Lead screening and follow-up in an urban pediatric clinic.
The purpose of this study was to examine screening and follow-up procedures used in testing for lead toxicity at an urban pediatric clinic. A retrospective chart review of all patients with elevated zinc protoporphyrin levels was undertaken. In the first four months of 1990, 66 of 438 patients screened (15.1%) had elevated zinc protoporphyrin levels. Sixty charts were located and reviewed to evaluate five key interventional strategies. Iron therapy was implemented in 31 (51.2%), and follow-up was scheduled in 21 (35.0%). Two exposure histories and two dietary histories were documented (3.3% each). Only 26 children (43.3%) had venous blood drawn for lead-level determination. Eleven patients (18.3%) had none of these five steps documented, and an additional 26 (43.3%) received only one. Fifteen children (25.0%) received two interventions, six (10.0%) received three, and two (3.3%) received four. No patients received all five steps. Better procedures are needed at this site to ensure the implementation and documentation of diagnostic and therapeutic interventions in children with elevated zinc protoporphyrin levels. Other screening programs may benefit from examination for similar methodologic problems.
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College of Physicians & Surgeons, Columbia University, New York, NY.
D002648:Child; D003430:Cross-Sectional Studies; D006801:Humans; D015994:Incidence; D007855:Lead Poisoning / Q000453:epidemiology / Q000517:prevention & control*; D008403:Mass Screening; D009519:New York City / Q000453:epidemiology; D011524:Protoporphyrins / Q000097:blood; D014505:Urban Population
D011524:Protoporphyrins; C017803:zinc protoporphyrin