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A comparison of costs of universal versus targeted lead screening for young children.
Environ Res. 1999 Jan; 80(1):84-91.ER

Abstract

The purposes of this study were to compare universal blood lead screening for young children versus targeting by a risk assessment questionnaire and to examine the cost implications of each approach. Costs reflect the total number of blood tests required and cost of specimen collection, handling, and testing per elevated case. The setting included the metropolitan areas of Minneapolis and St. Paul, Minnesota. Children (N=9603) from 17 community organizations had blood tests. In addition, each child's parent or guardian completed a questionnaire assessing potential risk for lead poisoning. Four different screening approaches are presented. Each screening approach is presented with associated costs of overall screening and cost per child identified at blood levels of >/=10 microg/dl (N=1140) and >/=15 microg/dl (N=317). Based on the screening strategy selected and an estimate of $17 per blood test, total screening costs ranged from $91,596 to $165,945. The cost per child identified with elevated lead levels ranged from $361 to $523 at >/=15 and $105 to $146 at >/=10. Nine to 13% of children would not have been detected by policies other than universal screening. A geographically based approach was able to detect 90% of children with elevated blood levels at two-thirds the cost of universal screening. Blood tests would be taken for all children living within city limits. Those residing elsewhere would be tested only if answers to questionnaire items pertaining to age of housing, prior history of lead poisoning, or eating paint chips indicated risk. The new CDC guidelines suggest that screening be based on an assessment of housing, population demographics, and community risk and resources. This paper presents such an assessment.

Authors+Show Affiliations

Group Health Foundation, HealthPartners, Minneapolis, Minnesota.No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

9931230

Citation

Rolnick, S J., et al. "A Comparison of Costs of Universal Versus Targeted Lead Screening for Young Children." Environmental Research, vol. 80, no. 1, 1999, pp. 84-91.
Rolnick SJ, Nordin J, Cherney LM. A comparison of costs of universal versus targeted lead screening for young children. Environ Res. 1999;80(1):84-91.
Rolnick, S. J., Nordin, J., & Cherney, L. M. (1999). A comparison of costs of universal versus targeted lead screening for young children. Environmental Research, 80(1), 84-91.
Rolnick SJ, Nordin J, Cherney LM. A Comparison of Costs of Universal Versus Targeted Lead Screening for Young Children. Environ Res. 1999;80(1):84-91. PubMed PMID: 9931230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of costs of universal versus targeted lead screening for young children. AU - Rolnick,S J, AU - Nordin,J, AU - Cherney,L M, PY - 1999/2/5/pubmed PY - 1999/2/5/medline PY - 1999/2/5/entrez SP - 84 EP - 91 JF - Environmental research JO - Environ Res VL - 80 IS - 1 N2 - The purposes of this study were to compare universal blood lead screening for young children versus targeting by a risk assessment questionnaire and to examine the cost implications of each approach. Costs reflect the total number of blood tests required and cost of specimen collection, handling, and testing per elevated case. The setting included the metropolitan areas of Minneapolis and St. Paul, Minnesota. Children (N=9603) from 17 community organizations had blood tests. In addition, each child's parent or guardian completed a questionnaire assessing potential risk for lead poisoning. Four different screening approaches are presented. Each screening approach is presented with associated costs of overall screening and cost per child identified at blood levels of >/=10 microg/dl (N=1140) and >/=15 microg/dl (N=317). Based on the screening strategy selected and an estimate of $17 per blood test, total screening costs ranged from $91,596 to $165,945. The cost per child identified with elevated lead levels ranged from $361 to $523 at >/=15 and $105 to $146 at >/=10. Nine to 13% of children would not have been detected by policies other than universal screening. A geographically based approach was able to detect 90% of children with elevated blood levels at two-thirds the cost of universal screening. Blood tests would be taken for all children living within city limits. Those residing elsewhere would be tested only if answers to questionnaire items pertaining to age of housing, prior history of lead poisoning, or eating paint chips indicated risk. The new CDC guidelines suggest that screening be based on an assessment of housing, population demographics, and community risk and resources. This paper presents such an assessment. SN - 0013-9351 UR - https://www.unboundmedicine.com/medline/citation/9931230/A_comparison_of_costs_of_universal_versus_targeted_lead_screening_for_young_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-9351(98)93879-8 DB - PRIME DP - Unbound Medicine ER -