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Blood Lead Testing Of Children

A blood lead test is the only way to find out if a child has a high lead level. Most children with high levels of lead in their blood have no symptoms. Although lead hazards in pre-1978 housing are the most common risk to young children, lead can be found in many products and places.

A child’s risk of exposure changes rapidly as they become more mobile. One test does not rule out future exposure. It is very difficult to predict if a child has been exposed to lead by using a questionnaire.

The Iowa Department of Public Health recommends that all children in Iowa get a blood lead test at 1, 2 and 3 years of age.

Recommended Blood Lead Testing for Children 12, 24 and 36 Months of Age:

  • Collect a blood lead test every year, especially in the first three years of life
  • Assess a child’s need for a test at every visit, not just annual well child checks
  • Assume that if you don’t have a blood lead test result in the child’s chart for the past year, the child should be tested at the visit
  • If possible, collect the blood specimen in your office rather than referring the family to an off-site location
  • Set up reminders in the child’s medical chart or electronic medical record

Kindergarten Enrollment for Lead Screening

In Iowa, legislation requires all children entering kindergarten have at least one blood lead test.

House File 158 was passed in 2007, amended in 2008, and became effective July 1, 2008. This is referred to as “Mandatory Blood Lead Testing.” The Mandatory Blood Testing Rules can be found here.  Additional information regarding protocols for schools and IDPH to follow for the mandatory blood lead testing can be found here

Consider Blood Lead Testing for Children 36 to 72 Months of Age if the Child…

  • Had a prior elevated blood lead level or has a sibling with an elevated BLL
  • Lives in older, poorly maintained rental properties or moves often
  • Is low income or on Medicaid
  • Has a mental or behavioral disorder that increases mouthing
  • Has parents who are exposed to lead at work

For information about adult lead testing, visit the IDPH Adult Blood Lead web page.

Reference level

Experts now use a reference level of 5 micrograms per deciliter (µg/dL) to identify children with blood lead levels that are much higher than most children’s levels. This new level is based on the U.S. population of children ages 1-5 years who are in the highest 2.5% of children when tested for lead in their blood as part of the 2007-2008 and 2009-2010 National Health and Nutrition Examination Survey (NHANES*). CDC will assess the reference value every four years using the two most recent NHANES surveys. The reference level may change over time. The reference level should not be confused with action levels for case management of services provided under local CLPPP contracts or by the IDPH Lead Program.

*NHANES is a population-based survey to assess the health and nutritional status of adults and children in the United States and determine the prevalence of major diseases and risk factors for diseases.

Visit the IDPH Adult Blood Lead webpage for information about adult blood lead reference levels.

 Mandatory Blood Lead Testing in Iowa

In Iowa, legislation requires all children entering kindergarten have at least one blood lead level test.

Iowa House File 158 was passed in 2007, amended in 2008 and became effective July 1, 2008. This is referred to as “Mandatory Blood Lead Testing.” Additional information regarding protocols for schools and IDPH to follow for the mandatory blood lead testing can be found in the Resources section.

 

For more information on lead poisoning contact us at  1-800-972-2026 or online at Contact Us.