Lead Poisoning Prevention Guidance for Health Care Providers

Blood Lead Test

The Healthy Homes Lead Poisoning Prevention Program works with health care providers to ensure that all children are tested for lead. Vermont law requires that all children are tested for lead at 12 months and 24 months.

Find out more about the health effects of lead poisoning and potential lead exposures.

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.
  • For children of refugees: test all children, age 6 months to 16 years old, upon entry to the U.S. Within three to six months, a follow-up blood lead test should be performed on all refugee children age 6 months to 6 years, regardless of initial screening result.
  • Other at-risk populations: International adoptees, immigrants, children of migrant workers, children in foster care, and children diagnosed with pica or special health needs that increase hand-to-mouth behavior.

Read the Childhood Lead Poisoning Prevention Reports to the Legislature

Confirmation of Capillary Blood Lead Tests

Capillary levels at or above 5 µg/dL (micrograms per deciliter) need to be confirmed by venous sampling. The Health Department provides education and initiates case management for venous confirmed blood lead levels at or above 5 µg/dL.

Capillary Blood Lead Levels Confirm with Venous Test Within
5 – 9 µg/dL 3 months
10 – 44 µg/dL 1 month
45 – 59 µg/dL 48 hours
60 – 69 µg/dL 24 hours
70+ µg/dL Immediately as an emergency test

The higher the capillary test result, the more urgent the need for a confirmatory venous test.

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 that may contain lead
  • Symptoms or signs consistent with lead poisoning—including irritability, headaches, vomiting, seizures or other neurological symptoms, anemia, loss of appetite, abnormal pain, cramping or constipation
Reporting Requirements for Blood Lead Test Results

All blood lead results are required by state law to be reported to the Vermont Department of Health. Most analytical laboratories report directly to the Health Department.

If you have a Lead Care II machine, you are required by state law to report all blood lead results to the Health Department. Please call the Healthy Homes Lead Poisoning Prevention Program at (802) 863-7220 or (800) 439-8550 (toll-free in Vermont) for more information and procedures on how to report results.

Resources for Health Care Providers: Lead Poisoning Prevention, Testing, and Lead-Safe Practices
Title Description
Pediatric Blood Lead Testing Guidelines

These guidelines outline when to screen asymptomatic children for lead, when to confirm capillary blood lead tests, and other indications to screen for lead.

Flowchart: Pediatric Blood Lead Testing

A visual guide for testing and case management procedures from the initial blood lead test through clinical treatment for venous confirmed blood lead levels ≥ 5 µg/dL.

Pediatric Medical Case Management for Venous Confirmed Blood Lead Levels Retesting schedule and clinical treatment guidelines for venous confirmed blood lead levels ≥ 5 µg/dL
Health and Immunization Registry There is a page in the Health and Immunization Registry under an individual’s patient information where providers can view blood lead test results to make access to children’s lead results more efficient. The Confidentiality Agreement in this table must be completed for access.
Health and Immunization Registry Access and Confidentiality Agreement

To access the Lead section of the Health and Immunization Registry, providers must submit this agreement form. Email the completed form, checking the "Blood Lead" box, to AHS.HealthyHomes@vermont.gov

Blood Lead Analysis and Sample Collection Resources

A resource sheet to describe the options available to health care providers for blood lead testing and analysis.

Capillary Blood Lead Specimen Collection Instructions

Instructions on how to prepare, collect, and submit the capillary blood lead sample to the Health Department Laboratory.

Blood Lead Testing Medicaid Payment Guidelines

How to code blood lead testing for Medicaid.

Parent Education Materials

A variety of information and resources for parents on sources of lead, lead poisoning prevention, lead testing, and lead-safe practices.

Lead in Paint

A fact sheet on how to find out if your home has lead-based paint, what temporary measures can reduce your child’s risk of lead poisoning, and which solutions can reduce your family’s risk of lead poisoning.

Lead in Soil

A fact sheet on possible sources of lead in soil around your home, how to test your soil for lead, and how to protect children from lead in soil.

Lead in Drinking Water

Facts about lead in drinking water and how to test for it.

Lead and Your Job: What Adults Should Know About Lead Poisoning

A fact sheet on how adults can become exposed lead from their occupation, what types of jobs that lead can be found in, signs and symptoms of lead poisoning, how to reduce exposure, and how to reduce children’s exposure lead that may be taken home from the job.

Poster: Lead-Free Kids for a Healthy Future

An 11x17 poster to display in your office that outlines keeping homes lead-safe, testing children for lead, and getting the facts on lead poisoning.

Pregnancy and Lead Poisoning A fact sheet on the health effects of lead on pregnant women and their babies, how to protect babies before birth, and possible lead exposures.
Resources for Refugees and New Americans

Fact Sheets

We offer Arabic, Nepali, and Somali translations of these materials: Lead Poisoning Prevention, Your Child's Lead Test, and Finding Lead in Your Home.

Videos

We offer Healthy Homes: Prevent Lead Poisoning videos in Arabic, Nepali, and Somali.