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 Laboratory
Tests: Lead
Screening
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Childhood
lead poisoning is the most common environmental disease
in children younger than 6 years of age in the United States.
Lead
screening and prompt intervention in early childhood
help reduce the risk of learning disabilities, attention
deficits, hyperactivity, and behavioral disorders caused
by elevated lead levels.
For
more information, contact the DC Lead Poisoning Prevention
Division at (202) 535-2634
or 535-1394. |
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Periodicity
and Guidelines for Lead Screening |
The Standard
Medical Record Forms (SMRFs) summarize lead screening
periodicity and guidelines:
| All
Children require a lead test between 9 and 12 mos and at
24 mos. Medicaid-enrolled children aged 36-72 months require
a test unless previously tested; all other children 36-72
months require a test unless assessed as low lead risk.
Lead level of concern: greater than or equal to 10
ug/dL1 |
Screening
Guidelines
- The
DC Lead Poisoning Prevention Division requires venipuncture technique
for all blood lead samples.
- Send blood
lead samples to a recommended laboratory (see below).
- Confirm with
a venous blood sample any test result greater than or equal to
10 micrograms per deciliter (dl) of blood.
- If blood
lead level is greater than or equal to 10 micrograms/dl, screen
with a blood test at each preventive health visit through 6 years
of age.
- Continue
to assess risk and provide guidance on reducing lead exposure.
- Document
all test results and guidance in the child's medical record.
Lead
Risk Assessment and Health Education
Although lead
screening is mandatory in DC, it is important to assess possible
sources of lead in the child's environment and to educate families
on ways to reduce lead exposure. Use the following resource tool
to assess lead risk, then provide targeted health education.
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 Verbal
Lead Risk Assessment2
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- Has
your child been diagnosed with lead poisoning (elevated
lead level)?
- Are
there any children with a current or past history of
lead poisoning living in or regularly visiting your
home?
- Does
your child live in or regularly visit a home with chipping
or peeling paint?
- Does
your child eat dirt or cigarettes or fireplace ashes,
or chew on old metal or painted toys?
- Have
you seen your child chewing on paint chips or painted
surfaces (doors, railing, window sills, etc.)?
- Does
your child live in or regularly visit a home with recent,
ongoing, or planned renovations or remodeling?
- Do
you or any other adults in your home have a hobby that
involves lead (i.e., furniture refinishing, home renovations,
construction work, or automobile repairs)?
- Do
you regularly store food or liquid in pottery, ceramic
dishes, or previously opened metal cans?
- Does
(or did) your child regularly live in or visit a home
near an active lead smelting plant, battery recycling
plant, or industry likely to release lead?
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References
1 Language
taken from the back of DC HealthCheck Standard Medical Record
Forms Numbers 4-5.
Available online at http://www.brightfutures.org/healthcheck/resources/index.html#smrf
1 Risk
Assessment questions are based on Centers for Disease Control
and Prevention. 1997. Screening Young Children for Lead
Poisoning: Guidance for State and Local Public Health Officials. Atlanta,
GA: CDC. Available online at http://www.cdc.gov/nceh/programs/lead/guide/1997/guide97.htm
Resources
DC
Department of Health recommends sending blood lead samples to one
of two laboratories that participate in CDC's blood lead proficiency-testing
program:
- DC
Department of Human Services' Bureau of Laboratories
(202) 727-0557 (no charge for blood tests)
- Clinical
Laboratory at Children's Hospital National Medical Center
(202) 884-5355
For more information, contact the DC Lead Poisoning
Prevention Division at (202) 535-2634 or 535-1394.
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