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Development of a population-specific risk assessment to predict elevated blood lead levels in Santa Clara County, California.
Pediatrics. 1995 Oct; 96(4 Pt 1):643-8.Ped

Abstract

OBJECTIVES

To determine: (1) the prevalence of a blood lead level (PbB) of 10 micrograms/dL or greater and 20 micrograms/dL or greater among children aged 6 to 72 months attending the Santa Clara County (SCC), California, public clinics, (2) risk factors for elevated PbB in this population, and (3) whether an SCC public clinic population-specific risk-assessment tool and a five-question lead poisoning questionnaire developed by the Centers for Disease Control and Prevention are useful for prospectively identifying children at higher risk for elevated PbB.

METHODS

We tested for PbB 3630 children aged 6 to 72 months attending SCC public outpatient clinics between August 8, 1991, and September 1, 1992. We then conducted two matched case-control studies. Five local risk-factor questions were combined with the CDC's five-question lead poisoning questionnaire, and from May 1, 1993, to June 30, 1993, we conducted risk assessments on 247 children tested for PbB.

RESULTS

Two hundred twenty-two of 3630 children (6.1%) had a PbB of 10 micrograms/dL or greater. Thirty-nine (1.1%) had a PbB at least 20 micrograms/dL. Seventy-nine percent of the children screened and 91.0% of the children with PbB at least 10 micrograms/dL were Hispanic. Twenty percent of Mexican-born Hispanic children had a PbB of 10 micrograms/dL or greater, versus 7% of U.S.-born Hispanic children. Several factors were associated with elevated PbB among Hispanic children. For identifying children with a PbB of at least 10 micrograms/dL, the sensitivity and predictive value negative for the CDC's "high risk" definition were 30% and 93%, respectively, whereas for the SCC population-specific high-risk definition, the sensitivity was 90% and the predictive value negative was 98%.

CONCLUSIONS

Hispanic children attending SCC public clinics have risk factors for elevated PbB that were not included in the CDC's lead poisoning questionnaire. Methods for prioritizing the frequency of lead screening may be improved by combining the CDC's questions with a population-specific risk assessment.

Authors+Show Affiliations

Department of Public Health, Santa Clara Valley Health and Hospital System, San Jose, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7567324

Citation

Snyder, D C., et al. "Development of a Population-specific Risk Assessment to Predict Elevated Blood Lead Levels in Santa Clara County, California." Pediatrics, vol. 96, no. 4 Pt 1, 1995, pp. 643-8.
Snyder DC, Mohle-Boetani JC, Palla B, et al. Development of a population-specific risk assessment to predict elevated blood lead levels in Santa Clara County, California. Pediatrics. 1995;96(4 Pt 1):643-8.
Snyder, D. C., Mohle-Boetani, J. C., Palla, B., & Fenstersheib, M. (1995). Development of a population-specific risk assessment to predict elevated blood lead levels in Santa Clara County, California. Pediatrics, 96(4 Pt 1), 643-8.
Snyder DC, et al. Development of a Population-specific Risk Assessment to Predict Elevated Blood Lead Levels in Santa Clara County, California. Pediatrics. 1995;96(4 Pt 1):643-8. PubMed PMID: 7567324.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Development of a population-specific risk assessment to predict elevated blood lead levels in Santa Clara County, California. AU - Snyder,D C, AU - Mohle-Boetani,J C, AU - Palla,B, AU - Fenstersheib,M, PY - 1995/10/1/pubmed PY - 1995/10/1/medline PY - 1995/10/1/entrez SP - 643 EP - 8 JF - Pediatrics JO - Pediatrics VL - 96 IS - 4 Pt 1 N2 - OBJECTIVES: To determine: (1) the prevalence of a blood lead level (PbB) of 10 micrograms/dL or greater and 20 micrograms/dL or greater among children aged 6 to 72 months attending the Santa Clara County (SCC), California, public clinics, (2) risk factors for elevated PbB in this population, and (3) whether an SCC public clinic population-specific risk-assessment tool and a five-question lead poisoning questionnaire developed by the Centers for Disease Control and Prevention are useful for prospectively identifying children at higher risk for elevated PbB. METHODS: We tested for PbB 3630 children aged 6 to 72 months attending SCC public outpatient clinics between August 8, 1991, and September 1, 1992. We then conducted two matched case-control studies. Five local risk-factor questions were combined with the CDC's five-question lead poisoning questionnaire, and from May 1, 1993, to June 30, 1993, we conducted risk assessments on 247 children tested for PbB. RESULTS: Two hundred twenty-two of 3630 children (6.1%) had a PbB of 10 micrograms/dL or greater. Thirty-nine (1.1%) had a PbB at least 20 micrograms/dL. Seventy-nine percent of the children screened and 91.0% of the children with PbB at least 10 micrograms/dL were Hispanic. Twenty percent of Mexican-born Hispanic children had a PbB of 10 micrograms/dL or greater, versus 7% of U.S.-born Hispanic children. Several factors were associated with elevated PbB among Hispanic children. For identifying children with a PbB of at least 10 micrograms/dL, the sensitivity and predictive value negative for the CDC's "high risk" definition were 30% and 93%, respectively, whereas for the SCC population-specific high-risk definition, the sensitivity was 90% and the predictive value negative was 98%. CONCLUSIONS: Hispanic children attending SCC public clinics have risk factors for elevated PbB that were not included in the CDC's lead poisoning questionnaire. Methods for prioritizing the frequency of lead screening may be improved by combining the CDC's questions with a population-specific risk assessment. SN - 0031-4005 UR - https://www.unboundmedicine.com/medline/citation/7567324/Development_of_a_population_specific_risk_assessment_to_predict_elevated_blood_lead_levels_in_Santa_Clara_County_California_ DB - PRIME DP - Unbound Medicine ER -