PEDIATRICS Vol. 56 No. 2 August 1975, pp. 298-302
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Non-Treatment of Screened Children With Intermediate Blood Lead Levels

Michael C. Klein M.D.1 and Mary Schlageter R.N.1

1 Department of Pediatrics, University of Rochester School of Medicine and Dentistry, and the Westside Health Services Rochester, New York

An aggressive screening and follow-up program for children at risk for lead poisoning was conducted by a nurse practitioner in a small family practice unit. Subsequent venous blood lead determinations in untreated cases show the natural fall in lead level over 12 to 18 months. Many of these children would have been chelated by others, yet individualized, specific, personalized care by a nurse practitioner permitted monitoring without treatment even in persistently leaded environments. No chelation therapy was necessary until the third summer, when coincident with a long, hot, dry season, the city's abatement system became nonfunctional. Nontreatment requires close follow-up, a relatively small population, and cooperation from the city.