Blood Lead Screening Guidelines
- Criteria for Testing Asymptomatic Children
- Confirmation of Capillary Blood Lead Tests
- Other Indications to Screen for Lead
- Blood Lead Testing & Reporting Rule
Criteria for Testing Asymptomatic Children
These criteria are for testing asymptomatic children at well child visits and do not apply to children previously or currently lead poisoned.
Test all children at 12 months and 24 months.
Test all children ages 36 to 72 months who have not been previously tested.
Children of Refugees: Perform a lead test on all children of refugees ages 6 months to 16 years old upon entry to the United States. A follow-up test should be performed 3 to 6 months following entry to the United States on all children 6 months to 6 years.
Other at risk populations: Children of migrant workers and children with special health needs that increase hand-to-mouth behavior.
Confirmation of Capillary Blood Lead Tests
Capillary levels ≥10 µg/dL should be confirmed by venous sampling.
Medicaid requires this confirmation test.
| Capillary Blood Lead Levels | Confirm Within |
|---|---|
| ≤ 9 µg/dL | Not recommended |
| 10 – 19 µg/dL | 2 weeks |
| 20 – 44 µg/dL | 1 week |
| 45 – 69 µg/dL | 24 – 48 hours |
| 70+ µg/dL | Immediately as an emergency test |
The Vermont Department of Health provides education for all blood lead levels ≥5 µg/dL and case management for venous confirmed blood lead tests ≥10 µg/dL.
Other Indications to Screen for Lead
Blood lead testing should be considered part of a diagnostic work-up of any child, regardless of age, with any of the following symptoms.
- Developmental problems/delays or behavioral problems such as aggression, hyperactivity, attention deficit, school problems, learning disabilities, excessive mouthing or pica behavior or other behavior disorders
- Ingestion of an object
- Symptoms or signs consistent with lead poisoning including irritability, headaches, vomiting, seizures or other neurological symptoms, anemia, loss of appetite, abnormal pain and cramping or constipation
Notes
All blood lead results must be reported to the Vermont Department of Health. Most analytical laboratories report directly to the Department.
Contact the Health Department's Childhood Lead Poisoning Prevention Program at 800-439-8550 or 802- 652-0357 to confirm that your laboratory reports all results or for other questions relating to lead poisoning.