Lead Screening: What You Need to Know
- Lead Screening Protocols for Children Under Age 6 Years
District law requires that all children receive 2 blood lead tests before age 3. District law also requires additional testing under certain specific circumstances. (See screening questionnaire below)
- Did you know?
More than 25% of high blood lead levels are identified on the second test, and not on the first.
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Age of Child |
Required Testing |
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1 |
Between 6 to 14 months. |
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2 |
Between 22 and 26 months. |
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3 |
As needed according to screening questionnaire. |
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4 |
As needed according to screening questionnaire. |
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5 |
As needed according to screening questionnaire. |
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Blood Levels( μg /dL) |
Status of Blood Level |
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<5 μg /dL |
97.5% of children, age 5 and below, fall in this category. Note that any lead is potentially harmful. |
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≥5 μg /dL |
CDC considers this an indication of an unusual lead exposure that can cause adverse health effects and developmental delays. |
Testing Methods
Look at the chart below to learn more about the preferred specimen collection.
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Form of Collection |
Characteristics |
Reporting Duties |
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Venous |
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All results must be reported to DDOE, including in-house tests |
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Capillary (includes Lead Care 2 unit) |
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All results must be reported to DDOE, including in-house tests |
Remember: The higher the capillary screening result, the more urgent the need for a venous confirmatory test.
Diagnostic Blood Lead Testing
Blood lead testing should also be considered part of a standard diagnostic work-up of any child, regardless of age, who presents the following symptoms:
- Behavioral problems: aggression, hyperactivity, attention deficit, school problems, learning disabilities, excessive mouthing or pica behavior and other otherwise unexplained disorders.
- Developmental problems: growth, speech and language delays and/or hearing loss.
- Symptoms or signs consistent with lead poisoning: irritability, headaches, vomiting, seizuresor other symptoms of neurological disorders, anemia, loss of appetite, abdominal pain, and cramping or constipation.
Confirmatory Testing Schedule
Any capillary screening blood lead level equal to or greater than 10 μg/dL must be confirmed with a venous sample. The table below outlines the confirmatory venous schedule based on the initial screening result.
Important Note: Because lead levels ≥ 45 µg/dL are associated with lifelong injury and critical health outcomes, such initial test results must be followed by a retest within 24 hours.
If result of capillary test (μg /dL) is: Perform confirmatory test on venous blood within:
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If the capillary test result is |
Perform confirmatory test on venus blood within: |
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(Public Health Action Level) 5-9 μg /dL |
1 week |
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10-19 μg /dL |
3 days |
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20-44 μg /dL |
1 day |
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≥45 μg /dL |
Immediately as an emergency lab test |
Screening Questionnaire:
Use this questionnaire to determine who needs to receive a lead screening. [If any boxes are checked, then a lead screening should be provided on the same day.] Follow-up questions may be needed to further clarify responses.
If desired, forward the completed questionnaire along with any questions to the District Department of the Environment.
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Yes |
Screening Questions |
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Has your child recently lived in or regularly visited a home, child care or other building built before 1950? |
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Has your child recently lived in or regularly visited a home, child care or other building built before 1978, with recent or ongoing painting, repair and/or remodeling? |
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Is your child enrolled in or attending a Head Start program? |
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Does your child have a brother, sister, other relative, housemate or playmate with lead poisoning? |
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Does your child spend time with anyone that has a job or hobby that may involve working with lead? Examples: painting, home remodeling, auto radiators, batteries, auto repair, soldering, making sinkers, bullets, stained glass, pottery, going to shooting ranges, hunting or fishing. |
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Do you have pottery or ceramics made in other countries or lead crystal or pewter that are used for cooking, storing or serving food or drink? |
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Has your child ever taken any traditional home remedies or used imported cosmetics? Examples: Azarcon, Alarcon, Greta, Rueda, Pay-loo-ah, or Kohl |
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Has your child been adopted from, lived in or visited another country in the past two years? |
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Do you have concerns about your child’s development or behavior? |
A lead test should be performed if any boxes have been filled to indicate “Yes”.
