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Did you decline 12 month bloodwork? - Page 7

post #121 of 160
Quote:
Originally Posted by riverscout View Post
And in some cases regional differences account for some people's failure to understand why anyone would choose not to test.
Actually, Riverscout, by posting her "Amen!" to Orangefoot, Slsurface was not discussing her choice not to test, but rather applauding a complete misunderstanding of the nature of lead exposure (i.e. the idea that testing the water supply would solve the problem). Further, the point here is that while regional differences would certainly justify a lack of interest in testing in some (I don't expect someone in suburban Phoenix to be terribly concerned) someone living in Michigan has no excuse for ignorance.
post #122 of 160
Quote:
Originally Posted by slsurface View Post
I am not against testing per se. Rather, I am against the notion that one solution fits all. I suggest that it is important to be mindful of the environment in which we choose to live. I am aware that there are many contaminants in my area. Arsenic is actually a bigger problem in my town than lead. In addition, before we bought our house, we made sure it did not have lead pipes and tested it for lead elsewhere. If we made these decisions, there may not be the need for everyone to test their child.

As for toys with lead paint. Only a handful have been recalled in the past decade due to lead (and most of those were not meant for infants/toddlers). My dh and I also make careful decisions about the types of toys our ds has. For example, we do not buy toys from China (for moral/economic principles more than anything else).

Frankly, I am just surprised at the level of hostility in this thread. We should be channeling this energy into getting our lawmakers to reduce the amounts of toxins released into our environments and placed in our foods and health products without or knowledge. In the last decade these controls have been repeatedly loosened and are seldom enforced when they are in place. The question of when and whether to test your child is a personal one, just like vax-ing and circ-ing. I don't hold any judgment about whether or not you do any of these things, let's try to be more respectful of each other's person decisions.
Slsurface, if you are not against testing per se, then you should not have posted "Amen!" to Orangefoot, since she obviously is.

Only a handful of toys have been recalled in the last decade for lead? Try hundreds, all in the last year.

You are "surprised at the level of hostility in this thread." Well, perhaps it's a little frustrating to see page after page of solid information and links be dismissed with a one-word "Amen!" to a thoroughly misinformed post. Your most recent post is far more thoughtful, and though I may not agree with your conclusions, if you had posted that instead of an apparently kneejerk "amen," it wouldn't have called forth the reaction that it did.
post #123 of 160
Some information on lead pipes, since this keeps coming up. Lead in piping was not restricted nationally until 1986, and at that point, it's not as if all pipes were automatically replaced. Further, faucet fixtures are still allowed to contain as much as 8% lead.


Quote:
Lead-contaminated drinking water is most common in recently constructed or very old homes. Many homes built in the early 1900's used lead pipes for interior plumbing. Lead piping was also used for many service connections that join homes to public water supplies. In 1986, a nationwide ban restricted the use of lead pipes for drinking water supplies.

When copper pipes replaced lead pipes, lead solder and flux were often used to join the pipes. Lead solder is a major cause of lead contamination in drinking water today. The N.C. Building Code Council banned lead solder in 1985. Since 1988, solder that has a lead content over 0.2 percent must be labeled to say that it cannot be used for joints or fittings in any private or public drinking water system.

Homes with plastic drinking water lines, which are glued rather than soldered, should not have problems with lead contamination from pipes. However, household faucets may be a significant source of lead contamination. Chrome-plated faucets are generally made of brass, which contains 3 to 8 percent lead. Contamination can occur when water comes in contact with these fixtures.
http://www.bae.ncsu.edu/programs/ext...qwm/he395.html
post #124 of 160
Quote:
Originally Posted by BrklynMama View Post
Actually, Riverscout, by posting her "Amen!" to Orangefoot, Slsurface was not discussing her choice not to test, but rather applauding a complete misunderstanding of the nature of lead exposure (i.e. the idea that testing the water supply would solve the problem). Further, the point here is that while regional differences would certainly justify a lack of interest in testing in some (I don't expect someone in suburban Phoenix to be terribly concerned) someone living in Michigan has no excuse for ignorance.
I understood what the main point of your post was. However, your wording about regional differences was in general terms, hence my comment, which was also in general terms.
post #125 of 160
Everyone is still stuck on arguing about whether or not lead is important to check for as a routine finger prick blood test. Again, I will say that my exclusively breastfed healthy ds tested for severe iron deficiency from the same 'routine blood test'. If that hadn't been my situation, I may have been on here agreeing with most of you saying to decline the test and that its unnecessary. These are BOTH serious problems if the tests come back abnormal...Iron deficiency anemia is one of the most common causes of later diagnosed learning disabilities for children. If caught at a 12 month visit and addressed appropriately, this can be avoided. Come on, what is the point in making a big deal out of a finger prick if you could possibly prevent later learning problems for your dc?
post #126 of 160
I understand that your situation is different to ours but I cannot imagine routine blood testing being mandatory or even affordable by our National Health Service. I imagine that it so would be very difficult to justify.

