Lead screening practices of pediatric residents

Stanley J. Schaffer, James R. Campbell, Peter G. Szilagyi, Michael Weitzman

Research output: Contribution to journalArticle

Abstract

Objectives: As part of their training, pediatric residents provide primary care services to young children, including youngsters who may have elevated blood lead levels. We set out to (1) determine the percentage of pediatric residents who screen children for elevated blood lead levels according to the guidelines of the Centers for Disease Control and Prevention and the American Academy of Pediatrics; (2) assess the likelihood of lead screening by residents based on demographic and practice-setting characteristics; and (3) compare the attitudes of residents who report that they are universal screeners, selective screeners, or nonscreeners. Design: Confidential, cross-sectional survey of a nationally representative sample of pediatric residents conducted as part of the American Academy of Pediatrics 28th Periodic Survey of Fellows. Subjects: One hundred forty-three responding pediatric residents (51% response rate). Results: Seventy-five percent of pediatric residents reported screening all patients aged 9 to 36 months for elevated blood lead levels, 21% reported screening some, and 4% reported screening none. Pediatric residents who cared for patients in urban settings were more likely to report screening patients for elevated blood lead levels than were pediatric residents who cared for patients in suburban or rural settings (100% vs 73%; P<.001), and pediatric residents in the Northeast were more likely to report screening universally than were residents in the rest of the country (93% vs 63%; P<.001). Overall, pediatric residents who reported screening patients universally were more likely to believe that the benefits of screening outweigh the costs than were residents who reported screening patients selectively (67% vs 17%; P<.001). Conclusions: Most pediatric residents reported that they screened patients for elevated blood lead levels, either universally or selectively. Nevertheless, the screening practices of pediatric residents and their opinions concerning the relative benefits and costs of lead screening largely reflect the areas of the country and the practice settings in which they had their primary care experiences.

Original languageEnglish (US)
Pages (from-to)185-189
Number of pages5
JournalArchives of Pediatrics and Adolescent Medicine
Volume152
Issue number2
DOIs
StatePublished - Jan 1 1998

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Pediatrics
Lead
Primary Health Care
Centers for Disease Control and Prevention (U.S.)
Cost-Benefit Analysis
Cross-Sectional Studies
Demography
Guidelines
Costs and Cost Analysis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Lead screening practices of pediatric residents. / Schaffer, Stanley J.; Campbell, James R.; Szilagyi, Peter G.; Weitzman, Michael.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 152, No. 2, 01.01.1998, p. 185-189.

Research output: Contribution to journalArticle

Schaffer, Stanley J. ; Campbell, James R. ; Szilagyi, Peter G. ; Weitzman, Michael. / Lead screening practices of pediatric residents. In: Archives of Pediatrics and Adolescent Medicine. 1998 ; Vol. 152, No. 2. pp. 185-189.
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abstract = "Objectives: As part of their training, pediatric residents provide primary care services to young children, including youngsters who may have elevated blood lead levels. We set out to (1) determine the percentage of pediatric residents who screen children for elevated blood lead levels according to the guidelines of the Centers for Disease Control and Prevention and the American Academy of Pediatrics; (2) assess the likelihood of lead screening by residents based on demographic and practice-setting characteristics; and (3) compare the attitudes of residents who report that they are universal screeners, selective screeners, or nonscreeners. Design: Confidential, cross-sectional survey of a nationally representative sample of pediatric residents conducted as part of the American Academy of Pediatrics 28th Periodic Survey of Fellows. Subjects: One hundred forty-three responding pediatric residents (51{\%} response rate). Results: Seventy-five percent of pediatric residents reported screening all patients aged 9 to 36 months for elevated blood lead levels, 21{\%} reported screening some, and 4{\%} reported screening none. Pediatric residents who cared for patients in urban settings were more likely to report screening patients for elevated blood lead levels than were pediatric residents who cared for patients in suburban or rural settings (100{\%} vs 73{\%}; P<.001), and pediatric residents in the Northeast were more likely to report screening universally than were residents in the rest of the country (93{\%} vs 63{\%}; P<.001). Overall, pediatric residents who reported screening patients universally were more likely to believe that the benefits of screening outweigh the costs than were residents who reported screening patients selectively (67{\%} vs 17{\%}; P<.001). Conclusions: Most pediatric residents reported that they screened patients for elevated blood lead levels, either universally or selectively. Nevertheless, the screening practices of pediatric residents and their opinions concerning the relative benefits and costs of lead screening largely reflect the areas of the country and the practice settings in which they had their primary care experiences.",
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