USPSTF: Evidence Lacking for Elevated Lead Level Screening

The U.S. Preventive Services Task Force has determined that the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic young children and pregnant women cannot be ascertained. This finding forms the basis of an updated final recommendation statement published in the American Medical Association.

Amy G. Cantor, M.D., M.P.H., from Oregon Health & Science University in Portland, and colleagues reviewed data from 24 studies with 11,433 individuals to examine the effects of screening, testing, and treatment for elevated blood lead levels in pregnant women and children aged 5 years or younger.

The researchers found adequate evidence for the inaccuracy of questionnaires and other clinical prediction tools to identify asymptomatic children or asymptomatic pregnant women with elevated blood lead levels. There was adequate evidence for capillary blood testing accurately identifying children with elevated blood lead levels. Inadequate evidence was found for the effectiveness of treating elevated blood lead levels in asymptomatic young children and pregnant women. Based on these findings, the USPSTF concludes that the current evidence is inadequate and that the balance of benefits and harms of screening for elevated blood lead levels cannot be ascertained.

"Clinicians should use their best judgement about if and when to screen children and pregnant women without signs or symptoms for lead exposure and keep up to date on any concerns about lead in their community," task force member Michael Silverstein, M.D., M.P.H., said in a statement.

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