I am not 'obviously' against testing: I am just shocked by it. I cannot believe that in all the years that lead has been known to be a problem there has not been some massive investment in clean-up or highlighting of risk areas and that this is seen as the only way to deal with the problem.

In this country where high levels of contamination are found, remediation work is carried out. In 1998 1m depth of soil was removed from the gardens of one street in our town and replaced with new then the front gardens were paved over. The tenants have been advised not to grow any vegetables in their gardens an periodic re-testing is carried out. Local councils have contamination strategies and implement them.

Lots of older houses have had pipework replaced on installation of new heating systems as gas fired central heating or electric heaters become almost universal and few properties still use hot air vented heating. Surveys carried out when buying a home check for sources of possible contamination such as lead and asbestos both within the home and in the local area.

If your child tests positive do you then go on to test yourself and other family members along with your home, water supply and land to see if you can remedy any problems found there? If not then how do you prevent further contamination?

I agree that the only way to find out if there is a problem is to test but I suppose I just can't see that every child needs to be tested or that blood testing gets to the root of the problem; hence my shock.
post #127 of 160
Trust me, I agree there are many more things that need to be done to reduce the problem of lead exposure altogether. I am appalled not more is done also. I just think that this test is absolutely fine and very beneficial to ALL children. And, I know three children under the age of 3 who tested high lead levels at a 9 or 12 mos check and yes, their family members were all tested as were their houses checked - one house in particular ripped apart to get to the root of it. But, it is not nearly as dangerous of an exposure to you or I then is to a baby.

Yes, there should be more done to prevent further exposure problems, but this is one test proven helpful to many families (some on this board who've posted previously) and I guess I cannot understand why people are so shocked by the test. Everyone who is shocked and is giving this OP advice to decline obviously has been lucky in never getting scary blood test results for their little ones OR they may have a child with lead exposure or iron def. and not know because they were so stuck on refusing any routine tests.

I guess its all perspective.
post #128 of 160
Quote:
Originally Posted by mom2tatum View Post
I guess its all perspective.

So true.

Lori, sending you a PM in a minute!
post #129 of 160
Quote:
Originally Posted by orangefoot View Post
I understand that your situation is different to ours but I cannot imagine routine blood testing being mandatory or even affordable by our National Health Service. I imagine that it so would be very difficult to justify.
Outside of participation in some government programs, it's not mandatory. It's recommended. I do not believe that a blood test on all infants unduly taxes a universal healthcare system; on the contrary, preventative treatment and screening *saves* healthcare money as the costs of immediate intervention for severe cases and long term care needs for children who are exposed but go undetected far outweigh the cost of the screening.

Lead abatement is an ongoing process in the US. It is not a simple issue and, like asbestos, it is sometimes better to let "sleeping lead lie" as the clean-up process can end up causing more damage than good. There is no plan and no amount of money that could sweep the country to remove all sources of lead. As abatement continues to be an investment, so is education for parents on the risks of lead exposure.

I feel strongly that screening infants for lead makes sense and is the best and most sensible approach to the problem of lead in our environment in the US (and I suspect other industrialized nations but can't speak from a position of authority) and in the year 2007. It is an unfortunate state of affairs, I agree, hopefully my grandchildren will be in a different situation, but right here right now we need to know if children are being exposed and we need to know as soon as possible.
post #130 of 160
Quote:
Originally Posted by easy_goer View Post
It's recommended.
It is recommended by some local and state agencies that all young children in that area be tested for lead due to a higher level of risk. However, last time I checked, the CDC and the AAP do not recommend routine lead testing of all young children across the country, but rather recommend testing young children that are in high risk groups, such as children who live in older homes. While my daughter's pediatrician offered the test to us as an option, he did not recommend that we test. After asking us some questions, he actually agreed with our decision to decline.
post #131 of 160
This link says that the cdc does recommend routine testing of children 12 and 24 months. I think I would do the lead test if I lived in the U.S.

http://www.phac-aspc.gc.ca/publicat/...pdf/s2c25e.pdf
post #132 of 160
Quote:
Originally Posted by the_lissa View Post
This link says that the cdc does recommend routine testing of children 12 and 24 months. I think I would do the lead test if I lived in the U.S.

http://www.phac-aspc.gc.ca/publicat/...pdf/s2c25e.pdf
That's from a Canadian medical journal. To believe that, I would have to see a link from the CDC. I'll try and find one that states what I said they recommend.
post #133 of 160
[QUOTE=orangefoot;8923160]I am not 'obviously' against testing: I am just shocked by it. I cannot believe that in all the years that lead has been known to be a problem there has not been some massive investment in clean-up or highlighting of risk areas and that this is seen as the only way to deal with the problem.

