Tags

Type your tag names separated by a space and hit enter

Measurement Challenges at Low Blood Lead Levels.
Pediatrics. 2017 Aug; 140(2)Ped

Abstract

In 2012, the Centers for Disease Control and Prevention (CDC) adopted its Advisory Committee on Childhood Lead Poisoning Prevention recommendation to use a population-based reference value to identify children and environments associated with lead hazards. The current reference value of 5 μg/dL is calculated as the 97.5th percentile of the distribution of blood lead levels (BLLs) in children 1 to 5 years old from 2007 to 2010 NHANES data. We calculated and updated selected percentiles, including the 97.5th percentile, by using NHANES 2011 to 2014 blood lead data and examined demographic characteristics of children whose blood lead was ≥90th percentile value. The 97.5th percentile BLL of 3.48 µg/dL highlighted analytical laboratory and clinical interpretation challenges of blood lead measurements ≤5 μg/dL. Review of 5 years of results for target blood lead values <11 µg/dL for US clinical laboratories participating in the CDC's voluntary Lead and Multi-Element Proficiency quality assurance program showed 40% unable to quantify and reported a nondetectable result at a target blood lead value of 1.48 µg/dL, compared with 5.5% at a target BLL of 4.60 µg/dL. We describe actions taken at the CDC's Environmental Health Laboratory in the National Center for Environmental Health, which measures blood lead for NHANES, to improve analytical accuracy and precision and to reduce external lead contamination during blood collection and analysis.

Authors+Show Affiliations

Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia kcaldwell@cdc.gov.Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28771411

Citation

Caldwell, Kathleen L., et al. "Measurement Challenges at Low Blood Lead Levels." Pediatrics, vol. 140, no. 2, 2017.
Caldwell KL, Cheng PY, Jarrett JM, et al. Measurement Challenges at Low Blood Lead Levels. Pediatrics. 2017;140(2).
Caldwell, K. L., Cheng, P. Y., Jarrett, J. M., Makhmudov, A., Vance, K., Ward, C. D., Jones, R. L., & Mortensen, M. E. (2017). Measurement Challenges at Low Blood Lead Levels. Pediatrics, 140(2). https://doi.org/10.1542/peds.2017-0272
Caldwell KL, et al. Measurement Challenges at Low Blood Lead Levels. Pediatrics. 2017;140(2) PubMed PMID: 28771411.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Measurement Challenges at Low Blood Lead Levels. AU - Caldwell,Kathleen L, AU - Cheng,Po-Yung, AU - Jarrett,Jeffery M, AU - Makhmudov,Amir, AU - Vance,Kathryn, AU - Ward,Cynthia D, AU - Jones,Robert L, AU - Mortensen,Mary E, Y1 - 2017/07/17/ PY - 2017/03/28/accepted PY - 2017/8/4/entrez PY - 2017/8/5/pubmed PY - 2017/8/29/medline JF - Pediatrics JO - Pediatrics VL - 140 IS - 2 N2 - In 2012, the Centers for Disease Control and Prevention (CDC) adopted its Advisory Committee on Childhood Lead Poisoning Prevention recommendation to use a population-based reference value to identify children and environments associated with lead hazards. The current reference value of 5 μg/dL is calculated as the 97.5th percentile of the distribution of blood lead levels (BLLs) in children 1 to 5 years old from 2007 to 2010 NHANES data. We calculated and updated selected percentiles, including the 97.5th percentile, by using NHANES 2011 to 2014 blood lead data and examined demographic characteristics of children whose blood lead was ≥90th percentile value. The 97.5th percentile BLL of 3.48 µg/dL highlighted analytical laboratory and clinical interpretation challenges of blood lead measurements ≤5 μg/dL. Review of 5 years of results for target blood lead values <11 µg/dL for US clinical laboratories participating in the CDC's voluntary Lead and Multi-Element Proficiency quality assurance program showed 40% unable to quantify and reported a nondetectable result at a target blood lead value of 1.48 µg/dL, compared with 5.5% at a target BLL of 4.60 µg/dL. We describe actions taken at the CDC's Environmental Health Laboratory in the National Center for Environmental Health, which measures blood lead for NHANES, to improve analytical accuracy and precision and to reduce external lead contamination during blood collection and analysis. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/28771411/Measurement_Challenges_at_Low_Blood_Lead_Levels_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=28771411 DB - PRIME DP - Unbound Medicine ER -