Prevalence of Lead Exposure in a Clinic Using 1991 Centers for Disease Control and Prevention Recommendations

Blatt, Stephen P.; Weinberger, Howard L.

doi:10.1001/archpedi.1993.02160310063019

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…Average monthly BPb of children from urban areas tends to increase significantly in summer months (Billick et al 1979; Blatt and Weinberger 1993; Haley and Talbot 2004; Hayes et al 1994; Hunter 1977; Hwang and Wang 1990; Johnson and Bretsch 2002; Johnson et al 1996; Kimbrough et al 1994; Marrero et al 1983; Mielke and Reagan 1998; Rabinowitz and Needleman 1982; Rothenberg et al 1996; Stark et al 1980; U.S. EPA 1995, 1996; Yiin et al 2000).…”

Section: Seasonal Changes In Bpb Concentrationmentioning

confidence: 99%

Seasonality and Children’s Blood Lead Levels: Developing a Predictive Model Using Climatic Variables and Blood Lead Data from Indianapolis, Indiana, Syracuse, New York, and New Orleans, Louisiana (USA)

Laidlaw

Mielke

Filippelli

et al. 2005

Environ Health Perspect

197

117

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On a community basis, urban soil contains a potentially large reservoir of accumulated lead. This study was undertaken to explore the temporal relationship between pediatric blood lead (BPb), weather, soil moisture, and dust in Indianapolis, Indiana; Syracuse, New York; and New Orleans, Louisiana. The Indianapolis, Syracuse, and New Orleans pediatric BPb data were obtained from databases of 15,969, 14,467, and 2,295 screenings, respectively, collected between December 1999 and November 2002, January 1994 and March 1998, and January 1998 and May 2003, respectively. These average monthly child BPb levels were regressed against several independent variables: average monthly soil moisture, particulate matter < 10 μm in diameter (PM10), wind speed, and temperature. Of temporal variation in urban children’s BPb, 87% in Indianapolis (R2 = 0.87, p = 0.0004), 61% in Syracuse (R2 = 0.61, p = 0.0012), and 59% in New Orleans (R2 = 0.59, p = 0.0000078) are explained by these variables. A conceptual model of urban Pb poisoning is suggested: When temperature is high and evapotranspiration maximized, soil moisture decreases and soil dust is deposited. Under these combined weather conditions, Pb-enriched PM10 dust disperses in the urban environment and causes elevated Pb dust loading. Thus, seasonal variation of children’s Pb exposure is probably caused by inhalation and ingestion of Pb brought about by the effect of weather on soils and the resulting fluctuation in Pb loading.

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Section: Seasonal Changes In Bpb Concentrationmentioning

confidence: 99%

Seasonality and Children’s Blood Lead Levels: Developing a Predictive Model Using Climatic Variables and Blood Lead Data from Indianapolis, Indiana, Syracuse, New York, and New Orleans, Louisiana (USA)

Laidlaw

Mielke

Filippelli

et al. 2005

Environ Health Perspect

197

117

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“…Young children are particularly sensitive to the effects of lead. Guidelines (86 ) published by the US CDC in 1991 recommend screening of all children at the age of 2 years for low-level exposure because the prevalence of exposure in this group can be very high (87 ). These guidelines have subsequently been amended to focus screening in areas of high environmental lead contamination (88 ).…”

Section: Lead Poisoningmentioning

confidence: 99%

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Recommendations for the Use of Laboratory Tests to Support Poisoned Patients Who Present to the Emergency Department

