Laboratory Work Group Charge
1. Proficiency Testing (PT) Limits
The Laboratory Work Group (WG) will address whether Blood Lead proficiency testing (PT) acceptability limits should be more stringent than the current Clinical Laboratory Improvement Amendments of 1988 (CLIA ‘88) standard of ±4 µg/dL or ±10% (whichever is greater) and if so, what they should be.
The WG should draft a letter from the ACCLPP to the appropriate federal agency recommending that a change in CLIA ‘88 regulations be implemented that would tighten the minimum acceptable PT limits for blood lead.
2. Practice Standards for Point of Care Lead testing
The WG should address the need for recommended standards of practice for those using point of care blood lead testing.
3. Alternative matrices for assessing exposure to lead
The WG should investigate and report to the ACCLPP on the efficacy, reliability and validity of measuring lead in saliva as an index of lead exposure. To a lesser extent, the WG should investigate report to the ACCLPP on the reliability and validity of measuring lead in other non traditional matrices such as sweat, hair, nails and packed red cells as indices of lead exposure.
4. Environmental lead analytical issues
The WG should investigate and report back to the ACCLPP on the reliability of current technologies for assessing the lead content of paint, plastics and other environmental samples, laboratory capacity and capability for handling.
5. Reference intervals for adult lead exposure
The WG should investigate and report back to the ACCLPP on how clinical laboratories should report the reference interval for adult lead exposure. Currently, many labs report <30 µg/dL, <20 µg/dL as “normal” for adult blood lead levels.
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