If your child tests positive do you then go on to test yourself and other family members along with your home, water supply and land to see if you can remedy any problems found there? If not then how do you prevent further contamination?[QUOTE]



Testing is most certainly not seen as the only way to deal with the problem. Here in NY, just for example, there has been a "massive investment" in lead abatement of public facilities, and for private residences landlords are heavily regulated with regard to maintenance and disclosure of lead-painted buildings. Testing is important to identify children who are in the process of being poisoned; when high levels are found a variety of interventions may be made depending on the situation. The advent of routine testing in areas where lead exposure is common has been part of a multi-pronged campaign leading to a drastic drop in the numbers of children being poisoned (and incidentally, were it not for such testing we would have little idea if public and private abatement efforts were succeeding).

If a child tests positive, family members may or may not be tested. Often not, because lead exposure is primarily damaging to children's developing and vulnerable brains. It takes particularly extreme levels to produce damaging effects in adults. And yes, a variety of tests can be conducted of a child's living environment, many of which are publicly funded as a matter of community health. Again, the blood lead level will determine what kinds of inspections and interventions are warranted.
post #134 of 160
From the CDC page on lead http://www.cdc.gov/nceh/lead/ (bolding mine)

Quote:
As a result of this Act, the CDC Childhood Lead Poisoning Prevention Branch was created, with primary responsibility to:

Develop programs and policies to prevent childhood lead poisoning.

Educate the public and health-care providers about childhood lead poisoning.

Provide funding to state and local health departments to determine the extent of childhood lead poisoning by screening children for elevated blood lead levels, helping to ensure that lead-poisoned infants and children receive medical and environmental follow-up, and developing neighborhood-based efforts to prevent childhood lead poisoning.

Support research to determine the effectiveness of prevention efforts at federal, state, and local levels.
The page lists programs supported by the CDC lead mandate... the list includes increased testing of medicaid populations and funding of state programs for blood testing in childhood.

According to the AAP http://aappolicy.aappublications.org...ics;101/6/1072 (again, bolding mine)

Quote:
Although recent data continue to demonstrate a decline in the prevalence of elevated blood lead levels (BLLs) in children, lead remains a common, preventable, environmental health threat. Because recent epidemiologic data have shown that lead exposure is still common in certain communities in the United States, the Centers for Disease Control and Prevention recently issued new guidelines endorsing universal screening in areas with 27% of housing built before 1950 and in populations in which the percentage of 1- and 2-year-olds with elevated BLLs is 12%. For children living in other areas, the Centers for Disease Control and Prevention recommends targeted screening based on risk-assessment during specified pediatric visits. In this statement, The American Academy of Pediatrics supports these new guidelines and provides an update on screening for elevated BLLs. The American Academy of Pediatrics recommends that pediatricians continue to provide anticipatory guidance to parents in an effort to prevent lead exposure (primary prevention). Additionally, pediatricians should increase their efforts to screen children at risk for lead exposure to find those with elevated BLLs (secondary prevention).
So in a way, everyone is right The CDC and AAP recommend universal testing in some places and in some populations (and these populatios change over time) but risk-assessment testing in others.

However, the impression I get from the CDC page is that they recommend this test for most children (bu please read through the page and see if you get the same vibe). I mean, after all, how do you identify if a population fits the 12% "with elevated levels" classification if you're not testing a fair chunk of that population? And if you actually read the AAP paper you'll see that the CDC did endorse universal blanket screening from 1991-1998....apparently this "true universal screening" cost to much and it was revised from "test unless you know there is no risk" to "test if you know there is a risk". Hmmmmm...gotta love money driven medicine!
post #135 of 160
Since that post was getting info dense... I forget who asked about the short term/long term impact of lead and at what amount these were seen... From the AAP paper linked above:

Quote:
No threshold for the toxic effects of lead has been identified. The impact of lead exposure on cognition in young children at BLLs 10 µg/dL has been amply demonstrated,23 and the literature is remarkably consistent.23-25 The magnitude of the effect of blood lead on IQ in young children has been estimated as an average loss of two to three points for BLLs averaging 20 µg/dL, compared with BLLs averaging 10 µg/dL.23,26-28

A number of studies recently reviewed by the National Research Council found an association between lead levels and intellectual function in children.23 In one population, for example, moderately increased body lead burden (defined as a dentine lead level of >24 ppm, corresponding with a peak BLL of >30 µg/dL) was correlated with an increase in the percentage of children with severe deficits (ie, IQ <80) from an expected 4% to 16% and a decrease in the percentage of children with an IQ 125 from an expected 5% to 0%.29,30

