You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 149 No. 4, April 1995 TABLE OF CONTENTS
  Archives
  •  Online Features
  ARTICLE
 This Article
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Contact me when this article is cited
 Related Content
 •Similar articles in this journal

Screening for lead poisoning by fingerstick in suburban pediatric practices

D. J. Schonfeld, P. M. Rainey, M. R. Cullen, D. R. Showalter and D. V. Cicchetti
Department of Pediatrics, Yale University School of Medicine, New Haven, Conn., USA.

OBJECTIVE: To assess the false-positive rate of blood lead determinations on samples obtained by fingerstick from children screened in private suburban and rural practices. METHODS: Screening capillary lead samples were obtained by fingerstick; children with capillary lead levels of 0.7 mumol/L (15 micrograms/dL) or greater were recalled for a confirmatory venous lead test that served as the criterion standard. Parents completed a five-question risk assessment questionnaire at the time of initial screening. SETTING: Four private suburban to rural practices that serve predominantly white, middle-class populations. PARTICIPANTS: Children seen for routine care between August 1992 and February 1993 (N = 1085; 98% between 6 months and 6 years of age). RESULTS: Capillary lead level was 0.7 mumol/L (15 micrograms/dL) or greater in 35 children (3% of total sample); venous lead samples were obtained in 30 patients. Nine of the elevated capillary lead results were true-positives (venous lead = 0.7, 0.8, 0.8, 0.9, 0.9, 0.9, 1.1, 1.1, and 1.7 mumol/L [15, 17, 17, 18, 18, 18, 22, 22, and 35 micrograms/dL]); parents of only two of these children answered yes to any question on the risk assessment questionnaire. Although the false-positive rate of the capillary lead screening test was 70% (21/30) in this setting, only 2% of the total sample had a false-positive screening test (an average of fewer than one false-positive per month per practice). Screening by fingerstick allowed phlebotomy to be avoided for 97% of the children. CONCLUSION: Fingerstick screening for lead poisoning is a reasonable alternative to direct venous testing within private suburban and rural practices, provided that care is taken to avoid specimen contamination, that appropriate caution is used in the interpretation of screening test results, and that medical and environmental interventions are based on the results of confirmatory venous testing.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Interpreting and Managing Blood Lead Levels of Less Than 10 {micro}g/dL in Children and Reducing Childhood Exposure to Lead: Recommendations of the Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention
Binns et al.
Pediatrics 2007;120:e1285-e1298.
ABSTRACT | FULL TEXT  

Inaccuracy in Parental Reporting of the Age of Their Home for Lead-Screening Purposes
Schwab et al.
Arch Pediatr Adolesc Med 2003;157:584-586.
ABSTRACT | FULL TEXT  

Filter Paper-collected Blood Lead Testing in Children The authors of the editorial cited above respond:
Verebey et al.
Clin. Chem. 2000;46:1024-1028.
FULL TEXT  

Filter Paper Lead Testing
Moyer et al.
Clin. Chem. 1999;45:2055-2056.
FULL TEXT  

Evaluation of Risk Assessment Questions Used to Target Blood Lead Screening in Illinois
Binns et al.
Pediatrics 1999;103:100-106.
ABSTRACT | FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1995 American Medical Association. All Rights Reserved.