LEAD SCREENING PRACTICES OF PEDIATRIC RESIDENTS

Objectives: As part of their training, pediatric residents provide pri mary care services to young children, including youngsters who may hav e elevated blood lead levels. We set out to (1) determine the percenta ge of pediatric residents who screen children for elevated blood lead levels according to the guidelines of the Centers for Disease Control and Prevention and the American Academy of Pediatrics; (2) assess the likelihood of lead screening by residents based on demographic and pra ctice-setting characteristics; and (3) compare the attitudes of reside nts who report that they are universal screeners, selective screeners, or nonscreeners. Design: Confidential, cross-sectional survey of a na tionally representative sample of pediatric residents; conducted as pa rt of the American Academy of Pediatrics 28th Periodic Survey of Fello ws. Subjects: One hundred forty-three responding pediatric residents ( 51%;, response rate). Results: Seventy-five percent of pediatric resid ents reported screening all patients aged 9 to 36 months for elevated blood lead levels, 21% reported screening some, and 4% reported screen ing none. Pediatric residents who cared for patients in urban settings were more likely to report screening patients for elevated blood lead levels than were pediatric residents who cared for patients in suburb an or rural settings (100% vs 73%; P<.001), and pediatric residents in the Northeast were more likely to report screening universally than w ere residents in the rest of the country (93% vs 63%; P<.001). Overall , pediatric residents who reported screening patients universally were more likely to believe that the benefits of screening outweigh the co sts than were residents who reported screening patients selectively (6 7% vs 17%; P<.001). Conclusions: Most pediatric residents reported tha t they screened patients for elevated blood lead levels, either univer sally or selectively. Nevertheless, the screening practices of pediatr ic residents and their opinions concerning the relative benefits and c osts of lead screening largely reflect the areas of the country and th e practice settings in which they had their primary care experiences.