et al. 2003

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Background: Exposure to drugs and toxins is a major cause for patients' visits to the emergency department (ED).Methods: Recommendations for the use of clinical laboratory tests were prepared by an expert panel of analytical toxicologists and ED physicians specializing in clinical toxicology. These recommendations were posted on the world wide web and presented in open forum at several clinical chemistry and clinical toxicology meetings. Results: A menu of important stat serum and urine toxicology tests was prepared for clinical laboratories who provide clinical toxicology services. For drugs-ofabuse intoxication, most ED physicians do not rely on results of urine drug testing for emergent management decisions. This is in part because immunoassays, although rapid, have limitations in sensitivity and specificity and chromatographic assays, which are more definitive, are more labor-intensive. Ethyl alcohol is widely tested in the ED, and breath testing is a convenient procedure. Determinations made within the ED, however, require oversight by the clinical laboratory. Testing for toxic alcohols is needed, but rapid commercial assays are not available. The laboratory must provide stat assays for acetaminophen, salicylates, co-oximetry, cholinesterase, iron, and some therapeutic drugs, such as lithium and digoxin. Exposure to other heavy metals requires laboratory support for specimen collection but not for emergent testing. Conclusions: Improvements are needed for immunoassays, particularly for amphetamines, benzodiazepines, opioids, and tricyclic antidepressants. Assays for new drugs of abuse must also be developed to meet changing abuse patterns. As no clinical laboratory can provide services to meet all needs, the National Academy of Clinical Biochemistry Committee recommends establishment of regional centers for specialized toxicology testing. © 2003 American Association for Clinical Chemistry PreambleThis is the ninth in the series of Laboratory Medicine Practice Guidelines sponsored by the National Academy Clinical Chemistry 49:3 357-379 (2003) Special Report 357of Clinical Biochemistry (NACB). 10 An expert Committee of emergency department (ED) physicians and clinical laboratory medicine toxicologists was assembled and prepared recommendations on the use of clinical laboratory tests to support the diagnosis and management of the poisoned patient who presents to the ED. Excluded from these discussions were drug testing conducted for the workplace, forensic and medical examiner toxicology, athletic drug testing, and testing for various compliance programs (e.g., criminal justice, psychiatric, and physician health). Many of these other programs are guided by other recommendations and regulations, such as the Substance Abuse and Mental Health Services Administration, the American Academy of Forensic Sciences, and the International Olympic Committee. Recommendations for detection of drugs in pregnant women and newborns exposed during the intrauterine period are discussed in a previous NACB guidelines (1 ). Som...

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“…Thus, temporal variations in the monitoring data need to be examined to ensure accurate interpretation of any exposure models which might be developed. Several investigators have reported seasonal variation in blood lead values (Hunter, 1977;Rabinowitz et al, 1984;Mielke et al, 1991;Blatt and Weinberger, 1993;Kimbrough et al, 1994;Brody et al, 1994), but few quantifications of the phenomenon have been described in detail. Studies by Robinowitz and Needleman (1982) and Hwang and Wang (1990) with neonates having blood lead levels in the 6-8 lag dV 1 range, both showed that infants born during summer months had blood leads about 1 lag dV 1 higher than infants born during winter months.…”

Section: Introductionmentioning

confidence: 99%

Seasonal variation in paediatric blood lead levels in Syracuse, NY, USA

Johnson

McDade

Griffith

1996

Environ Geochem Health

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Venous blood lead values for 2,633 children aged 0-4 years in Syracuse, New York, collected between 1 April 1992 and 31 March 1993 were summarised by census tract for study of geographic variability. A demographic exposure model is presented showing housing stock and SES (socioeconomic status) parameters as the most significant predictor variables. A seasonal trend in blood lead levels was observed with late summer values about 40% higher than late winter values for census tracts with the highest geometric mean PbB levels. Seasonal variation is compared with a biokinetic uptake model to examine hypotheses about temporal variations in soil and dust lead exposure patterns.

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Prevalence of Lead Exposure in a Clinic Using 1991 Centers for Disease Control and Prevention Recommendations

Cited by 9 publications

References 13 publications

Seasonality and Children’s Blood Lead Levels: Developing a Predictive Model Using Climatic Variables and Blood Lead Data from Indianapolis, Indiana, Syracuse, New York, and New Orleans, Louisiana (USA)

Seasonality and Children’s Blood Lead Levels: Developing a Predictive Model Using Climatic Variables and Blood Lead Data from Indianapolis, Indiana, Syracuse, New York, and New Orleans, Louisiana (USA)

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Recommendations for the Use of Laboratory Tests to Support Poisoned Patients Who Present to the Emergency Department

Seasonal variation in paediatric blood lead levels in Syracuse, NY, USA

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