The Journal of Pediatrics
Volume 119, Issue 4 , Pages 548-550, October 1991

Evaluation of the erythrocyte protoporphyrin test as a screen for elevated blood lead levels*

    DVM, MPH
  • Michael D. McElvaine

      Affiliations

    • Division of Environmental Hazards and Health Effects, Center for Environmental Health and Injury Control, Centers for Disease Control, Atlanta, Georgia, USA
    • City of Chicago Department of Health, Chicago, Illinois USA
    • Corresponding Author InformationReprint requests: Michael D. McElvaine, DVM, MPH, Division of Environmental Hazards and Health Effects, Center for Environmental Health and Injury Control, Centers for Disease Control, Mail Stop F-28, 1600 Clifton Rd. NE, Atlanta, GA 30333.
  • , PhD
  • Hyman G. Orbach

      Affiliations

    • Division of Environmental Hazards and Health Effects, Center for Environmental Health and Injury Control, Centers for Disease Control, Atlanta, Georgia, USA
    • City of Chicago Department of Health, Chicago, Illinois USA
  • , MD
  • Sue Binder

      Affiliations

    • Division of Environmental Hazards and Health Effects, Center for Environmental Health and Injury Control, Centers for Disease Control, Atlanta, Georgia, USA
    • City of Chicago Department of Health, Chicago, Illinois USA
  • , PhD
  • Lorry A. Blanksma

      Affiliations

    • Division of Environmental Hazards and Health Effects, Center for Environmental Health and Injury Control, Centers for Disease Control, Atlanta, Georgia, USA
    • City of Chicago Department of Health, Chicago, Illinois USA
  • , PhD
  • Edmond F. Maes

      Affiliations

    • Division of Environmental Hazards and Health Effects, Center for Environmental Health and Injury Control, Centers for Disease Control, Atlanta, Georgia, USA
    • City of Chicago Department of Health, Chicago, Illinois USA
  • , PhD
  • Richard M. Krieg

      Affiliations

    • Division of Environmental Hazards and Health Effects, Center for Environmental Health and Injury Control, Centers for Disease Control, Atlanta, Georgia, USA
    • City of Chicago Department of Health, Chicago, Illinois USA

Received 3 April 1991; accepted 20 June 1991.

To study the effect of lowering the definition of an elevated blood lead level on the performance of the erythrocyte protoporphyrin screening test and the number of children who would require follow-up, we collected laboratory data from a screening program. The estimated sensitivity of an erythrocyte protoporphyrin level ≥35 μg/dl for identifying children with elevated blood lead levels was 73% when we used 1985 Centers for Disease Control guidelines (elevated blood lead level ≥25 μg/dl). Eight percent of the tests showed positive results. When we redefined an elevated blood lead level as ≥15 μg/dl, the sensitivity estimate was reduced to 37% and the number of positive test results increased fourfold.

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* Presented in part at the 1990 Epidemic Intelligence Service Conference, April 23–27, 1990, Atlanta, Ga.The authors of this article are solely responsible for all analysis and interpretation of the data presented here.

PII: S0022-3476(05)82402-3

The Journal of Pediatrics
Volume 119, Issue 4 , Pages 548-550, October 1991