Turning up the dirt on cholesterol screens.

Turning up the dirt in cholesterol screens

Shoppers who take a cholesterol test at the mall may not get what they bargained for. Many public cholesterol screenings are inaccurate, unsanitary and improperly conducted, according to a report released this week by Richard P. Kusserow, inspector general of the Department of Health and Human Services.

"Much of public cholesterol screening is tainted by staggering sloppiness, frequent indifference to infection control, and widespread use of untrained personnel employing improperly maintained or poorly calibrated equipment," says Rep. Ron Wyden (D-Ore.), who chairs the House Small Business Subcommittee on Regulation and Business Opportunities. Wyden's subcommittee is examining the safety and reliability of medical testing.

Kusserow's office gathered information on public cholesterol screening from all 50 states and the District of Columbia, and sent staffers to be tested at 71 such screenings. The staffers reported that public screeners often ignored operating recommendations from the National Cholesterol Education Program (NCEP). For instance, more than half the staffers said testers squeezed their pricked fingers rather than letting the blood flow out freely. "Milking" the finger can break down red blood cells or introduce extraneous material, yielding artificially low results, Kusserow notes.

Most staffers whose cholesterol readings surpassed 200--the borderline-high range--weren't told to see a physician, despite NCEP's recommendation that they should. Eight sites were dirty. A third of the testers didn't wear gloves when taking blood, even though many of these also handled money. Of those who wore gloves, only about half changed them between tests. And at more than half the sites, workers did not dispose of used lancets and needles in a container marked for biohazardous wastes.

"Given today's concern for the spread of AIDS and hepatitis, these findings are particularly disturbing," Kusserow says.

Wyden says a 1988 law requires cholesterol screeners to register with their states by 1991 and obtain licenses. Today, only 16 states regulate public cholesterol screening, Kusserow says.

In a statement released this week, the American Heart Association expressed concern about mass cholesterol screenings "that are not part of the medical care system." They may have limited value, according to the statement, because most people they reach are at low risk or already know their cholesterol levels. The association recommends a shift to smaller-scale screens conducted by health professionals at workplaces, schools and churches.