Barriers to pediatric lead screening: implications from a web-based survey of Vermont pediatricians.
The pernicious effects of lead on child health are well documented. The Vermont Department of Health (VDH) recommends screening all 12- and 24-month-old children for elevated blood lead levels (BLL). In 2006, only 41.4% of 24-month-old Vermont children were screened. To identify barriers preventing pediatricians from performing blood lead screening, a survey was distributed to Vermont primary care pediatricians-divided in higher and lower screening groups. Vermont pediatricians were more likely to be lower screeners if they reported negative health outcomes began at BLL >" xbd="641" xhg="618" ybd="1456" yhg="1421"/> 10 microg/dL (odds ratio [OR] = 3.64, 95% confidence interval [CI] = 1.12-11.99), practiced in Chittenden County (OR = 3.34, 95% CI = 1.14-9.78), or disagreed with the VDH's recommendation (OR = 4.90, 95% CI = 1.66-15.50). Adjusted analysis indicated the most significant determinants of lower screening rates were male gender, a perceived dangerous BLL as >10 microg/dL and low self-reported Medicaid population. The VDH may have an opportunity to increase BLL screening emphasizing the significant health risks associated with BLL < or = 10 microg/dL.
University of Vermont, Burlington, VT, USA. britton.keeshan@uvm.edu
Britton
B
Keeshan
Catherine
C
Avener
Amanda
A
Abramson
Jillian
J
Brennan
Elizabeth
E
Hill
Jeffrey
J
Maclean
Kelly
K
Mebust
Sanchit
S
Maruti
Jan
J
Carney
Wendy
W
Davis
Austin
A
Sumner
D017677:Age Distribution; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002675:Child, Preschool; D003144:Communication Barriers; D016001:Confidence Intervals; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D020407:Internet; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008403:Mass Screening / Q000592:standards / Q000639:trends*; D016017:Odds Ratio; D010372:Pediatrics / Q000592:standards / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000639:trends; D011634:Public Health; D018570:Risk Assessment; D017678:Sex Distribution; D014707:Vermont / Q000453:epidemiology
D007854:Lead