UTILITY OF A RISK ASSESSMENT QUESTIONNAIRE IN IDENTIFYING CHILDREN WITH LEAD-EXPOSURE

Objective: To evaluate the utility of the Centers for Disease Control and Prevention (CDC) Risk Questionnaire and a behavioral risk factor q uestionnaire in identifying children with blood lead concentrations of 0.48 mu mol/L (10 mu g/dL) or more. Design: Cross-sectional study of 463 urban Massachusetts children (6 to 72 months of age) screened for lead with venous blood. Results: Twenty-two percent of the children ha d elevated blood lead concentrations. Of the five CDC questions, only one was significantly associated with an increased adjusted odds ratio for elevated blood lead: having a sibling, house-mate, or playmate wh o was followed up or treated for lead poisoning (odds ratio, 2.7; 95% confidence interval, 1.7 to 4.2; P<.001). Children who had at least on e positive or equivocal response to any of the five CDC questions (n=3 18 [68.7%]) were not at higher risk than were children who displayed a negative response to all five questions (odds ratio, 1.1, 95% confide nce interval, 0.7 to 1.8, P=.69). Of nine behaviors surveyed, two were associated with an increased adjusted odds for elevated blood lead: u se of a pacifier (odds ratio, 2.4; 95% confidence interval, 1.3 to 4.4 ; P=.01) and playing near the outside of the home (odds ratio, 3.4; 95 % confidence interval, 2.0 to 5.8; P<.001). Conclusions: In this popul ation of children, the CDC risk questionnaire did not identify a group at higher risk for lead exposure. We suggest that practitioners in ur ban communities screen all children according to the same schedule. We conclude that risk factors differ by community and no risk questionna ire developed at the national level should be applied across communiti es to target screening.