LAMP: A CDC Program to Ensure the Quality of Blood-Lead Laboratory Measurements

Abstract

Laboratories participating in the CDC's LAMP program can accurately measure blood lead using the current Clinical Laboratory Improvement Amendments of 1988 guidance of ±4 μg/dL or ±10%, with a success rate of 96%. However, when we apply limits of ±2 μg/dL or ±10%, the success rate drops to 89%. When challenged with samples that have target values between 3 and 5 μg/dL, nearly 100% of reported results fall within ±4 μg/dL, while 5% of the results fall outside of the acceptability criteria used by the CDC's LAMP program. As public health focuses on lower blood lead levels, laboratories must evaluate their ability to successfully meet these analytical challenges surrounding successfully measuring blood lead. In addition proposed CLIA guidelines (±2 μg/dL or 10%) would be achievable performance by a majority of US laboratories participating in the LAMP program.