Utility of a risk assessment questionnaire in identifying children with lead exposure.
OBJECTIVE
To evaluate the utility of the Centers for Disease Control and Prevention (CDC) Risk Questionnaire and a behavioral risk factor questionnaire in identifying children with blood lead concentrations of 0.48 mumol/L (10 micrograms/dL) or more.


METHODS
Cross-sectional study of 463 urban Massachusetts children (6 to 72 months of age) screened for lead with venous blood.


RESULTS
Twenty-two percent of the children had elevated blood lead concentrations. Of the five CDC questions, only one was significantly associated with an increased adjusted odds ratio for elevated blood lead: having a sibling, housemate, or playmate who was followed up or treated for lead poisoning (odds ratio, 2.7; 95% confidence interval, 1.7 to 4.2; P < .001). Children who had at least one positive or equivocal response to any of the five CDC questions (n = 318 [68.7%]) were not at higher risk than were children who displayed a negative response to all five questions (odds ratio, 1.1; 95% confidence interval, 0.7 to 1.8; P = .69). Of nine behaviors surveyed, two were associated with an increased adjusted odds for elevated blood lead: use of a pacifier (odds ratio, 2.4; 95% confidence interval, 1.3 to 4.4; P = .01) and playing near the outside of the home (odds ratio, 3.4; 95% confidence interval, 2.0 to 5.8; P < .001).


CONCLUSIONS
In this population of children, the CDC risk questionnaire did not identify a group at higher risk for lead exposure. We suggest that practitioners in urban communities screen all children according to the same schedule. We conclude that risk factors differ by community and no risk questionnaire developed at the national level should be applied across communities to target screening.
Dalton
M A
MA
Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Sargent
J D
JD
Stukel
T A
TA
D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D004781:Environmental Exposure; D006801:Humans; D007854:Lead / Q000097:blood; D007855:Lead Poisoning / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D008403:Mass Screening / Q000379:methods; D008404:Massachusetts; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States; D014504:Urban Health
D007854:Lead