March 4, 1996

Sanford D. Zelnick, Ltd. Col., USAF, MC
Chief, Occupational Medicine
HQ AFMO/SGOE
110 Luke Avenue, Room 400
Bolling AFB, DC 20332-7050

Dear Lt. Col. Zelnick:

This is in response to your letter dated October 12, 1995, to the Occupational Safety and Health Administration (OSHA) regarding the biological monitoring requirements under the Final Rule for Lead, 29 CFR 1910.1025(j)(2) and the Interim Final Rule for Lead in Construction, 29 CFR 1926.62(j)(2). I apologize for the long delay in our response.

You are concerned that the zinc protoporphyrin (ZPP) test required as part of the biological monitoring requirements of the lead standards has no utility as part of medical surveillance, because medical removal protection is not triggered based on an employee's ZPP level. You are recommending that OSHA consider citing the omission of the ZPP test from biological monitoring as a de minimis notification rather than a serious violation, when the serum lead value has been done.

Medical surveillance program requirements such as frequency of biological monitoring and medical removal protection, are not triggered based upon an employee's ZPP level. Even though an employee's ZPP level is not used to trigger any medical surveillance program requirements, ZPP is essential in estimating an exposed employee's lead toxicity. Also, ZPP is one of the specified elements of the medical examination that the examining physician is required to evaluate to determine if an employee is at increased risk of material impairment to his/her health. The provision of the ZPP test is an obligatory element of the medical surveillance program. Omission of this test from the medical surveillance program, even if blood lead sampling is done, is a violation of 29 CFR 1910.1025(j)(2) and 1926.62(j)(2) and can be cited as an other-than-serious violation, as a minimum.

OSHA does allow an employer to use an alternate test that is comparable to the ZPP test for complying with the requirements of 29 CFR 1926.62(j)(2) and 1910.1025(j)(2). In OSHA Instruction CPL 2-2.58, titled "29 CFR 1926.62, Lead Exposure In Construction; Interim Final - Inspection and Compliance Procedures," OSHA discusses this enforcement policy which states "OSHA has determined that the Free Erythrocyte Protoporphyrin (FEP) test is comparable to the ZPP test for determining lead toxicity. Where an employer uses the FEP test for the ZPP test, the CSHO shall treat the violation as de minimis."

De Minimis violations are violations of standards which have no direct or immediate relationship to safety or health and are not included in citations. In providing the FEP test instead of the ZPP test, an employer will be considered to be compliance with the intent of 29 CFR 1910.1025(j)(2) and 1926.62(j)(2), and the deviation from the standards' requirements is in a manner that has no direct or immediate relationship to employee safety and health. Please bear in mind that failure to provide either ZPP or FEP will be considered at least an other-than-serious violation.

Thank you for seeking clarification on this issue and for your interest in safety and health in the workplace.

Sincerely,



Ruth McCully, Director
Office of Health Compliance Assistance




October 12, 1995

MEMORANDUM FOR OSHA, DIRECTOR OF COMPLIANCE
              ATTN MR JOHN MILES

FROM:          HQ AFMOA/SGOE 
              110 Luke Avenue, Room 400 
              Bolling AFB, DC  20332-7050

SUBJECT:       ZPP Testing For Lead Exposed Workers

As you are aware, the above standards mandate that workers exposed over the action level receive a zinc protoporphyrin (ZPP) level in addition to serum lead. Failure to perform zinc protoporphyrin testing is listed as a serious violation in the OSHA Health Compliance Manual.

Zinc protoporphyrin testing adds little to the worker who has been acutely or chronically exposed to lead. It has no place in any clinical decisions which may be made, such as the decision whether an employee requires chelation therapy or not. The serum lead value is routinely used for the purpose. The ZPP level also has little value in removal from or return to work decisions. The serum lead value is used for this purpose as well.

While the ZPP may have some value in estimating the body burden of lead in an exposed individual, its omission should not have such weight as to constitute a serious violation of law when the serum lead value has been done. The serum lead value provides sufficient information to adequately protect exposed workers.

The laboratory cost at our facilities to perform a ZPP test is $25.00. In the Air Force, the test is mainly performed on plant services employees, who may perform a variety of tasks, to include depainting or sanding on surfaces which have not been characterized with regard to lead content. While the number of such employees at a typical Air Force base is relatively small (7-10 employees), the cost adds up when you consider the costs Air Force wide.

We appreciate the kind consideration you give to our request that omission of ZPP testing be considered a de minimis violation of OSHA standards as opposed to a serious violation. I may be reached at HQ AFMOA/SGOE, 110 Luke Avenue, Room 400, Washington, DC 20332-7050, (202)767-1731, ext 363, if you require additional information regarding this recommendation.



SANFORD D. ZELNICK, Lt Col, USAF, MC
Chief, Occupational Medicine
Air Force Medical Operations Agency
Office of the Surgeon General