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Screening for Elevated Blood Lead Levels in Children: Assessment of Criteria and a Proposal for New Ones in France

Author

Listed:
  • Anne Etchevers

    (INSERM (National Institute of Health and Medical Research) U1085, Irset-Environmental and Occupational Health Research Institute, Rennes 35043, France)

  • Philippe Glorennec

    (INSERM (National Institute of Health and Medical Research) U1085, Irset-Environmental and Occupational Health Research Institute, Rennes 35043, France
    EHESP (School of Public Health), Sorbonne Paris Cité, Rennes 35043, France)

  • Yann Le Strat

    (InVS—French Institute for Public Health Surveillance, Saint Maurice 94415, France)

  • Camille Lecoffre

    (InVS—French Institute for Public Health Surveillance, Saint Maurice 94415, France)

  • Philippe Bretin

    (Ministry of Health, Directorate for Health, Paris 75350, France)

  • Alain Le Tertre

    (InVS—French Institute for Public Health Surveillance, Saint Maurice 94415, France)

Abstract

The decline in children’s Blood Lead Levels (BLL) raises questions about the ability of current lead poisoning screening criteria to identify those children most exposed. The objectives of the study were to evaluate the performance of current screening criteria in identifying children with blood lead levels higher than 50 µg/L in France, and to propose new criteria. Data from a national French survey, conducted among 3831 children aged 6 months to 6 years in 2008–2009 were used. The sensitivity and specificity of the current criteria in predicting blood lead levels higher than or equal to 50 µg/L were evaluated. Two predictive models of BLL above 44 µg/L (for lack of sufficient sample size at 50 µg/L) were built: the first using current criteria, and the second using newly identified risk factors. For each model, performance was studied by calculating the area under the ROC (Receiver Operating Characteristic) curve. The sensitivity of current criteria for detecting BLL higher than or equal to 50 µg/L was 0.51 (0.26; 0.75) and specificity was 0.66 (0.62; 0.70). The new model included the following criteria: foreign child newly arrived in France, mother born abroad, consumption of tap water in the presence of lead pipes, pre-1949 housing, period of construction of housing unknown, presence of peeling paint, parental smoking at home, occupancy rates for housing and child’s address in a cadastral municipality or census block comprising more than 6% of housing that is potentially unfit and built pre-1949. The area under the ROC curve was 0.86 for the new model, versus 0.76 for the current one. The lead poisoning screening criteria should be updated. The risk of industrial, occupational and hobby-related exposure could not be assessed in this study, but should be kept as screening criteria.

Suggested Citation

  • Anne Etchevers & Philippe Glorennec & Yann Le Strat & Camille Lecoffre & Philippe Bretin & Alain Le Tertre, 2015. "Screening for Elevated Blood Lead Levels in Children: Assessment of Criteria and a Proposal for New Ones in France," IJERPH, MDPI, vol. 12(12), pages 1-13, December.
  • Handle: RePEc:gam:jijerp:v:12:y:2015:i:12:p:14989-15378:d:59912
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    References listed on IDEAS

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    1. Apostolou, A. & Garcia-Esquinas, E. & Fadrowski, J.J. & McLain, P. & Weaver, V.M. & Navas-Acien, A., 2012. "Secondhand tobacco smoke: A source of lead exposure in US children and adolescents," American Journal of Public Health, American Public Health Association, vol. 102(4), pages 714-722.
    2. Joseph, A. & Spector, L. & Wickham, K. & Janis, G. & Winickoff, J. & Lindgren, B. & Murphy, S., 2013. "Biomarker evidence of tobacco smoke exposure in children participating in lead screening," American Journal of Public Health, American Public Health Association, vol. 103(12), pages 54-59.
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    Cited by:

    1. You Li & Jian Qin & Xiao Wei & Chunhong Li & Jian Wang & Meiyu Jiang & Xue Liang & Tianlong Xia & Zhiyong Zhang, 2016. "The Risk Factors of Child Lead Poisoning in China: A Meta-Analysis," IJERPH, MDPI, vol. 13(3), pages 1-13, March.
    2. Marsela Tanaka & Konstantinos Petsios & Stavroula K. Dikalioti & Stavroula Poulopoulou & Vassiliki Matziou & Stamatios Theocharis & Ioanna D. Pavlopoulou, 2018. "Lead Exposure and Associated Risk Factors among New Migrant Children Arriving in Greece," IJERPH, MDPI, vol. 15(6), pages 1-10, May.
    3. Giovanni S. Leonardi & Ekaterine Ruadze & Ayoub Saei & Adam Laycock & Simon Chenery & Helen Crabbe & Elizabeth Marchant & Irma Khonelidze & Lela Sturua & Paata Imnadze & Amiran Gamkrelidze & Michael J, 2023. "Identifying Sources of Lead Exposure for Children in the Republic of Georgia, with Lead Isotope Ratios," IJERPH, MDPI, vol. 20(20), pages 1-17, October.
    4. Howard W. Mielke, 2016. "Editorial: Lead Risk Assessment and Health Effects," IJERPH, MDPI, vol. 13(6), pages 1-3, June.

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