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7474973 
Journal Article 
The accuracy of a portable instrument for analysis of blood lead in children 
Shannon, M; Rifai, N 
1997 
0 
Ambulatory Child Health
ISSN: 1355-5626
EISSN: 1467-0658 
3 
3 
249-254 
English 
Background. Screening of children for lead poisoning is complicated by cumbersome, labor intensive methods of blood lead analysis, most commonly atomic absorption spectrophotometry (AAS). We investigated the accuracy of a portable, handheld anodic stripping voltammetry (HHASV) instrument for the measurement of blood lead in a cohort of both lead-poisoned and non-lead-poisoned children. Methods. Subjects consisted of a convenience sample of children ≤ 7 years seen either at the lead treatment program or primary care clinic of an urban children's hospital. In all cases a venipuncture blood lead level was obtained as a routine part of the clinic visit. Blood was placed in lead-free sodium heparin tubes then split for analysis by AAS and HHASV. Additionally, the HHASV was compared with spiked blood lead samples obtained as part of the Centers for Disease Control quality assurance program. Outcome measures included between-group agreement, bivariate correlation, sensitivity at identifying children with lead poisoning (blood lead ≤ 10 μg/dl) and reproducibility. Results. Two-hundred and thirty-one children participated in the study. Mean age (SD) was 2.8 ± 1.8 years. Eighty-one children (35%) had lead poisoning. Mean blood lead level was 9.7 μg/dl by AAS versus 9.0 μg/dl by HHASV (mean difference 1.01 μg/dl; 95% Cl, 0.65 to 1.38). Pearson's correlation coefficient for AAS versus HHASV was r = 0.948 (p = 0.001). Among the 81 children with lead poisoning HHASV identified 71 (sensitivity, 0.87; specificity, 0.97, false-positive rate, 0.03). Triplicate measurement of 96 samples by HHASV produced a mean coefficient of variation of 0.11 ± 0.14. Conclusions. These data identify a novel method of lead analysis which is both portable and accurate. Implications for practice. This instrument offers the potential for office-based measurement of blood for practice lead in children. 
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