USPSTF: evidence lacking for lead screen in kids, pregnancy

(HealthDay)—The U.S. Preventive Services Task Force (USPSTF) has concluded that current evidence is insufficient for assessing the balance of harms and benefits of screening for elevated blood lead levels in asymptomatic children and pregnant women. These findings form the basis of a draft recommendation statement published online Oct. 30.

Amy Cantor, M.D., M.P.H., from Oregon Health & Science University in Portland, and colleagues conducted a systematic literature review to update a prior review on screening for elevated blood lead levels in childhood. The researchers found that none of the studies directly assessed clinical benefits or harms of screening versus not screening children for elevated lead levels. Short-term reductions in blood lead levels were seen in treatment studies of chelating agents, but these reductions were not sustained and were associated with short- and longer-term harms.

In a second evidence review, Cantor and colleagues updated a prior systematic review on screening for elevated blood lead levels in pregnancy. The researchers found that none of the studies assessed the clinical harms and benefits of screening pregnant women versus no screening or examined variation in the effectiveness of screening based on the gestational age at which screening was performed. None of the studies reported health outcomes or harms associated with interventions to reduce blood lead levels in asymptomatic pregnant women.

"Until there is more research, clinicians should use their best judgment about when to screen for lead exposure and keep up to date on any concerns about lead in their community," USPSTF member Michael Silverstein, M.D., M.P.H., said in a statement.

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