Clinical Chemistry
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Clinical Chemistry 43: 302-311, 1997;
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(Clinical Chemistry. 1999;43:302-311.)
© 1999 American Association for Clinical Chemistry, Inc.

Articles

Screening children exposed to lead: an assessment of the capillary blood lead fingerstick test

Patrick J. Parsons1,2,a, Andrew A. Reilly1,3 and Debra Esernio-Jenssen4

1 Wadsworth Center, New York State Department of Health, P.O. Box 509, Albany, NY 12201-0509.
Departments of
2 Environmental Health and Toxicology and
3 Statistics, School of Public Health, State University of New York at Albany, Albany, NY 12201.

4 Division of General Pediatrics, North Shore University Hospital, Manhasset, NY 11030.
a Address correspondence to this author at: Lead Poisoning/Trace Elements Laboratory, Wadsworth Center, New York State Department of Health, P.O. Box 509, Albany, NY 12201-0509. Fax 518-473-2895; e-mail patrick.parsons{at}wadsworth.org

We describe results of a 3-year study in which 499 paired venous and capillary blood specimens, collected by fingerstick on the same day, were analyzed for lead (BPb) and erythrocyte protoporphyrin (EP). False-positive rates (FPRs) and the proportion of false positives were calculated at four BPb thresholds. At the 100 µg/L threshold, the FPR for all data was 13%, but the proportion of false positives was only 5%. The log ratios of capillary-to-venous BPb data indicate that, with the exception of eight outliers, two subpopulations exist that follow a log-normal distribution. These two subpopulations, the "core" (n = 303) and "shifted" (n = 188) groups, on average generated a positive bias at 100 µg/L BPb of 8.6% and 30.3%, respectively. The log ratios of capillary-to-venous EP data followed a normal distribution, indicating that capillary EP is not statistically different from venous EP.


Key Words: indexing terms: pediatric laboratory medicine • contamination • atomic absorption spectrometry • poisoning • erythrocyte protoporphyrin • false-positive errors




The following articles in journals at HighWire Press have cited this article:


Home page
 PediatricsHome page
H. J. Binns, C. Campbell, M. J. Brown, and for the Advisory Committee on Childhood Lead Poiso
Interpreting and Managing Blood Lead Levels of Less Than 10 {micro}g/dL in Children and Reducing Childhood Exposure to Lead: Recommendations of the Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention
Pediatrics, November 1, 2007; 120(5): e1285 - e1298.
[Abstract] [Full Text] [PDF]

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 Am J EpidemiolHome page
N. B. Jain, F. Laden, U. Guller, A. Shankar, S. Kazani, and E. Garshick
Relation between Blood Lead Levels and Childhood Anemia in India
Am. J. Epidemiol., May 15, 2005; 161(10): 968 - 973.
[Abstract] [Full Text] [PDF]

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 AJPHHome page
T. A. Dignam, A. Evens, E. Eduardo, S. M. Ramirez, K. L. Caldwell, N. Kilpatrick, G. P. Noonan, W. D. Flanders, P. A. Meyer, and M. A. McGeehin
High-Intensity Targeted Screening for Elevated Blood Lead Levels Among Children in 2 Inner-City Chicago Communities
Am J Public Health, November 1, 2004; 94(11): 1945 - 1951.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
K. Verebey, T. P. Moyer, D. E. Nixon, and O. K. Ash
Filter Paper-collected Blood Lead Testing in Children The authors of the editorial cited above respond:
Clin. Chem., July 1, 2000; 46(7): 1024 - 1028.
[Full Text] [PDF]

Home page
 Clin. Chem.Home page
T. P. Moyer, D. N. Nixon, and K. O. Ash
Filter Paper Lead Testing
Clin. Chem., December 1, 1999; 45(12): 2055 - 2056.
[Full Text] [PDF]

Home page
 Clin. Chem.Home page
D. Esernio-Jenssen, V. Bush, and P. J. Parsons
Evaluation of Vacutainer Plus Low Lead Tubes for Blood Lead and Erythrocyte Protoporphyrin Testing
Clin. Chem., January 1, 1999; 45(1): 148 - 150.
[Full Text] [PDF]

Home page
 PediatricsHome page
H. J. Binns, S. A. LeBailly, A. R. Fingar, and S. Saunders
Evaluation of Risk Assessment Questions Used to Target Blood Lead Screening in Illinois
Pediatrics, January 1, 1999; 103(1): 100 - 106.
[Abstract] [Full Text] [PDF]


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Copyright © 1997 by the American Association for Clinical Chemistry.