, Environmental Defense Fund, New York, NY
ROBERT A. HIATT, University of California, San Francisco
PHILIP K. HOPKE, Clarkson University, Potsdam, NY
SAMUEL KACEW, University of Ottawa, Ontario
H. SCOTT MATTHEWS, Carnegie Mellon University, Pittsburgh, PA
THOMAS E. MCKONE, University of California, Berkeley
TERRY L. MEDLEY, E.I. du Pont de Nemours & Company, Wilmington, DE
JANA MILFORD, University of Colorado at Boulder, Boulder
RICHARD L. POIROT, Vermont Department of Environmental Conservation, Waterbury
MARK A. RATNER, Northwestern University, Evanston, IL
KATHRYN G. SESSIONS, Health and Environmental Funders Network, Bethesda, MD
JOYCE S. TSUJI, Exponent Environmental Group, Bellevue, WA
Senior Staff
JAMES J. REISA, Director
DAVID J. POLICANSKY, Scholar
RAYMOND A. WASSEL, Senior Program Officer for Environmental Studies
ELLEN K. MANTUS, Senior Program Officer for Risk Analysis
SUSAN N.J. MARTEL, Senior Program Officer for Toxicology
EILEEN N. ABT, Senior Program Officer
MIRSADA KARALIC-LONCAREVIC, Manager, Technical Information Center
RADIAH ROSE, Manager, Editorial Projects
OTHER REPORTS OF THE BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY
Science for Environmental Protection: The Road Ahead (2012)
Exposure Science in the 21st Century: A Vision and A Strategy (2012)
A Research Strategy for Environmental, Health, and Safety Aspects of Engineered Nanomaterials (2012)
Macondo Well–Deepwater Horizon Blowout: Lessons for Improving Offshore Drilling Safety (2012)
Feasibility of Using Mycoherbicides for Controlling Illicit Drug Crops (2011)
Improving Health in the United States: The Role of Health Impact Assessment (2011)
A Risk-Characterization Framework for Decision-Making at the Food and Drug Administration (2011)
Review of the Environmental Protection Agency’s Draft IRIS Assessment of Formaldehyde (2011)
Toxicity-Pathway-Based Risk Assessment: Preparing for Paradigm Change (2010)
The Use of Title 42 Authority at the U.S. Environmental Protection Agency (2010)
Review of the Environmental Protection Agency’s Draft IRIS Assessment of Tetrachloroethylene (2010)
Hidden Costs of Energy: Unpriced Consequences of Energy Production and Use (2009)
Contaminated Water Supplies at Camp Lejeune—Assessing Potential Health Effects (2009)
Review of the Federal Strategy for Nanotechnology-Related Environmental, Health, and Safety Research (2009)
Science and Decisions: Advancing Risk Assessment (2009)
Phthalates and Cumulative Risk Assessment: The Tasks Ahead (2008)
Estimating Mortality Risk Reduction and Economic Benefits from Controlling Ozone Air Pollution (2008)
Respiratory Diseases Research at NIOSH (2008)
Evaluating Research Efficiency in the U.S. Environmental Protection Agency (2008)
Hydrology, Ecology, and Fishes of the Klamath River Basin (2008)
Applications of Toxicogenomic Technologies to Predictive Toxicology and Risk Assessment (2007)
Models in Environmental Regulatory Decision Making (2007)
Toxicity Testing in the Twenty-first Century: A Vision and a Strategy (2007)
Sediment Dredging at Superfund Megasites: Assessing the Effectiveness (2007)
Environmental Impacts of Wind-Energy Projects (2007)
Scientific Review of the Proposed Risk Assessment Bulletin from the Office of Management and Budget (2007)
Assessing the Human Health Risks of Trichloroethylene: Key Scientific Issues (2006)
New Source Review for Stationary Sources of Air Pollution (2006)
Human Biomonitoring for Environmental Chemicals (2006)
Health Risks from Dioxin and Related Compounds: Evaluation of the EPA Reassessment (2006)
Fluoride in Drinking Water: A Scientific Review of EPA’s Standards (2006)
State and Federal Standards for Mobile-Source Emissions (2006)
Superfund and Mining Megasites—Lessons from the Coeur d’Alene River Basin (2005)
Health Implications of Perchlorate Ingestion (2005)
Air Quality Management in the United States (2004)
Endangered and Threatened Species of the Platte River (2004)
Atlantic Salmon in Maine (2004)
Endangered and Threatened Fishes in the Klamath River Basin (2004)
Cumulative Environmental Effects of Alaska North Slope Oil and Gas Development (2003)
Estimating the Public Health Benefits of Proposed Air Pollution Regulations (2002)
Biosolids Applied to Land: Advancing Standards and Practices (2002)
The Airliner Cabin Environment and Health of Passengers and Crew (2002)
Arsenic in Drinking Water: 2001 Update (2001)
Evaluating Vehicle Emissions Inspection and Maintenance Programs (2001)
Compensating for Wetland Losses Under the Clean Water Act (2001)
A Risk-Management Strategy for PCB-Contaminated Sediments (2001)
Acute Exposure Guideline Levels for Selected Airborne Chemicals (thirteen volumes, 2000-2012)
Toxicological Effects of Methylmercury (2000)
Strengthening Science at the U.S. Environmental Protection Agency (2000)
Scientific Frontiers in Developmental Toxicology and Risk Assessment (2000)
Ecological Indicators for the Nation (2000)
Waste Incineration and Public Health (2000)
Hormonally Active Agents in the Environment (1999)
Research Priorities for Airborne Particulate Matter (four volumes, 1998-2004)
The National Research Council’s Committee on Toxicology: The First 50 Years (1997)
Carcinogens and Anticarcinogens in the Human Diet (1996)
Upstream: Salmon and Society in the Pacific Northwest (1996)
Science and the Endangered Species Act (1995)
Wetlands: Characteristics and Boundaries (1995)
Biologic Markers (five volumes, 1989-1995)
Science and Judgment in Risk Assessment (1994)
Pesticides in the Diets of Infants and Children (1993)
Dolphins and the Tuna Industry (1992)
Science and the National Parks (1992)
Human Exposure Assessment for Airborne Pollutants (1991)
Rethinking the Ozone Problem in Urban and Regional Air Pollution (1991)
Decline of the Sea Turtles (1990)
Copies of these reports may be ordered from the National Academies Press
(800) 624-6242 or (202) 334-3313
www.nap.edu
Lead poses an occupational health hazard, and the Occupational Safety and Health Administration (OSHA) developed a lead standard in 1978 for general industry that regulates many workplace exposures to this metal, including exposures on firing ranges. A large body of literature on health effects of lead exposure and factors that influence lead toxicity has been published since the lead standard was established. Most recently, the National Toxicology Program released a monograph on the health effects of low-level lead exposure, and the US Environmental Protection Agency is in the process of updating its Integrated Science Assessment for Lead in support of its review of the National Ambient Air Quality Criteria for lead.
