Prevalence of lead exposure in a clinic using 1991 Centers for Disease Control and Prevention recommendations.
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 mumol/L (10 micrograms/dL) and to use blood lead levels as the primary method of screening in young children.


METHODS
Retrospective patient series.


METHODS
Outpatient pediatric department in a university hospital.


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


METHODS
Consecutive children.


METHODS
None.


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 (> or = 0.48 mumol/L) (10 micrograms/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.
Blatt
S D
SD
Department of Pediatrics, State University of New York Health Science Center, Syracuse 13210.
Weinberger
H L
HL
D000554:Ambulatory Care Facilities; D002675:Child, Preschool; D004781:Environmental Exposure; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000517:prevention & control*; D011524:Protoporphyrins / Q000097:blood; D012621:Seasons
D011524:Protoporphyrins; D007854:Lead