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Opportunistic blood lead testing in a paediatric inpatient population
R Aldrich1, R Toneguzzi, J Wlodarczyk
1Newcastle Environmental Toxicology Research Unit, (NETRU), NSW.
Insights
Opportunistic testing of paediatric blood lead levels offers a cost-effective method for community surveillance. This approach provides valuable data on children
Area of Science:
- Environmental Health
- Paediatric Toxicology
- Public Health Surveillance
Background:
- Elevated blood lead levels in children pose significant health risks.
- Traditional community surveys for blood lead levels can be resource-intensive.
- A need exists for efficient methods to monitor community paediatric blood lead levels.
Purpose of the Study:
- To evaluate a simple protocol for estimating community paediatric blood lead levels using opportunistic testing.
- To assess the feasibility and cost-effectiveness of this method compared to large-scale surveys.
Main Methods:
- Recruited 397 children (1 month to 13 years) admitted to general paediatric wards.
- Obtained parental consent for lead assay on leftover blood samples.
- Achieved an 89.2% overall result rate from suitable blood samples.
Main Results:
- The mean blood lead level was 5.3 µg/dL.
- The highest mean level was 6.4 µg/dL in the 36 to <60 month age group.
- A trend of increasing blood lead levels was observed with higher population density and proximity to lead industries.
Conclusions:
- Opportunistic testing is a promising, practical, and resource-efficient technique for community paediatric blood lead level estimation.
- This method can serve as an alternative to extensive community surveys for public health surveillance.
- Further studies are recommended to validate its utility as a community surveillance tool.
Abstract:
We report a simple protocol which has potential to estimate community paediatric blood lead levels using opportunistic testing. Permission to use leftover blood for a lead assay was sought from parents or guardians of 397 children one month to 13 years of age who were admitted to general paediatric wards of John Hunter Hospital, Newcastle, between May and August 1993 and who had blood for a full blood count taken for any reason. Results were reviewed by a medical officer and returned to parents. Where a child's blood lead level was of concern according to National Health and Medical Research Council guidelines, the child was referred to a specialist paediatrician for clinical assessment. Written consent was received from the parents or guardians of 95.5 per cent of eligible children (n = 379); 93.4 per cent of responders (354 of 379) had blood suitable for testing, giving an overall result rate of 89.2 per cent (354 of 397). The mean blood lead level for the whole group was 5.3 micrograms/dL. The highest blood lead level for any age group was 6.4 micrograms/dL in the 36 to < 60 month age group. Stratification by geographical area showed a trend in increasing blood lead with increasing population density and areas where lead polluting industries exist. The approximate cost per result achieved was $40. This opportunistic survey method provides a promising technique for obtaining data on community blood lead levels. It may be a practical and resource-efficient alternative to large-scale community surveys. Further studies are under way to validate the method as a community surveillance tool.