Screening for lead poisoning by fingerstick in suburban pediatric practices.
To assess the false-positive rate of blood lead determinations on samples obtained by fingerstick from children screened in private suburban and rural practices.
Screening capillary lead samples were obtained by fingerstick ; children with capillary lead levels of 0.7 mumol/L (15 mug/dL) or greater were recalled for a confirmatory venous lead test that served as the criterion standard.
Parents completed a five-question risk assessment questionnaire at the time of initial screening.
Four private suburban to rural practices that serve predominantly white, middle-class populations.
Children seen for routine care between August 1992 and February 1993 (N=1085 ; 98% between 6 months and 6 years of age).
Capillary lead level was 0.7 mumol/L (15 mug/dL) or greater in 35 children (3% of total sample) ; venous lead samples were obtained in 30 patients.
Nine of the elevated capillary lead results were true-positives (venous lead=0.7,0.8,0.8,0.9,0.9,0.9,1.1,1.1, and 1.7 mumol/L [15,17,17. 18,18,18,22,22, and 35 mug/dL]) ; parents of only two of these children answered yes to any question on the risk assessment questionnaire.
Although the false-positive rate of the capillary lead screening test was 70% (21/30) in this setting, only 2% of the total sample had a false-positive screening test (an average of fewer than one false-positive per month per practice).
Mots-clés Pascal : Intoxication, Accident, Enfant, Homme, Dépistage, Sang, Microméthode, Analyse biochimique, Faux positif, Validation test, Plomb, Métal lourd
Mots-clés Pascal anglais : Poisoning, Accident, Child, Human, Medical screening, Blood, Microassay, Biochemical analysis, False positive, Test validation, Lead, Heavy metal
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0278096
Code Inist : 002B03L05. Création : 01/03/1996.