PEDIATRICS Vol. 93 No. 2 February 1994, pp. 164-171
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Binns, H. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Binns, H. J.

Is There Lead in the Suburbs? Risk Assessment in Chicago Suburban Pediatric Practices

Helen J. Binns MD1, Susan A. LeBailly PhD1, John Poncher MD1, T. Randall Kinsella MD1, Stephen E. Saunders MD, MPH2, and Pediatric Practice Research Group

1 Department of Pediatrics, Children's Memorial Hospital, North-western University, Chicago, IL
2 Illinois Department of Public Health, Springfield, IL

Objective. This study was designed to determine: (1) the prevalence of elevated blood lead (BPb) levels (BPb ge 10 µg/dL) in Chicago suburban children attending Pediatric Practice Research Group practices at 12 and 24 months of age, and (2) the efficacy of the Centers for Disease Control and Prevention (CDC) and Illinois lead exposure risk assessment questions.

Methods. Parents bringing their 1- and 2-year-old children for health supervision visits at pediatric practices completed questionnaires. BPb levels were drawn on children. Both questionnaire and an analyzable BPb level were obtained on 1393 subjects (79.2%).

Results. Only 2.1% of our sample had a venous BPb level ge10 µg/dL (0.48 µmol/L); no subjects had a level ge30µg/dL (1.45 µmol/L). The CDC risk assessment questions had a sensitivity of .69 and specificity of .70. Due to the low prevalence of elevated BPb levels in this sample, CDC and Illinois screening strategies had high negative predictive values (.99) and low positive predictive values (.05 and .04, respectively). However, some of the subjects with BPb levels ge10 µg/dL were not at high risk by CDC and Illinois screening questions; 9 of 29 subjects with elevated lead levels (31%) did not respond affirmatively to any CDC risk assessment questions. The question best predicting an elevated BPb was the determination that the house the child lives in was built before 1960 (sensitivity = .83, specificity = .67). This question is not currently included in CDC or Illinois screening strategies. Screening based on the single question "Was your house built before 1960?" would have missed only five (17%) of the children with BPb levels ge10 µg/dL. Three of these five children were among the 17.1% of 1-year-olds and 26.3% of 2-year-olds in our sample who had moved.

Conclusions. In this sample, children living in houses built before 1960 should be considered at high risk for high-dose lead exposure. Due to the high mobility of our sample, phrasing the question to include lifetime exposure (ie, Has your child ever lived in a house built before 1960?) should also be considered. Selective BPb testing of high-risk children in low-prevalence suburban areas using this question would miss few children with elevated BPb. Useful risk assessment questions in other areas and other populations may differ.

Submitted on May 14, 1993
Accepted on September 23, 1993




This article has been cited by other articles:


Home page
 PediatricsHome page
H. J. Binns, C. Campbell, M. J. Brown, and for the Advisory Committee on Childhood Lead Poiso
Interpreting and Managing Blood Lead Levels of Less Than 10 {micro}g/dL in Children and Reducing Childhood Exposure to Lead: Recommendations of the Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention
Pediatrics, November 1, 2007; 120(5): e1285 - e1298.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
L. T. Schwab, J. R. Roberts, and J. R. Reigart
Inaccuracy in Parental Reporting of the Age of Their Home for Lead-Screening Purposes
Arch Pediatr Adolesc Med, June 1, 2003; 157(6): 584 - 586.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
K. Verebey, T. P. Moyer, D. E. Nixon, and O. K. Ash
Filter Paper-collected Blood Lead Testing in Children The authors of the editorial cited above respond:
Clin. Chem., July 1, 2000; 46(7): 1024 - 1028.
[Full Text] [PDF]

Home page
 PediatricsHome page
H. J. Binns, S. A. LeBailly, A. R. Fingar, and S. Saunders
Evaluation of Risk Assessment Questions Used to Target Blood Lead Screening in Illinois
Pediatrics, January 1, 1999; 103(1): 100 - 106.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
A. R. Kemper, W. C. Bordley, and S. M. Downs
Cost-effectiveness Analysis of Lead Poisoning Screening Strategies Following the 1997 Guidelines of the Centers for Disease Control and Prevention
Arch Pediatr Adolesc Med, December 1, 1998; 152(12): 1202 - 1208.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
Committee on Environmental Health
Screening for Elevated Blood Lead Levels
Pediatrics, June 1, 1998; 101(6): 1072 - 1078.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
B. P. Lanphear, R. S. Byrd, P. Auinger, and S. J. Schaffer
Community Characteristics Associated With Elevated Blood Lead Levels in Children
Pediatrics, February 1, 1998; 101(2): 264 - 271.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
B. Harvey
New Lead Screening Guidelines From The Centers for Disease Control and Prevention: How Will They Affect Pediatricians?
Pediatrics, September 1, 1997; 100(3): 384 - 388.
[Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
R. Casey, C. Wiley, R. Rutstein, and J. Pinto-Martin
Longitudinal Assessment for Lead Poisoning
Clinical Pediatrics, February 1, 1996; 35(2): 58 - 61.
[Abstract] [PDF]

Home page
 CLIN PEDIATRHome page
E. G. Flaherty
Risk of Lead Poisoning in Abused and Neglected Children
Clinical Pediatrics, March 1, 1995; 34(3): 128 - 132.
[Abstract] [PDF]

Home page
 Journal Watch DermatologyHome page
Lead Poisoning: Asking the Right Questions
Journal Watch Dermatology, April 1, 1994; 1994(401): 13 - 13.
[Full Text]

Home page
 JWatch GeneralHome page
NEW FINDINGS ON LEAD POISONING
Journal Watch (General), March 11, 1994; 1994(311): 7 - 7.
[Full Text]