Is screening for lead poisoning justified?

Abstract

Evidence is insufficient to recommend for or against universal screening of young children for lead poisoning in high- prevalence communities (strength of recommendation [SOR]: C). In low-prevalence communities, evidence is insufficient to recommend for or against a targeted screening approach, employing locale-specific demographic risk factors and personal risk questionnaires to inform screening decisions (SOR: C). Although evidence does not suggest that treatment of individuals with elevated blood lead levels improves individual outcomes, public health strategies aimed at decreasing lead in the environment appear to have resulted in a significant decline in the number of children with elevated blood lead levels in recent decades. One could thus argue that screening may identify communities with high rates of lead poisoning, where environmental strategies could be targeted. Because the epidemiology of lead poisoning continues to change, local and state health authorities must continuously update information on which to base decisions about screening.