Establishment of an Occupational Diseases Surveillance System to Monitor Blood Lead Levels in Taiwan

Background. Occupational diseases share many common characteristics with infectious diseases. However, the successful approach of using surveillance systems to eradicate infectious diseases has never been applied to the control and prevention of occupational diseases. Methods. On the basis of a nationwide survey of blood lead levels in the general population in Taiwan, we (the Ministry of Health, Taiwan) have developed an obligatory surveillance system for blood lead. Results. This government-administered system, which uses laboratory data as its source of information, enrolls all workers whose blood lead level exceeds regulation points (40 μg/dl for men and 30 μg/dl for women). A Group for Health Promotion of Lead-using Workers (GHPLW) has been organized to be responsible for conducting epidemiological investigations to locate exposure sources in the workplace and to improve the working environment of cases and other workers with the same exposure. Conclusions. We emphasize that the accomplishment of the GHPLW′s task depends not only on "curing" the case, but also on eradicating the lead exposure source and decreasing the blood lead level of workers in the workplace during long-term follow-up. The system aims to upgrade occupational disease control to the stage of specific prevention and health promotion. The establishment of this system is a historic step in industrial hygiene and occupational disease prevention in Taiwan.