SCREENING FOR CHILDHOOD LEAD-POISONING - A COST-MINIMIZATION ANALYSIS

Decision analysis was used to compare the costs of three screening str ategies for childhood lead poisoning: (1) venipuncture. (2) capillary sample with venipuncture confirmation if the blood lead level is eleva ted; (3) stratification by risk, with venipuncture for high-risk child ren and capillary sample for low-risk children. Under baseline conditi ons, the cost of screening by the venipuncture, stratification, and ca pillary strategies is $22, $25, and $27, respectively. Venipuncture re mains the least expensive strategy unless the cost of venipuncture is more than three times that of capillary sampling. The annual cost of a national lead screening program that uses a single venipuncture sampl e would be $352 million. Initial screening with a capillary sample wou ld cost $432 million, 23% more than venipuncture.