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1.
J Community Health ; 42(4): 779-784, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28210915

ABSTRACT

Childhood Lead Poisoning Prevention Programs throughout the U.S. have addressed childhood lead poisoning by implementing primary and secondary prevention efforts. While many programs have helped increase screening rates, in some states children under the age of six still have not been tested for lead. This study aims to identify the barriers to childhood blood lead testing and develop a strategy to increase the number of children tested. Clark County physicians who work with children six and under were surveyed about blood lead level (BLL) testing practices, particularly, adherence to Centers for Disease Control and Prevention (CDC) guidelines, and parental compliance with orders to have their children tested to determine their blood lead levels. In addition, select in-person interviews were conducted with physicians who reported high parental compliance to identify best practices and barriers. Of the 77 physicians that provided data, 48% indicated they did not follow CDC guideline compared to 52% who follow guidelines. 18 of the 30 (or 60%) physicians reported more than 80% of parents complied with doctor recommended BLL testing. Twelve physicians identified cost, lack of insurance, and absence of symptomology as persistent barriers to lead screening. This study identified barriers to childhood lead screening including inadequate parental adherence to physician-ordered screenings and physician non-compliance with screening recommendations are two primary contributors. Addressing these issues could increase screening in children and reduce the risk of lead poisoning.


Subject(s)
Lead Poisoning/diagnosis , Lead/blood , Mass Screening/statistics & numerical data , Centers for Disease Control and Prevention, U.S. , Child, Preschool , Guideline Adherence/statistics & numerical data , Humans , Infant , Lead Poisoning/blood , Mass Screening/standards , Parents , Practice Guidelines as Topic , United States
2.
Clin Pediatr (Phila) ; 51(11): 1048-55, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22935218

ABSTRACT

BACKGROUND: Childhood lead poisoning continues to be a public health problem; however, lead screening rates remain low in many areas. Our objective is to increase screening in pediatric clinics, while testing a questionnaire for its predictability of elevated blood lead levels (BLLs). METHODS: Participants were approached at pediatric clinics in Las Vegas, Nevada. A brief questionnaire assessed the child's potential exposure to lead and a blood sample was collected from each child. RESULTS: Of 564 children tested, 35 had detectable BLLs. Two questions from the questionnaire demonstrated significant differences in proportions (Fisher's exact test: P < .05) of affirmative/negative responses, for the 35 participants with detectable BLLs. CONCLUSION: The questionnaire failed to identify reliable associations between detectable BLLs and affirmative responses, limiting its use as an in-office tool. More research is recommended to identify and alleviate barriers to childhood lead screening in the clinical setting and to develop more applicable risk assessment tools.


Subject(s)
Environmental Exposure/adverse effects , Lead Poisoning/diagnosis , Lead/blood , Mass Screening/statistics & numerical data , Surveys and Questionnaires , Algorithms , Child , Child Health Services , Child, Preschool , Female , Hospitals, University , Humans , Infant , Lead Poisoning/blood , Lead Poisoning/prevention & control , Male , Nevada , Outpatient Clinics, Hospital , Predictive Value of Tests , Reproducibility of Results , Risk Assessment , Risk Factors , Sensitivity and Specificity
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