Faculty Collaboration Database

Effectiveness of a pediatric verbal lead exposure screening protocol in emergency department patients. Pediatr Emerg Care 2013 Feb;29(2):156-61

Date

02/01/2013

Pubmed ID

23364376

DOI

10.1097/PEC.0b013e3182808abe

Scopus ID

2-s2.0-84879985431 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

PURPOSE: The population demographics found in many urban emergency departments (EDs) often mirrors those of children at risk for elevated serum lead levels. We evaluated the effectiveness of a verbal lead screening program for screening high-risk children presenting to the ED.

METHODS: A prospective observational cohort study was conducted of children aged 9 months to 6 years, living in 2 target counties and presenting to an urban, academic, Midwestern ED. Those with a prior lead level, enrolled in a program requiring lead testing, or with an unstable medical condition were excluded. A 6-question validated verbal survey was administered to all parents of eligible children, and the results recorded in the patient's electronic medical record. Children who screened positive were referred to their local health department for blood lead testing. Health department records were reviewed for follow-up visits and blood lead levels.

RESULTS: During the study period, 3513 children were eligible (mean age, 2.6 years; 53.3% male), with 815 patients screened and 209 (25.6%) screening positive. Most positively screened patients (71.8%) documented only 1 affirmative question, most often indicating they lived in a home built before 1978. Of those children who screened positive, 14.8% (31/209) had a blood lead level performed within 6 months. Of those tested, 4 children had an elevated lead level (>10 µg/dL).

CONCLUSIONS: Use of an ED verbal lead exposure screening tool identified children requiring additional follow-up testing. However, health department-referred children had poor follow-up, and few children were ultimately documented with elevated lead levels.

Author List

Creighton S, Hafner JW, Aldag JC

Author

Sara Elizabeth Creighton MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Chi-Square Distribution
Child
Child, Preschool
Emergency Service, Hospital
Female
Hospitals, Urban
Humans
Illinois
Infant
Lead Poisoning
Male
Mass Screening
Retrospective Studies
Surveys and Questionnaires