USPSTF Releases Updated Recommendations for Blood Lead Screening

The USPSTF has updated its 2006 recommendations on screening for elevated blood lead levels in children and pregnant women, which advised against screening in most patients.

The new recommendation statement, instead, concludes that there is insufficient evidence to recommend for or against screening in asymptomatic children and pregnant women.

The researchers reviewed available evidence on the benefits and harms of screening for and treatment of elevated blood lead levels, defining elevated levels according to the CDC reference level of 5 μg/dL. In the 2006 recommendations, elevated levels were defined as 10 μg/dL.

Among their findings:

• There is adequate evidence that questionnaires and other clinical prediction tools used to identify asymptomatic children and pregnant women with elevated blood lead levels are inaccurate.
• There is adequate evidence that capillary blood testing accurately identifies children with elevated blood lead levels.
• There is inadequate evidence on the harms of screening for or treatment of elevated blood lead levels in asymptomatic children and pregnant women.

“The USPSTF concluded that the current evidence is insufficient, and that the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children 5 years and younger and in pregnant women cannot be determined.”

—Michael Potts

Reference:

USPSTF. Screening for elevated blood lead levels in children and pregnant women. JAMA. 2019;321(15):1502-1509.