Many Kids With Too Much Lead Don't Get Retested
Children Need Follow-Up Tests If Their Lead Level Is Too High, Say Experts
May 10, 2005 -- Children who have abnormally high blood levels of lead need follow-up testing to see if the problem has improved, but a lot of kids don't get rescreened, says a new study in The Journal of the American Medical Association.
About 434,000 U.S. children aged 1-5 years have blood levels of lead that are too high (10 micrograms per deciliter of blood), says the CDC's web site on lead.
Lead poisoning can cause learning disabilities, behavioral problems, and, at very high levels, seizures, coma, and even death, says the CDC. Symptoms of lead poisoning in children can include fatigue, crankiness, and stomachaches. However, usually there are no signs and the best way to diagnose lead poisoning is a blood test for lead.
Children younger than 6 years old may be at risk because they're growing rapidly and tend to put their hands or other objects into their mouths, says the CDC. A simple finger prick or a small amount of blood taken from the vein can determine blood lead levels.
Major lead sources are lead-based paint and lead-contaminated dust in deteriorating buildings, says the CDC. Lead-based paints have been banned in the U.S. since 1978 but may linger on old walls.
'Too Little, Too Late'
The new study tracked nearly 3,700 Michigan children with abnormally high blood lead levels. All were enrolled in Medicaid.
Only 54% had their blood lead levels retested within six months, say the researchers, who included Alex Kemper, MD, MPH, MS, of the University of Michigan. Follow-up blood testing was less likely for Hispanic or nonwhite children, kids from urban areas, and those living in high-risk areas for lead.
"The rate of follow-up testing after an abnormal screening blood lead level was low, and children with increased likelihood of lead poisoning were less likely to receive follow-up testing," says the study.
That's "too little, too late," says a journal editorial by Bruce Lamphear, MD, MPH, of Cincinnati Children's Hospital Medical Center.
More than half of the children (59%) who did not get follow-up tests had seen at least one health care worker during the six-month period. But in many cases, they didn't go to their primary provider, so doctors may not have realized that a follow-up lead test was needed.
That's a sign of "a fragmented healthcare system," writes Lamphear, who has served as an expert witness in Rhode Island's lawsuit against the lead industry, says the journal.
Every state handles lead testing differently, so Michigan's results might not be typical, say Kemper and colleagues.
Is Your Home at Risk?
"Approximately 24 million housing units in the U.S. have deteriorated lead paint and elevated levels of lead-contaminated house dust," says the CDC. "More than four million of these dwellings are homes to one or more young children."