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[Occurrence of lead poisoning during follow-up of children at risk with initial screening lead blood levels below 100 microg/L].
Rev Epidemiol Sante Publique. 2009 Aug; 57(4):249-55.RE

Abstract

BACKGROUND

Follow-up is recommended for children initially screened with a lead blood level below the threshold for lead poisoning of 10 microg/dL when they have one or more risk factors. At first, the frequency of a follow-up lead blood test was calculated in children at risk for lead poisoning. In second time, we calculated the rate of occurrence and independent factors for lead poisoning in the follow-up group.

METHODS

Since 1992, the Greater Paris lead poisoning monitoring system (SSSIILF) has been systematically recording data on lead levels in blood tests conducted for screening and follow-up in Greater Paris. Children initially screened before the age of seven whose blood lead level was inferior to 10 microg/dL and who had one or more risk factors were selected. The association between qualitative variables and a follow-up lead blood test was compared using the Chi(2) test. For children given follow-up, the association between qualitative variables and occurrence of lead poisoning was compared using the Chi(2) test; independent factors for lead poisoning were estimated by logistic regression.

RESULTS

A follow-up lead blood test was more frequent and the difference was statistically significant, for children with one or more of the following risk factors identified at the time of screening: home address in Seine Saint-Denis or central Paris, screened in mother/child healthcare centers (PMI) or through a private physician, a blood lead level 5 microg/dL on initial screening, young age (<24 months) at the time of screening and some others known risk factors. The rate of occurrence of lead poisoning during follow-up was 25.9% for children screened between 1992 to 1994 and decrease to 5.1% for children screened in 2004 to 2005 (p<0.001) and was lower in central Paris and Seine Saint-Denis than in other districts in Greater Paris (p<0.01). The rate of occurrence during follow-up, independent of known risk factors for lead poisoning (p<0.01), was higher for children screened before the age of two (p<0.01) and for children whose mothers were from Sub-Saharan Africa (p<0.01).

CONCLUSION

It is essential to follow up children at risk with an initial lead blood level below 10 microg/dL, especially those initially screened before the age of 24 months. Local action on home environment could also be needed when the initial blood lead level is 5 microg/dL and more than one risk factor has been identified.

Authors+Show Affiliations

Cellule Interrégionale d'Epidémiologie d'Ile-de-France, Institut de Veille Sanitaire, 12 Rue du Val-d'Osne, 94410 Saint-Maurice, France.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

19553045

Citation

Tararbit, K, et al. "[Occurrence of Lead Poisoning During Follow-up of Children at Risk With Initial Screening Lead Blood Levels Below 100 Microg/L]." Revue D'epidemiologie Et De Sante Publique, vol. 57, no. 4, 2009, pp. 249-55.
Tararbit K, Carré N, Garnier R, et al. [Occurrence of lead poisoning during follow-up of children at risk with initial screening lead blood levels below 100 microg/L]. Rev Epidemiol Sante Publique. 2009;57(4):249-55.
Tararbit, K., Carré, N., & Garnier, R. (2009). [Occurrence of lead poisoning during follow-up of children at risk with initial screening lead blood levels below 100 microg/L]. Revue D'epidemiologie Et De Sante Publique, 57(4), 249-55. https://doi.org/10.1016/j.respe.2009.03.003
Tararbit K, et al. [Occurrence of Lead Poisoning During Follow-up of Children at Risk With Initial Screening Lead Blood Levels Below 100 Microg/L]. Rev Epidemiol Sante Publique. 2009;57(4):249-55. PubMed PMID: 19553045.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Occurrence of lead poisoning during follow-up of children at risk with initial screening lead blood levels below 100 microg/L]. AU - Tararbit,K, AU - Carré,N, AU - Garnier,R, AU - ,, Y1 - 2009/06/23/ PY - 2008/12/03/received PY - 2009/03/04/revised PY - 2009/03/04/accepted PY - 2009/6/26/entrez PY - 2009/6/26/pubmed PY - 2009/10/9/medline SP - 249 EP - 55 JF - Revue d'epidemiologie et de sante publique JO - Rev Epidemiol Sante Publique VL - 57 IS - 4 N2 - BACKGROUND: Follow-up is recommended for children initially screened with a lead blood level below the threshold for lead poisoning of 10 microg/dL when they have one or more risk factors. At first, the frequency of a follow-up lead blood test was calculated in children at risk for lead poisoning. In second time, we calculated the rate of occurrence and independent factors for lead poisoning in the follow-up group. METHODS: Since 1992, the Greater Paris lead poisoning monitoring system (SSSIILF) has been systematically recording data on lead levels in blood tests conducted for screening and follow-up in Greater Paris. Children initially screened before the age of seven whose blood lead level was inferior to 10 microg/dL and who had one or more risk factors were selected. The association between qualitative variables and a follow-up lead blood test was compared using the Chi(2) test. For children given follow-up, the association between qualitative variables and occurrence of lead poisoning was compared using the Chi(2) test; independent factors for lead poisoning were estimated by logistic regression. RESULTS: A follow-up lead blood test was more frequent and the difference was statistically significant, for children with one or more of the following risk factors identified at the time of screening: home address in Seine Saint-Denis or central Paris, screened in mother/child healthcare centers (PMI) or through a private physician, a blood lead level 5 microg/dL on initial screening, young age (<24 months) at the time of screening and some others known risk factors. The rate of occurrence of lead poisoning during follow-up was 25.9% for children screened between 1992 to 1994 and decrease to 5.1% for children screened in 2004 to 2005 (p<0.001) and was lower in central Paris and Seine Saint-Denis than in other districts in Greater Paris (p<0.01). The rate of occurrence during follow-up, independent of known risk factors for lead poisoning (p<0.01), was higher for children screened before the age of two (p<0.01) and for children whose mothers were from Sub-Saharan Africa (p<0.01). CONCLUSION: It is essential to follow up children at risk with an initial lead blood level below 10 microg/dL, especially those initially screened before the age of 24 months. Local action on home environment could also be needed when the initial blood lead level is 5 microg/dL and more than one risk factor has been identified. SN - 0398-7620 UR - https://www.unboundmedicine.com/medline/citation/19553045/[Occurrence_of_lead_poisoning_during_follow_up_of_children_at_risk_with_initial_screening_lead_blood_levels_below_100_microg/L]_ DB - PRIME DP - Unbound Medicine ER -