Related Experiment Video
Updated: Oct 2, 2026
Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children
Published on: September 11, 2018
Should we screen for lead poisoning after 36 months of age? Experience in the inner city
Robert J Karp1, J Abramson, M Clark-Golden
1Lead Poisoning Prevention Programs, Kings County Hospital Center, USA.
Insights
New lead exposure can occur in children over age 3, but routine screening past this age is not recommended. Most elevated blood lead levels in this group were mild and temporary.
Area of Science:
- Pediatric Environmental Health
- Toxicology
- Public Health
Background:
- Current lead screening guidelines focus on children under 3 years.
- Elevated blood lead levels are observed in children aged 3-6 years, but the timing (new vs. chronic) is often unclear.
Purpose of the Study:
- To determine the incidence of new elevated blood lead levels (≥10 µg/dL) in children after age 3, given normal prior testing.
Main Methods:
- Retrospective analysis of 39,000 venous lead tests from 1993-1998.
- Identified 2,046 children with normal lead levels before 36 months and follow-up tests after 36 months.
Main Results:
- 3.2% (66/2046) of children showed new elevated blood lead levels (10-25 µg/dL) after age 3.
- Most elevations were mild (10-12 µg/dL), and 63.3% normalized on repeat testing.
Conclusions:
- New cases of elevated blood lead levels occur after age 3 in high-risk communities.
- Universal lead screening beyond age 3 is not warranted in this population due to low yield of clinically significant exposures.
Introduction:
Current lead screening guidelines recommend monitoring lead levels in children under 3 years of age. There are, however, a number of children between the ages of 3 and 6 years who have elevated blood lead levels. Whether these lead elevations are new or chronic has not been examined.
Objective:
To determine the proportion of children with lead levels greater than or equal to 10 microg/dL after their third birthday when all prior testing had been normal.
Methods:
Retrospective study based on 39000 venous lead tests obtained between 1993 and 1998. From this group, 2046 children were located who had blood lead levels of less than 10 microg/dL before 36 months and who had a follow-up lead level after 36 months. All lead assays were done by the City of New York laboratories, which had an intrasample variability of 13%.
Results:
Sixty-six (3.2%) of the 2046 children showed an elevation in blood lead for the first time after their third birthday. The abnormal values ranged from 10 to 25 microg/dL. The majority (72%) of the screen-positive children, however, had lead levels of 10 to 12 microg/dL, and 63.3% of screen-positive children with repeat tests had lead levels that reverted to below 10 microg/dL.
Conclusions:
The data indicate that some new cases of lead level elevations did occur after 3 years of age in this 'high-risk' community; however, the current study provides evidence that universal screening for lead poisoning beyond 3 years of age is not warranted in this community as it is not likely to pick up clinically important exposure.
More Related Videos
07:08Long-term Behavioral and Reproductive Consequences of Embryonic Exposure to Low-dose Toxicants
Published on: March 6, 2018
14:05Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Related Concept Videos
01:23Toxicity Testing in Animals
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.