What are the recommended criteria for screening patients for lead poisoning in primary care?

Recommended criteria for screening patients for lead poisoning in primary care focus primarily on identifying individuals at increased risk due to environmental, occupational, or social factors. Screening is advised for children and adults who have potential exposure to lead through living in or frequenting older housing with lead-based paint, especially if the housing is in poor repair or undergoing renovation.

Children under 5 years old are a key group for screening due to their increased vulnerability to lead toxicity and higher likelihood of exposure through hand-to-mouth activity.

Additional criteria include patients with unexplained symptoms consistent with lead poisoning such as abdominal pain, cognitive or behavioural changes, or anaemia, and those with occupational exposure in industries such as battery manufacturing, construction, or recycling.

Screening is also recommended for individuals with a history of pica, recent immigration from countries with higher environmental lead exposure, or those living in communities with known lead contamination.

Blood lead level testing is the standard screening method in primary care settings.

This approach aligns with UK public health guidance emphasizing targeted screening based on risk factors rather than universal screening ¹. Recent literature supports this targeted strategy, highlighting the importance of primary prevention by identifying high-risk homes and populations to reduce exposure (Campbell and Osterhoudt, 2000; Campbell et al., 2011).