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Children should not be used as lead detectors. For decades, nothing was done to
prevent lead poisoning until a child was finally identified as lead poisoned. Thankfully,
those days are almost over. Now, there is a greater focus on fixing up the nation's
older housing stock before a child is poisoned. But there are some
38 million homes that still contain lead-based paint, with about 25% of all US housing
containing actual lead exposure hazards. This means that it is
inevitable that many more children will continue to get exposed to lead year after
year, while work on housing proceeds and public education about how to prevent childhood
lead poisoning continues as well.
The health effects of exposure to lead can be devastating, both to the child with
an elevated blood lead level, and to that child's family. Those health effects get
worse and worse if nothing is done to eliminate the lead exposure problem. Therefore,
the first essential step is to identify each and every child with a lead problem.
This can only be done by getting children tested for the presence of lead in their
blood.
Since we know that the peak ages of risk for lead poisoning are between 12 months
and 24 months of age, these are the most important points in time in
which to get children tested. Ideally, all children under the age of six should
be tested at least once. However, where resources are lacking or old housing is
scarce, it may make more sense to promote a targeted approach to screening children
for lead, focusing on children who are more likely to be exposed to lead, primarily
because of where they live. In a 1997 guidance document, the US Centers for Disease
Control and Prevention (CDC) set out its policy recommendations for a targeted screening
approach. CDC's recommendations include a specific focus on screening children
who live in neighborhoods where there is a substantial percentage of housing built
prior to 1950.
Other CDC recommendations include screening children who live in or regularly visit
a home built prior to 1978, where recent or ongoing renovations or remodeling are
occurring. Also, children who are enrolled in Medicaid are known to be at greater
than average risk for lead poisoning and must be screened.
There are two acceptable methods that can be used to screen children for exposure
to lead. The preferred method is taking a venous blood sample. The alternative,
called the fingerstick (or capillary) method, is generally considered to be a less
accurate method, and it requires special care to insure against contaminated samples.
For instance, the child's fingers must be carefully cleaned prior to taking a blood
sample via the fingerstick method. Also, a fingerstick that reveals a blood-lead
level above 10µg/dL must be followed by a venous sample to confirm the result.
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