Getting Your Child's Blood Lead Tested - Avoiding Pain and Ignorance

Parents attempting to get a blood lead level assessment of their child want two things: an accurate reading, and a blood tiling that is as painless as possible. The best way of achieving this is to get your own doctor to refer you to a reputable pathology service which is involved in the Australian Standards quality control program for assessing blood lead levels and can give you an appointment with a venipuncturist (person who takes the blood) specialising in children. Your results will be sent to your own doctor in one to two weeks.

1) The doctor - far too many GPs are ignorant of the risk factors which would indicate the need to test for lead or may try to take the blood themselves or refer you to an inexperienced pathologist (My sons first blood lead level was tested using the heel prick method which is both inaccurate and extremely distressing for parent and baby - we both left in tears). If your doctor does appear to know little about lead, explain that lead in blood even at fairly low levels (less than 10 µg/dL) has been linked with IQ loss, and the reasons why you think your child may be affected (e.g. living near a busy street, living in a smelter town, old paint in house, lots of hand sucking, living in urban area, etc.). You could also suggest (particularly if they are an inner-city or smelter town doctor with no real excuse for not being aware of lead) that they contact one of the public health units for some more information or The LEAD Group at the

Community Lead Information Centre (CLIC). Volunteers at CLIC can send doctors advice for GP's written by Dr Garth Alperstein, community paediatrician. Parents can familiarise themselves with the risk factors by reading the handout "Is your child being exposed to Lead?" also available from CLIC.

2) The results: it is not uncommon to ring up for blood lead level results and to be told "Oh it's OK your baby is in the normal range", which can mean anywhere between 0 and 25 µg/dL; as Australia (to it's shame) has only this month changed from recommending a blood lead level of concern of 25 µg/dL to recommending a goal of 10 µg/dL (the US level of concern) combined with blood lead action guidelines which bring about an individual management response for levels above 15 µg/dL; your child may have quite high blood lead levels and you will still be given a cheery assurance of normality - therefore you must get the actual reading. The reading itself may be in micromoles per litre (µmol/L) which you have to convert to micrograms per decilitre (µg/dL) by multiplying by 20.7, in order to relate your result to the international debate.

CONVERSION TABLE 0 µg/dL = 0 µmol/L

5 µg/dL = 0.241 µmol/L
10 µg/dL = 0.483 µmol/L
15 µg/dL = 0.724 µmol/L
20 µg/dL = 0.965 µmol/L
25 µg/dL = 1.206 µmol/L
30 µg/dL = 1.448 µmol/L

3) The myths - don't fall prey to the argument that there is or was no point having the blood lead level tested because there's nothing you can do about it. Reducing lead in petrol in the US and controlling lead in food cans, took the mean blood lead level from 15 µg/dL to less than 4 µg/dL and various studies of individual management have found ways to reduce children's blood levels by various amounts. The onus is now on environmental and health authorities to bring that research tothe attention of doctors and carry out further research where necessary. Doctors need to be aware of the following NHMRC recommendations (see next item).