In light of improved knowledge about the hazards posed by occupational lead exposure, the Department of Defense (DOD) asked the National Research Council to evaluate potential health risks related to 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 their workers adequately and to evaluate potential risk-assessment options.
In response to DOD’s request, the National Research Council convened the Committee on Potential Health Risks from Recurrent Lead Exposure of DOD Firing Range Personnel, which prepared this report. The members of the committee were selected for their expertise in general toxicology, inhalation toxicology, neurotoxicology, reproductive and developmental toxicology, immunotoxicology, toxicokinetics, epidemiology, industrial hygiene, occupational medicine, exposure assessment, risk assessment, and biostatistics (see Appendix A for biographic information on the members).
This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of the independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards of objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript
remain confidential to protect the integrity of the deliberative process. We thank the following for their review of this report: Floyd Bloom, The Scripps Research Institute; Deborah Cory-Slechta, University of Rochester; William Halperin, University of Medicine and Dentistry of New Jersey; David Lawrence, The Wadsworth Center; William J. Moorman, National Institute for Occupational Safety and Health (retired); Rosemary Sokas, Georgetown University; Kenneth Still, Portland State University; and Rochelle Tyl, RTI International.
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of the report was overseen by Robert Goyer, University of Western Ontario (retired), and Linda McCauley, Emory University. Appointed by the National Research Council, they were responsible for making certain that an independent examination of the report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of the report rests entirely with the author committee and the institution.
The committee is grateful for the assistance of National Research Council staff in preparing the report. It particularly wishes to acknowledge the support of project director Susan Martel, who coordinated the project and contributed to the committee’s report. Other staff members who contributed to this effort are James Reisa, director of the Board on Environmental Studies and Toxicology; Keri Stoever, research assistant; Tamara Dawson, program associate; Norman Grossblatt, senior editor; and Mirsada Karalic-Loncarevic, manager of the Technical Information Center.
Finally, I thank all the members of the committee for their efforts throughout the development of this report.
David C. Dorman, DVM, PhD, Chair
Committee on Potential Health Risks
from Recurrent Lead Exposure of DoD
Firing Range Personnel
ACGIH® | American Conference of Governmental Industrial Hygienists | |
ACOEM | American College of Occupational and Environmental Medicine | |
AIHA® | American Industrial Hygiene Association | |
ALA | aminolevulinic acid | |
ALAD | delta-aminolevulinic acid dehydratase | |
ALAU | aminolevulinic acid level in urine | |
AOEC | Association of Occupational and Environmental Clinics | |
AQCD | air quality criteria document | |
BAT | biological tolerance values (German) | |
BAEP | brainstem auditory evoked potential | |
BEI® | biological exposure index | |
BLL | blood lead level | |
CaNa2EDTA | calcium disodium ethylenediamine tetraacetic acid | |
CBLI | cumulative blood lead index | |
CD | cluster of differentiation | |
CDC | Centers for Disease Control and Prevention | |
CES-D | Center for Epidemiological Studies – Depression Scale | |
CI | confidence interval | |
CKD | chronic kidney disease | |
CPA | Center for Policy Alternatives (at the Massachusetts Institute of Technology) | |
CPT | current perception threshold | |
CSTE | Council of State and Territorial Epidemiologists | |
CTL | cytotoxic T lymphocyte | |
CVD | cardiovascular disease | |
DBP | diastolic blood pressure | |
DMSA | 2,3-dimercaptosuccinic acid | |
ECG | electrocardiogram | |
EEG | electroencephalogram | |
EPO | erythropoietin | |
FEP | free erythrocyte protoporphyrin |
3-3 Time-dependent relationship between BLL and air lead concentration as estimated with the CPA model used by OSHA to develop the permissible exposure level
4-1 The biosynthetic pathway of heme
TABLES
1-4 Air and Blood Lead Concentrations Measured on Indoor and Outdoor Firing Ranges
2-1 Occupational-Exposure Guidelines for Lead
4-1 Key Studies of the Effects of Lead on Neurologic Outcomes
4-2 Key Studies of the Hematopoietic Effects of Lead
4-3 Key Studies of the Renal Effects of Lead
4-4 Key Studies of the Male Reproductive Effects of Lead
4-5 Key Studies of the Female Reproductive Effects of Lead
4-6 Key Studies of the Immunologic Effects of Lead
4-7 Key Studies of the Effects of Lead on Cardiovascular Disease
5-1 Key Human Studies of the Carcinogenic Effects of Lead
5-2 Dose-Response Data on Renal Tumors from Some Oral Studies in Rodents