This article presents a summary of lead exposure levels and lead poisoning at workplaces in China reported in the Chinese medical literature between 1990 and 2005. A comprehensive literature search identified 618 papers reporting lead exposure and lead poisoning data. The data were analyzed in terms of time period, type of industry, size of factory, and task or process. In 2002 the new Occupational Diseases Prevention and Control Act was passed in China, with new provisions specifically for regulatory enforcement. Therefore, a comparison of lead exposure levels and lead poisoning rates before and after the 2002 Act will shed some light on the effectiveness of the new regulation. The reported lead exposure levels covered a wide range; some measurements were in excess of 250 mg/m(3), which was orders-of-magnitude higher than the occupational exposure levels (OELs) for lead in China. The overall arithmetic mean, median, and geometric mean were 0.92, 0.25, and 0.24 mg/m(3), respectively. Approximately 53.7% of the averages reported in the papers were above the national OELs. The data demonstrated that many facilities in the lead industries reported in the literature were not in compliance with the OELs. Similarly, there appeared to be only a minor impact of the 2002 Act on the reduction of occupational lead poisoning in China. The lead poisoning rates reported in the literature were well above 30%. Judging by the lead exposure levels and the lead poisoning rates, the current overall occupational health monitoring system appears inadequate, lacking the necessary enforcement. The 2002 Act, without the necessary enforcement, did not appear to have a major impact on either lead exposures or lead poisoning in China. Much work in enforcing the 2002 Act remains to be done.