When should my child be tested for lead poisoning?


Written by Dr. Sara Connolly, MD, FAAP

Lead poisoning is one of the most common, preventable childhood diseases. The Centers for Disease Control and Prevention (CDC) estimates that there are at least 4 million U.S. households with young children exposed to lead, and as many as 500,000 children currently have dangerous blood levels of lead (defined as above 5 micrograms/dL).
To help identify children at risk of lead exposure, all children should be screened by their doctors at their one and two-year-old well-child visits. Universal blood screening is not recommended, but children who have any risk factors should have a blood test to determine blood lead levels. However, all children who receive Medicaid are required to have blood tests at 12- and 24-months of age.
A blood test is the only way to determine if dangerous levels of lead are present.
Your child is at highest risk for lead exposure if they live, attend school, or play in homes built before 1960, when lead was commonly found in paint and plumbing. Lead-based paint was banned in 1978.
Lead testing is done in the doctor’s office, at the health department or in a clinical lab. A blood sample is obtained by a finger stick or venous draw, and then analyzed to determine the blood lead level (BLL).
If the BLL is higher than 5 micrograms/dL, action should be taken to evaluate the child’s environment to reduce exposure and remove potential sources of lead. At higher blood levels, treatment to remove lead begins. There is no “safe” level of lead in the blood, although achieving zero BLL is difficult because lead is very common in the environment.
Parents are encouraged to learn about the lead risks both in their community and their workplace. Environments rich in lead products require special cleaning to avoid kicking lead dust into the air. Home renovations, including painting, should be completed by contractors certified in lead removal, and older homes should be tested by qualified experts before a renovation begins to determine if lead is present. Pregnant women and children should not live in a home with lead that is undergoing renovation.
Children exposed to lead may not show obvious outward symptoms. Lead poisoning can be chronic and result in widespread cognitive, behavioral, and developmental issues that emerge slowly and worsen over time. Lead screening is an important tool in helping prevent long-term or permanent damage.
·       All children should be regularly screened for lead exposure.
·       Children who may have been exposed to lead should have a blood test.
·       Blood levels in excess of 5 micrograms/dL are considered dangerous, although there is no “safe” blood level.
·       Blood tests are conducted with a simple finger prick, or venous draw.
1.     American Academy of Pediatrics. Detection of Lead Poisoning.
2.     American Academy of Pediatrics. Lead Exposure: Steps to Protect Your Family.
3.     Centers for Disease Control and Prevention. Preventing Lead Poisoning in Young Children.
4.     Centers for Disease Control and Prevention. Lead Levels in Children Fact Sheet

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