A-327 Pre-analytical and Analytical Modifications to Improve the Quality of Pediatric Lead Tests

Abstract

Abstract Background The recent decrease in the CDC Blood Lead Reference Value (BLRV) to 3.5 ug/dL has highlighted the need for systematic changes that some clinicians and laboratories need to implement to assure the quality of reported pediatric lead results. Building upon the recommendations of the Blood Lead Reference Value Workgroup, APHL has developed specific recommendations and resources designed to assist medical professionals and laboratory scientists in minimizing the likelihood of contamination when collecting and testing blood specimens. Also included are analytical practices that can improve precision, accuracy, and sensitivity of pediatric lead assays. Methods Evaluation of existing protocols and practices to identify potential sources of contamination and opportunities for process improvement. Results APHL will provide practical recommendations to systematically improve point of care and fixed laboratory testing to improve confidence in reported pediatric lead concentrations. These improved measurements will improve environmental health surveillance and inform public health intervention and patient care. Conclusion Rigorous pre-analytical practices including education, updated specimen collection guidance, pre-screening of collection materials, improvement of point of care technology and refinement of spectroscopic analytical methods result in less ambient contamination, improved sensitivity, precision and accuracy of pediatric lead testing. Clinician office practices, public health and commercial clinical laboratories will all benefit from implementing these strategies.