In recent years, research has been directed to other aspects of the developmental neurotoxicity of lead. This research has been aided by the creation of instruments that provide valid, reliable measures of attention, behavior, and other aspects of neurodevelopment. Using these instruments, some investigators have identified associations between lead exposure and weaknesses in attention/vigilance,31 aggression, somatic complaints, and antisocial or delinquent behaviors.32,33 Other adverse neurodevelopmental sequelae that have been associated with low to moderate elevated BLLs include reduction in auditory threshold,34,35 abnormal postural balance,36 poor eye-hand coordination, longer reaction times,29 and sleep disturbances.37 Other studies have failed to confirm many of these results. Although these findings may be statistically significant, in some cases they may not be clinically significant.
post #136 of 160
I found this to somewhat clarify the US gov't recommendation:

Quote:
Between 1991 and 1997, both the AAP and CDC recommended universal screening, that is, that all children have their blood lead concentration measured, preferably when they are 1 and 2 years of age. Because the prevalence of elevated blood lead concentrations has decreased so much, a shift toward targeted screening has begun and the criteria for and implementation of targeted screening continues to develop.
It is dated Oct. 2005: http://aappolicy.aappublications.org...ics;116/4/1036

To be honest, the current-to-this-minute recommendation is foggy to me and seems to be under development. It does seem that the recommendation for truly universal testing is no longer in effect.

I mainly wanted to clarify that at no time was lead testing *mandatory* in the US.
post #137 of 160
Yeah, the "targeted screening" they mention icludes the following (from the AAP site):

Quote:
Children whose parents respond "yes" or "not sure" to any of these three risk-assessment questions should be considered for screening: 1) Does your child live in or regularly visit a house or child care facility built before 1950?; 2) Does your child live in or regularly visit a house or child care facility built before 1978 that is being or has recently been renovated or remodeled?; 3) Does your child have a sibling or playmate who has or did have lead poisoning?

Other candidates to be considered for targeted screening include children 1 to 2 years of age living in housing built before 1950 situated in an area not designated for universal screening (especially if the housing is not well maintained), children of ethnic or racial minority groups who may be exposed to lead-containing folk remedies, children who have emigrated (or been adopted) from countries where lead poisoning is prevalent, children with iron deficiency, children exposed to contaminated dust or soil, children with developmental delay whose oral behaviors place them at significant risk for lead exposure,40 victims of abuse or neglect,41,42 children whose parents are exposed to lead (vocationally, avocationally, or during home renovation), and children of low-income families who are defined as receiving government assistance (Supplemental Feeding Program for Women, Infants, and Children; Supplemental Security Income; welfare; Medicaid; or subsidized child care).
It makes sense, but I find it interesting that they include having a playmate with elevated levels as a reason to test. It makes sense since the littles are playing together and may share an exposure point outside of the affected child's home (park, play structure, tarmac, bike route, food seller, etc), but I wonder how many mamas would think to call their playgroup with this info? I know mamas will call if their little is sick...but what about elevated lead?

This whole thread has been so interesting and raised so many interesting questions...
post #138 of 160
Quote:
Originally Posted by easy_goer View Post
I found this to somewhat clarify the US gov't recommendation:



It is dated Oct. 2005: http://aappolicy.aappublications.org...ics;116/4/1036

To be honest, the current-to-this-minute recommendation is foggy to me and seems to be under development. It does seem that the recommendation for truly universal testing is no longer in effect.

I mainly wanted to clarify that at no time was lead testing *mandatory* in the US.
I knew you were just trying to say it wasn't mandatory, and I wasn't trying to be adversarial or nitpick at your wording. I just didn't want the impression to be given that all those who have chosen to not test were defying some kind of recommendation. I get the impression from some on this thread that they think parents who choose not to test are some kind of fringe group wackos who are defying the Man just for the sake of it, so I wanted to point out that many of us are not defying standard recommendations set forth by major medical organizations.
post #139 of 160
Quote:
Originally Posted by wombatclay View Post
Yeah, the "targeted screening" they mention icludes the following (from the AAP site):

...

Other candidates to be considered for targeted screening include ...children with iron deficiency...
Bolding mine to point out: now we've come full circle, haven't we? The commonly recommended blood test at 12 months is for both lead *and* iron levels...how do you find the children with iron deficiency without blood testing them? Oh, the irony.
post #140 of 160
H aI totally wouldn't think that even if it were the recommendation. I decline a lot of things that are recommend like vaxes, erythromycin, and vit k at birth.

And of course we don't lead test here.
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