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M D Lewin

Publications and source records attributed to M D Lewin.

2 recordsLinked to original sources
PubMed2006

The BeLPT: algorithms and implications.

BACKGROUND: The beryllium lymphocyte proliferation test (BeLPT) is used to identify persons with beryllium sensitization. The variability of laboratory results and lack of a "gold standard" have led to questions about the test's performance. Fortunately, a recently published study has credibly estimated standard epidemiologic parameters for the BeLPT. METHODS: Information from this recent study was used to assess the performance of two common algorithms for BeLPT testing. Standard epidemiologic parameters were determined for two common algorithms and then compared. RESULTS: One of the two algorithms was more sensitive than the other (86% vs. 66%). The specificity of both algorithms (99.8% or greater) was high. At an estimated 2% prevalence, the positive predictive value of both algorithms for beryllium sensitization remained high (90% or higher). CONCLUSIONS: A priori characterization of the testing algorithm under consideration can enhance public health decision-making.

Algorithms↗
PubMed1999

A multivariate linear regression model for predicting children's blood lead levels based on soil lead levels: A study at four superfund sites.

For the purpose of examining the association between blood lead levels and household-specific soil lead levels, we used a multivariate linear regression model to find a slope factor relating soil lead levels to blood lead levels. We used previously collected data from the Agency for Toxic Substances and Disease Registry's (ATSDR's) multisite lead and cadmium study. The data included the blood lead measurements (0.5 to 40.2 microg/dL) of 1015 children aged 6-71 months, and corresponding household-specific environmental samples. The environmental samples included lead in soil (18.1-9980 mg/kg), house dust (5.2-71,000 mg/kg), interior paint (0-16.5 mg/cm2), and tap water (0.3-103 microg/L). After adjusting for income, education of the parents, presence of a smoker in the household, sex, and dust lead, and using a double log transformation, we found a slope factor of 0.1388 with a 95% confidence interval of 0.09-0.19 for the dose-response relationship between the natural log of the soil lead level and the natural log of the blood lead level. The predicted blood lead level corresponding to a soil lead level of 500 mg/kg was 5.99 microg/kg with a 95% prediction interval of 2. 08-17.29. Predicted values and their corresponding prediction intervals varied by covariate level. The model shows that increased soil lead level is associated with elevated blood leads in children, but that predictions based on this regression model are subject to high levels of uncertainty and variability.

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