Lead screening update from the US Preventive Services Task Force

Jacobs, David E.

doi:10.1016/j.jpeds.2019.07.011

Cited by 5 publications

(3 citation statements)

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“…1,20 In September 2019, the US Preventive Services Task Force concluded that questionnaires and other clinical tools are unable to identify asymptomatic children who have elevated serum lead levels, based on a systematic review that included 24 previous studies. 21,22 Our data continue to question the utility of such screening tools, with less than 1% of patients in this study having elevated serum lead levels while the majority of these patients met high-risk criteria on local risk assessment tools. Furthermore, the data suggest that these screening tools are leading to overtesting of asymptomatic patients, which may lead to overutilization of clinical resources and patient harm.…”

Section: Discussionmentioning

confidence: 70%

“…19 Similar questionnaires developed to screen for lead exposure have been implemented at many pediatric clinics; however, studies have shown that these tools may not accurately identify a child’s risk of lead exposure. 1,20-22 Additionally, the implementation of screening tools in the primary care setting requires parental input as well as physician buy-in, training, and time, making implementation and application challenging. 23…”

Section: Introductionmentioning

confidence: 99%

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Who to Test? A Retrospective Study of Lead Testing in High-Risk Children

Hillyer

Matiz

Robbins-Milne

et al. 2021

Clin Pediatr (Phila)

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Background Nearly all pediatric patients in our setting meet high-risk criteria for lead exposure based on screening recommendations and guidelines. Implementation of screening and testing has been inconsistent. Objective To assess the utility and efficacy of performing universal lead testing between ages 1 and 5 at an urban academic pediatric practice. Methods Retrospective review of patients with routine lead testing between 2010 and 2015. Key variables included demographics, serum lead level, and behavioral diagnoses. Results A total of 6597 serum lead levels from 3274 patients were reviewed. Forty-seven samples (0.7%) from 24 patients (0.7%) were elevated. Of the 24 patients with elevated lead, 75% were identified at age 1 or 2. Sixty-seven percent of patients with first elevated lead level at age 3 or older had a diagnosis of developmental delay. Conclusion Routine testing of high-risk patients yielded minimal specificity in identifying elevated lead levels, especially in patients older than 3 years and without developmental delay.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Who to Test? A Retrospective Study of Lead Testing in High-Risk Children

Hillyer

Matiz

Robbins-Milne

et al. 2021

Clin Pediatr (Phila)

View full text Add to dashboard Cite

show abstract

“…Currently, the U.S. Preventive Services Task Force concludes that the available evidence is insufficient to assess the benefits and harms of screening for elevated blood lead levels in asymptomatic children, and the American Academy of Family Physicians recommends against universal lead testing of asymptomatic children ages 1 to 5 years [56]. However, the results of our study may call these recommendations into question and suggest adequate blood lead testing remains vital to uncovering and eliminating lead exposure pathways, as the measurable impact of proximity to airports on children's BLLs in our study is not likely to produce obvious symptoms [57,58].…”

Section: Discussionmentioning

confidence: 86%

The association between childhood blood lead levels and proximity to airports in Colorado

Berg,

Snow,

Richardson

2024

Discov Environ

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Background In October 2023, the U.S. Environmental Protection Agency announced a final endangerment finding that leaded aviation gasoline (avgas) contributes to air pollution that is harmful to public health. This study evaluates the evidence for a link between living in proximity to airports and children’s blood lead levels in Colorado. Methods We analyzed the association between childhood blood lead levels (BLLs) and proximity to airport point locations in children tested for lead in Colorado over a 10-year study period (2011–2020) using a correlated random effects model with bootstrapped standard errors (N = 56,002 observations, 47,322 individuals). Along with distance from airport point locations, we identified the number of days sampled children lived downwind of their nearest airport during the 60 days prior to their test date. We also adjusted the model for age, sex, detection limit, test type, sample order, seasonality, time, proximity to lead-releasing facilities, estimated monthly aircraft traffic, and demographic characteristics of the surrounding neighborhood. Results Our primary model estimates that living one mile (1.6 km) further from airport point locations decreases mean blood lead levels by 0.068 µg/dL. Additional analysis estimates that living one mile further from airport point locations decreases the odds of having a blood lead level ≥ 3.5 µg/dL by 13.2%. Conclusion Our results suggest that lead emissions from aircraft using leaded avgas have a small but statistically significant effect on the BLLs of children living near airport point locations in Colorado. While the risk from proximity to airports is likely less than the risks associated with deteriorating lead paint and dust, our findings highlight the value of lead testing in children who may be at risk of exposure from all sources, including those who live near airports.

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Research ethics and the Grimes court case

Jacobs¹

2023

Fifty Years of Peeling Away the Lead Paint Problem

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Lead screening update from the US Preventive Services Task Force

Abstract: Question What is the level of evidence for lead screening in asymptomatic children? Design Systematic review.

Cited by 5 publications

References 1 publication

Who to Test? A Retrospective Study of Lead Testing in High-Risk Children

Who to Test? A Retrospective Study of Lead Testing in High-Risk Children

The association between childhood blood lead levels and proximity to airports in Colorado

Research ethics and the Grimes court case

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