Occupational medical assessments in Germany are generally based on the investigation by the accident insurance company and the work anamnesis of the medical assessor. The Accident Prevention & Insurance Association has to investigate exposure, the occupational physician records the occupational and medical history. Here we report the case of a woman suffering from lead intoxication. Her blood lead level was high, although exposure had (supposedly) stopped several months previously. Neither the evaluation by the Accident Prevention & Insurance Association nor the medical examination revealed any indication of the cause. Therefore, the physician evaluated the workplace personally. He detected dust with a metallic appearance on the floor of the workplace. Dust analysis revealed a lead content of 3.4 %. Confronted with this finding, workers explained that they had filed on window frames which were made of lead. There were no protective measures at this workplace. Our observation emphasizes the importance of a detailed evaluation of the occupational environment. The assessor should evaluate workplaces personally in unclear cases.
