Blood lead (B-Pb) levels were determined in 1978-1979, 1980-1981, and 1985-1986 in subjects living in various regions in Italy according to the regulations contained in European Community Directive 77/312 and in Presidential Decree DPR 496/82. From the data obtained, a lowering time trend in median (\mathrm{B}-\mathrm{Pb}) levels was evident for subjects from most of the considered Italian regions. In the total samples of male subjects, the median (\mathbf{B}-\mathrm{Pb}) levels were 200,179 , and (153 \mu \mathrm{g} /) liter in (1978-1979,1980-1981), and 1985-1986, respectively. In female subjects median B-Pb levels were (140 \mu \mathrm{g} /) liter in 1978-1979, (122 \mu \mathrm{g} /) liter in (1980-) 1981, and (100 \mu \mathrm{g} /) liter in 1985-1986. A lowering time trend in B-Pb levels has been also observed in the period between 1980 and 1992 in subjects living in the province of Rome. Median B-Pb levels decreased from 190 to (66 \mu \mathrm{g} /) liter in males and from 150 to (42 \mu \mathrm{g}) /liter in females. During the period of the monitoring program, all over the national territory, the maximum lead content in gasoline has been progressively reduced from (0.635 \mathrm{~g} /) liter in 1980 to (0.15 \mathrm{~g} /) iter in 1991 . These data demonstrate how an appropriate measure may succeed in reducing environmental lead contamination, finally resulting in an actual reduction in the level of human exposure. Within the framework of the monitoring program, we studied the associations of blood lead to selected social, environmental, constitutional, and biochemical factors and to clinical parameters. (\mathrm{B}-\mathrm{Pb}) was directly related to alcohol consumption, cigarette smoking, and car-driving habits. A positive association was also found between (\mathrm{B}-\mathrm{Pb}) and both HDL-cholesterol and (\gamma)-glutamyl-transpeptidase, two biochemical indexes of alcohol consumption. Finally, B-Pb was directly and significantly related to both diastolic and systolic blood pressure. 1995 Academic Press. Inc