State of Alaska Epidemiology Bulletin Department of Health and Social Services Karleen Jackson, Commissioner 3601 Street, Suite 540, PO Box 240249 Anchorage, AK 99524-0249 Division of Public Health Jay C. Butler, MD, Director Local (907) 269-8000 gov 24 Hour Emergency 1-800-478-0084 Editors: Bradford D. Gessner, MD, MPH Joe McLaughlin, MD, MPH Bulletin N0. 16 April 26, 2007 Lead Exposure among High School Ri?e Team Members Interior Alaska, 2007 Background In March 2007, the Environmental Public Health Program received a report that a high school student from an interior Alaska community (Community A) had an elevated blood lead level (BLL). The student participated on the school?s ri?e team, and could have been exposed to lead at the local indoor ?ring range. CDC recognizes BLLs 310 pg/dL in children aged 56 years (I) and 225 ng/dL in adults (2) as levels of concern, although no similar level has been set by CDC for older children and adolescents. The Alaska Section of Epidemiology uses 210 llg/dl as the level of concern for all children and adolescents in Alaska. Methods On March 29, 2007, a health assessor and a public health nurse visited Community A to conduct an onsite investigation. Free blood lead testing was offered to all of the ri?e team shooters. Each person tested was asked to complete a short questionnaire. The Alaska State Public Health Laboratory in Anchorage performed the lead analyses. Results Ten of the 13 ri?e team members agreed to participate, and ?ve had an elevated BLL (Figure). Four students who had not shot at the range since late November 2006 or earlier had an average BLL of 5.3 llg/dL; by comparison, the six students who had shot at the range more recently had an average BLL of 19 lig/dL (2-tailed t-test; All 10 students reported that they helped clean the range and engaged in dry sweeping. Discussion This investigation demonstrates that recent exposure to an indoor ?ring range was associated with higher BLLs among adolescent student ri?e team members from Community A. A previous study in Alaska found that participation on a school ri?e team increased the risk of lead exposure, and dry sweeping increased the risk of having an elevated ELL (3). One indoor shooting range with a modern, well-maintained ventilation system, a written maintenance protocol and Figure. lood ead evels 0 fT en ommunity A High School Ri?e Team Members (The dashed line below represents the level of concern for children and adolescents in Alaskagsann??Blood lead level (11ng Student Recommendations 1. The Community A school district should hire a lead risk assessor to evaluate the ventilation system, maintenance practices, and extent of lead contamination at the range. 2. All indoor shooting ranges in Alaska should prohibit dry sweeping. Instead, adult employees should clean ranges using appropriate practices for the industry (4). 3. Children aged <18 years should not assist with cleaning indoor shooting ranges (3). 4. All student shooters in Alaska using lead ammunition at indoor ?ring ranges should have their blood lead level tested at the beginning, middle and end of each shooting season every year, as standard practice for the sport. 5. Healthc are providers should 0 onsider chelation therapy for young children with BLLs Z45 ug/dl References 1. Centers for Disease Control and Prevention. Screening young children for lead poisoning: guidance for state and local public health of?cials. Atlanta, GA: US Department of Health and Human Services, 1997. 2. Centers for Disease Control and Prevention. Adult blood lead epidemiology and surveillance-United States, 1998- 2001. In: Surveillance Summaries, December 13, 2002. MMWR 2002;51 3. T, Arnold S, Wood C, Castrodale L, Middaugh J, ?int" I I I pl?nm "anar?