OPPORTUNISTIC BLOOD LEAD TESTING IN A PEDIATRIC INPATIENT POPULATION

We report a simple protocol which has potential to estimate community paediatric blood lead levels using opportunistic testing. Permission t o use leftover blood for a lead assay was sought from parents or guard ians of 397 children one month to 13 years of age who were admitted to general paediatric wards of John Hunter Hospital, Newcastle, between May and August 1993 and who had blood for a full blood count taken for any reason. Results were reviewed by a medical officer and returned t o parents, Where a child's blood lead level was of concern according t o National Health and Medical Research Council guidelines, the child w as referred to a specialist paediatrician for clinical assessment. Wri tten consent was received from the parents or guardians of 95.5 per ce nt of eligible children (n = 379); 93.4 per cent of responders (354 of 379) had blood suitable for testing, giving an overall result rate of 89.2 per cent (354 of 397). The mean blood lead level for the whole g roup was 5.3 mu g/dL. The highest blood lead level for any age group w as 6.4 mu g/dL in the 36 to <60 month age-group. Stratification by geo graphical area showed a trend in increasing blood lead with increasing population density and areas where lead polluting industries exist. T he approximate cost per result achieved was $40. This opportunistic su rvey method provides a promising technique for obtaining data on commu nity blood lead levels. It may be a practical and resource-efficient a lternative to large-stale community surveys. Further studies are under way to validate the method as a community surveillance tool.