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Steven D. Blatt, MD; Howard L. Weinberger, MD

Am J Dis Child. 1993;147(7):761-763.

Abstract
• Objective.
—To determine the effects of applying the October 1991 recommendations of the Centers for Disease Control and Prevention to lower the acceptable blood lead level to 0.48 µmol/L (10 µg/dL) and to use blood lead levels as the primary method of screening in young children.

Design
—Retrospective patient series.

Setting.
—Outpatient pediatric department in a university hospital.

Participants.
—Two hundred thirty-three children between the ages of 9 and 24 months presenting at well-child visits during 1991.

Selection Procedures.
—Consecutive children.

Interventions.
—None.

Measurements and Results.
—All children underwent venous sampling for measurement of blood lead and erythrocyte protoporphyrin levels. Of 78 children aged 9 to 12 months, and 155 children aged 12 to 24 months, 25.5% and 36.1%, respectively, had elevated blood lead levels (0.48 µmol/L) (10 µg/dL). Of the 80 children with elevated levels of erythrocyte protoporphyrin, 55 (68.8%) had acceptable blood lead levels. Of 153 children with normal levels of erythrocyte protoporphyrin, 51 (33.3%) had elevated blood lead levels.

Conclusions.
—These data demonstrate the high prevalence in our clinic of lead poisoning among children aged 9 to 12 months and 12 to 24 months. Measurement of erythrocyte protoporphyrin has poor sensitivity and specificity and is no longer an adequate screening test. Greater efforts at primary and secondary prevention of lead poisoning are needed for young children. Repeated screening is necessary to identify those who would benefit from increased surveillance and intervention.

(AJDC. 1993;147:761-763)

Author Affiliations
From the Department of Pediatrics and University Hospital, State University of New York Health Science Center, Syracuse.

Footnotes
Accepted for publication January 27, 1993.

Presented in part at the Annual Meeting of the Ambulatory Pediatric Association, Baltimore, Md, May 6, 1992.

Reprint requests to Department of Pediatrics, SUNY Health Science Center, 750 E Adams St, Syracuse, NY 13210 (Dr Blatt).

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