Can the Adult Lead Methodology (ALM) be used to evaluate dietary lead exposures, specifically fish ingestion exposures?
Yes, but only when reliable site-specific information on fish ingestion and bioavailability for the lead in fish is known. This approach might be applicable to a local or regional source of lead that is not accounted for in nationally based recommendations regarding baseline lead levels, which consider commercially available fish species and average fish consumption rates. The addition of a specific fish exposure pathway may result in a slight overestimate of risk as a result of double-counting of dietary lead, because normal dietary exposure to lead in fish is already accounted for by the baseline blood lead concentration (PbB0) (see NHANES report available from the Guidance page). The ALM analysis could be performed to evaluate the local fish contribution to lead exposure. A fish advisory could also be developed by applying the ALM in reverse to derive an upper-bound ingestion rate for a given lead concentration in fish tissue, using an increasing intake of fish to determine an intak
