Lead levels in high-risk and low-risk young children in the Minneapolis- St Paul metropolitan area

Objectives. To determine distribution of lead levels among children in a low-risk area; to validate a prescreening questionnaire; and to determine if universal lead screening is necessary in children in this area. Design. Blood lead levels and questionnaires were obtained on eligible patients. Data were analyzed using stepwise regression analysis. Setting. Community clinics and a health maintenance organization (HMO) in the Minneapolis-St Paul metropolitan area. Patients. A total of 9603 children at well-child visits, age 6 months to 6 years at community clinics, and 6 months to 3 years at the HMO. Outcome Measures. Whole blood lead levels (WBLs) and questionnaires. Results. The total sample rate of WBLs at ≤10 μg/dL was 12%, at ≤15 μg/dL was 3 1/4 %, and at ≤20 μg/dL was 1.2%. At both 10 μg/dL and 15 μg/dL, the non-HMO group was at higher risk. For both groups, risk factors included living in the central cities, and living in housing built before 1950. For the non-HMO group a history of the child eating paint chips, or the child or a sibling having previous lead poisoning were also risk factors. Conclusions. Not all children need lead screening. Children living in the central cities, or with the risk factors of living in housing built before 1950 or a previous history of lead poisoning should be screened.