Physical Health

Lead Screening: Well-Child Health Care Fact Sheet

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Lead screening detects the risk for lead poisoning by measuring the amount of lead in the blood. Lead poisoning can cause serious injury to children. Health managers, staff, and disability coordinators can review this sheet for basic facts about lead and lead screening. Staff may find it useful in supporting positive health and developmental outcomes for children.

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What Is Lead Screening?
Lead screening measures the level of lead in the blood. Lead is a poison that is very dangerous for young children because of their small size and rapid growth and development. It can cause anemia, learning difficulties, and other medical problems.

Children can inhale or swallow lead through exposure to:

  • Home or child care environments, including those:
    • Built before 1960 with peeling paint or renovation
    • Located near a highway or lead industry
  • Family members who work with lead or have been treated for lead poisoning
  • Imported ceramic pottery for cooking, storing, or serving food
  • Home remedies with lead
  • Certain candies, which may contain high levels of lead in the wrapper or stick. Be cautious when providing imported candies to children.
  • Eating paint chips or dirt
  • Water pumped through lead-based pipes

How Is Lead Screening Done?
Lead screening involves a blood lead test, from a finger stick or a venous blood draw.

When Should Lead Screening Be Done?
Many states require blood lead screening at 12 months and 24 months of age. This requirement is a part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) schedules. As of 2012, states may apply for a waiver to transition to targeted screening through the Centers for Medicare and Medicaid Services (CMS). States may apply for this waiver if there is sufficient data to support it. Children from 3 to 6 years of age should have their blood tested if they have not been tested before and:

Lead test tube

  • Are Medicaid-eligible
  • Live in or regularly visit a house built before 1950
  • Live in or regularly visit a house built before 1978 with ongoing or recent renovations or remodeling
  • Have a sibling or playmate who has or had lead poisoning

Follow-up to Lead Screening
New recommendations from the Centers for Disease Control and Prevention (CDC) state that if screening indicates a lead level of five micrograms per deciliter or more, the child should be referred to a health professional.

What Can Families Do to Help Prevent Lead Exposure?
Lead poisoning can cause serious health and developmental problems in young children. Eliminating the source of lead and treating the child can improve their health and developmental outcomes. Below are considerations programs can discuss with families that may be exposed to lead.

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  • Determine the construction year of the house or the dwelling where your child spends a large amount of time (e.g., grandparents or daycare). In housing built before 1978, assume that the paint has lead unless tests show otherwise.
  • Talk to your state or local health department about testing for lead in paint and dust from your home. Make sure your child does not have access to peeling paint or chewable surfaces painted with lead-based paint. Use only lead-free containers, cookware, or tableware to store or cook foods or liquids. Immediately remove recalled toys and toy jewelry from children. Use only cold water from the tap for drinking, cooking, and making baby formula. If the water is contaminated, use bottled or filtered water instead.
  • Children and pregnant women should not be present in housing built before 1978 that is undergoing renovation. They should not participate in activities that disturb old paint or in cleaning up paint debris after work is completed.
  • Create barriers between living/play areas and lead sources. Until an environmental clean-up is completed, you should clean and isolate all sources of lead. Close and lock doors to keep children away from chipping or peeling paint on walls. You can also apply temporary barriers such as contact paper or duct tape, to cover holes in walls or to block children’s access to other sources of lead.
  • Regularly wash children’s hands and toys. Hands and toys can become contaminated from household dust or exterior soil. Both are known lead sources.
  • Regularly wet-mop floors and wet-wipe window components. Because household dust is a major source of lead, you should wet-mop floors and wet-wipe horizontal surfaces every two to three weeks. Window sills and wells can contain high levels of leaded dust. They should be kept clean. If feasible, windows should be shut to prevent abrasion of painted surfaces or opened from the top sash.
  • Take off shoes when entering the house to prevent bringing lead-contaminated soil in from outside.
  • Shower and change clothes after finishing a task that involves working with lead-based products (e.g., stained glass, pottery glazing, jewelry making).
  • Prevent children from playing in bare soil; if possible, provide them with sandboxes. Plant grass on areas of bare soil or cover the soil with grass seed, mulch, if possible.
  • Eat right. The amount of lead the human body retains can be reduced if your diet includes plenty of foods that contain iron, calcium, and zinc.

What Symptoms Might I Observe?
Most children with lead poisoning show no symptoms. However, you might notice:

  • Developmental delay
  • Learning Difficulties
  • Irritability
  • Headaches
  • Poor appetite or stomachache
  • Weight loss
  • Fatigue and sluggishness
  • Slow growth and development
  • Vomiting
  • Constipation
  • Hearing loss

Lead exposure treatment may include:

  • Nutrition counseling
  • Iron supplements
  • Medication to remove the lead from the blood
  • Follow-up testing of the child's blood
  • Referral for developmental testing

Treatment options are determined by a child’s pediatrician and a child’s blood-level level.