By: Laura Robbins-Milne, MD
1) A healthy 2 y/o is seeing you for well child care. In assessing for her lead risk you ascertain that she is well and that she has no known contact with peeling paint or other sources of lead. What is your next step?
2) You explain to the parents of your 2 year old patient that you will need to draw a blood lead level on their child. They ask you how their child would have acquired lead.
3) The parents of your 2 year old patient want to know why their 7 year old does not need to be tested for lead.
4) Your 2 year old patient’s lead comes back at 9, what follow up does she need and what symptoms do you expect to see.
Sources:
For the most up to date recommendation for lead poisoning prevention and management see the NYC DOHMH. Their most recent recommendations can be found on the NYC DOHMH website: www.nyc.gov/doh it is in Vol.26(3):15-22
Another good source for current recommendations is the CDC. The most current recommendations are
Center for Disease Control and Prevention. Preventing Lead Poisoning in Young Children. Atlanta, Ga:CDC:2005
A good article for management and screening as well as parental education
Schonfeld D, Needham D. Lead: A practical perspective. Contemporary Pediatrics.1994:11(5)64-96
A good article for the effects of and treatments for lead poisoning is
Piomelli S. Childhood Lead Poisoning. Pediatric clinics of North America.2002:49(12)
