To the Editor.
—The article on the utility of lead screening in Orange County by Gellert et al1 focuses attention on the importance of assessing the prevalence of elevated blood lead levels among children living in individual counties or localities. Until similar prevalence assessments are done in other geographic areas, the generalizability of the Orange County findings is difficult to ascertain. Basing screening decisions elsewhere on the Orange County data may be particularly unsuitable since few areas have as small a percentage of homes built before 1950 as does Orange County. Nevertheless, it is likely that new screening recommendations will eventually be developed that will be based on an assessment of the prevalence of elevated blood lead levels among children living in specific localities. Since the variability in the prevalence of elevated blood lead levels is great even within geographic regions,1,2 such an approach must be community based
Schaffer SJ. Screening Strategies for Lead Poisoning. JAMA. 1993;270(21):2555-2556. doi:10.1001/jama.1993.03510210041014