Brush with lead poison - day 1: Interpreting Blood Lead Test Results Difficult

Submitted by Norm Roulet on Sat, 05/20/2006 - 00:46.
Sherwin Williams ISKO

My son just turned one and we had him lead tested - the pediatrician's office called to report the results are less than 3 micrograms per deciliter - no level of lead is safe, and 3 µg/dL is certainly harmful.

I asked the pediatrician to clarify the results - she confirmed the lab report indicated the results are less than 3 micrograms per deciliter, but she was not able to interpret the results beyond what was reported to her from Quest Labs, which do not specify if the result is 0 or between 0 and 3 µg/dL, so she suggested I call Quest directly to discuss the results.

When I called, a receptionist answers the call. I explained I needed clarification on some results and was transferred to Customer Service, went through their Automatic Call Distribution (ACD) system, and eventually reached a customer service representative, I told the attendant I was calling regarding my son's test results. The attendant looked up the name and told me that the results indicated lead level less than 3 micrograms per deciliter, as the pediatrician's office reported. I asked if the results indicated if the level was 0, or if it indicated it was above 0 but below 3 µg/dL. The attendant was not able to determine that from the results, but stated that lead levels below 10 µg/dL are safe so I shouldn't be concerned. I explained to the attendant that is incorrect, that there is no safe level of lead, and that I needed to know if the results indicated any level of lead in my son's blood at all, as I would need to determine the source immediately, and may need to move the child out of our apartment until that is determined.

The attendant put me on hold to talk to someone in diagnostics to see if more information was available and upon return to the call said the results provided by Quest were designed to report if results were less than 3 µg/dL, so the attendant could not therefore determine if my son had lead in his blood. Dissatisfied with all aspects of the results, explanation from the attendant, and what she reported learning from talking to diagnostics, I asked to speak to her supervisor. She at first refused but with serious insistence I was able to get her to escalate my inquiry.

Within an hour, I was contacted by Sylvia. Sylvia confirmed what I was told by the attendant, and my pediatrician, that the reported results did not specify whether there was lead in the blood at all... only that there was not lead in excess of 3 micrograms per deciliter. Sylvia also explained that anything below 10 µg/dL was safe, and not to worry about the results. I explained to her she is incorrect and asked to speak to someone in the diagnostics lab. She told me to have my physician call to talk to diagnostics, and refused to connect me with diagnostics directly, so I asked her to refer me to the director of her legal department, and made clear I was escalating this issue further until my questions are answered satisfactorily. Sylvia agreed to refer my concerns forward in the organization.

Todd, from diagnostics, called me within an hour - we had a bad connection and I returned his call within an hour. He was able to provide clarification. He explained that the test they use does not provide results for blood lead levels less than 3 micrograms per deciliter, so he couldn't tell if my son is lead poisoned, despite having tested his blood for lead. He also explained that EBLs below 10 µg/dL are safe, so I should not be concerned. I explained to him that is incorrect, and that I need to determine if my son had any lead in his blood, as I need to determine if the source is in our home vacate immediately. He confided he has two children and cares deeply about lead, so he was sincerely concerned. He was also clearly misinformed about the hazard of lead, continuing a pattern of misinformation provided by his organization to patients, parents and physicians.

He recommended I have my son tested independently, using a different technology. He explained Quest uses Graphite Furnace Particle Absorption, which was not adequate, and suggested finding a lab that provides ICP-MS testing ( Inductively Coupled Plasma Mass Spectroscopy), which is more accurate. He did not know what labs provide that testing.
Having a pretty clear understanding of the situation at Quest, and realizing the lead testing of my son so far had been worthless, I explained to Todd that throughout my interactions with Quest Labs I was misinformed about lead risks by Quest representatives, including in my discussion with him, and that they need to revise their script for customer service attendants, and need to update their lead poison knowledge. He accepted my criticism in a very constructive way, and agreed. He was very professional and empathetic. He suggested I speak with the director of diagnostics at Quest Labs, and I asked that the director call me - the director is out until Monday or Tuesday, so I will have more information about Quest after that discussion.

One other interesting issue raised when I was talking with Todd, from diagnostics, was that the attendant and supervisor and he should not have provided me with any test information about my son directly in the first place - that information should only be provided according to HIPPA. While I appreciated that I was provided this information, by customer service, the supervisor and Todd, because I need it to make important medical desicions, I told Todd I was surprised by the fact they provided me with test results over the phone, without asking for any information confirming my identity or relationship to the patient, I believe violating HIPPA. He agreed that should not have happened.

I'm sure I'll learn more about that when I speak further with Quest Labs, my pediatrician and others, in the days ahead. The next steps are to have my son and his mother retested by ICP-MS. Upon research on-line, I found Welcome to! They offer ICP-MS testing for metal - setup is $170 and the cost to test for 1 to 5 metals is $100 - you can test for 60 metals for $450. Read more here! I hope to be able to cut a deal with them so I can afford to test Claes and his mother and myself and several other family members who share households (e.g. grandparents), for 60 metals if possible - lead for sure. Also, we're going to go get lead test kits and test my home and the homes of the grandparents, because now my sense of awareness is greatly heightened and I want to know what is in my children's environment.

I'll keep REALNEO posted - tomorrow is day 2. Peace.

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