Related Experiment Video
Updated: Oct 22, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Is there lead in the suburbs? Risk assessment in Chicago suburban pediatric practices. Pediatric Practice Research
H J Binns1, S A LeBailly, J Poncher
1Department of Pediatrics, Children's Memorial Hospital, Northwestern University, Chicago, IL 60614.
Insights
In Chicago suburban children, lead exposure risk assessment questions from the CDC and Illinois were evaluated. Identifying homes built before 1960 is a more effective screening method for elevated blood lead levels.
Area of Science:
- Pediatric Environmental Health
- Public Health Surveillance
- Toxicology
Background:
- Elevated blood lead (BPb) levels in children pose significant health risks.
- Current screening strategies by the CDC and Illinois may not be optimally effective in identifying at-risk children.
Purpose of the Study:
- To determine the prevalence of elevated BPb levels (> or = 10 micrograms/dL) in Chicago suburban children aged 12 and 24 months.
- To assess the efficacy of CDC and Illinois lead exposure risk assessment questionnaires.
Main Methods:
- A cross-sectional study involving 1393 children aged 1 and 2 years attending pediatric practices.
- Parents completed questionnaires, and children's BPb levels were measured.
- Analysis of questionnaire data against BPb levels to determine screening efficacy.
Main Results:
- The prevalence of elevated BPb levels was low (2.1%) in the study sample.
- CDC and Illinois screening questions demonstrated high negative predictive values but low positive predictive values.
- Identifying a child's residence as built before 1960 was the strongest predictor of elevated BPb levels (sensitivity = .83, specificity = .67).
Conclusions:
- Children residing in homes built before 1960 are at high risk for lead exposure.
- A revised screening question incorporating lifetime exposure (e.g., "Has your child ever lived in a house built before 1960?") is recommended.
- Selective BPb testing based on housing age in low-prevalence suburban areas can effectively identify children with elevated lead levels while minimizing missed cases.
Objective:
This study was designed to determine: (1) the prevalence of elevated blood lead (BPb) levels (BPb > or = 10 micrograms/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 > or = 10 micrograms/dL (0.48 mumol/L); no subjects had a level > or = 30 micrograms/dL (1.45 mumol/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 > or = 10 micrograms/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 > or = 10 micrograms/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.
More Related Videos
Related Concept Videos
01:23Sampling Plans
Random sampling is a method where each member of the population has an equal chance of being selected for the sample. It involves selecting individuals randomly, often using random number generators or lottery-type methods. For example, when analyzing the properties of a...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...