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Identification of children at risk for lead poisoning: an evaluation of routine pediatric blood lead screening in an HMO-insured population.
Pediatrics. 1996 Jan; 97(1):79-83.Ped

Abstract

OBJECTIVES

To estimate the prevalence of elevated blood lead levels in children receiving well-care checkups; and to evaluate the effectiveness of certain key risk factors in detecting children at higher risk for elevated blood lead levels.

DESIGN

Cross-sectional study.

SETTING

Two facilities of the Kaiser Permanente Medical Care Program (KPMCP) health maintenance organization (HMO), northern California region.

PATIENTS

Six hundred thirty-six children, aged 12 to 60 months, who were seen at four KPMCP facilities in two subregions for a well-care checkup from September 1991 through August 1992.

INTERVENTIONS

Blood samples were collected from each child and analyzed for lead content. Participating parents completed a questionnaire that included questions recommended by the Centers for Disease Control and Prevention (CDC) about the child's and the parents' lead exposure via home, workplace, and hobbies.

RESULTS

Ninety-six percent of the children had blood lead levels under 10 micrograms/dL. Blood lead levels declined with increasing age and were higher for black children compared with whites. Age of residential housing, mother's education, and residence in an old house with peeling paint had low sensitivity and positive predictive value for identifying children with blood lead levels over 10 micrograms/dL.

CONCLUSION

Universal routine screening for elevated blood lead levels in children in an employed, HMO-insured population is not warranted on grounds of prevalence. Responses to CDC questions do not effectively identify high-risk children in this population.

Authors+Show Affiliations

University of California, School of Medicine, Department of Community Health, Davis 95616, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8545230

Citation

Haan, M N., et al. "Identification of Children at Risk for Lead Poisoning: an Evaluation of Routine Pediatric Blood Lead Screening in an HMO-insured Population." Pediatrics, vol. 97, no. 1, 1996, pp. 79-83.
Haan MN, Gerson M, Zishka BA. Identification of children at risk for lead poisoning: an evaluation of routine pediatric blood lead screening in an HMO-insured population. Pediatrics. 1996;97(1):79-83.
Haan, M. N., Gerson, M., & Zishka, B. A. (1996). Identification of children at risk for lead poisoning: an evaluation of routine pediatric blood lead screening in an HMO-insured population. Pediatrics, 97(1), 79-83.
Haan MN, Gerson M, Zishka BA. Identification of Children at Risk for Lead Poisoning: an Evaluation of Routine Pediatric Blood Lead Screening in an HMO-insured Population. Pediatrics. 1996;97(1):79-83. PubMed PMID: 8545230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identification of children at risk for lead poisoning: an evaluation of routine pediatric blood lead screening in an HMO-insured population. AU - Haan,M N, AU - Gerson,M, AU - Zishka,B A, PY - 1996/1/1/pubmed PY - 1996/1/1/medline PY - 1996/1/1/entrez SP - 79 EP - 83 JF - Pediatrics JO - Pediatrics VL - 97 IS - 1 N2 - OBJECTIVES: To estimate the prevalence of elevated blood lead levels in children receiving well-care checkups; and to evaluate the effectiveness of certain key risk factors in detecting children at higher risk for elevated blood lead levels. DESIGN: Cross-sectional study. SETTING: Two facilities of the Kaiser Permanente Medical Care Program (KPMCP) health maintenance organization (HMO), northern California region. PATIENTS: Six hundred thirty-six children, aged 12 to 60 months, who were seen at four KPMCP facilities in two subregions for a well-care checkup from September 1991 through August 1992. INTERVENTIONS: Blood samples were collected from each child and analyzed for lead content. Participating parents completed a questionnaire that included questions recommended by the Centers for Disease Control and Prevention (CDC) about the child's and the parents' lead exposure via home, workplace, and hobbies. RESULTS: Ninety-six percent of the children had blood lead levels under 10 micrograms/dL. Blood lead levels declined with increasing age and were higher for black children compared with whites. Age of residential housing, mother's education, and residence in an old house with peeling paint had low sensitivity and positive predictive value for identifying children with blood lead levels over 10 micrograms/dL. CONCLUSION: Universal routine screening for elevated blood lead levels in children in an employed, HMO-insured population is not warranted on grounds of prevalence. Responses to CDC questions do not effectively identify high-risk children in this population. SN - 0031-4005 UR - https://www.unboundmedicine.com/medline/citation/8545230/Identification_of_children_at_risk_for_lead_poisoning:_an_evaluation_of_routine_pediatric_blood_lead_screening_in_an_HMO_insured_population_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=8545230 DB - PRIME DP - Unbound Medicine ER -