Interpreting and Managing Blood Lead Levels of Less than 10µ/dL in
Children and Reducing Childhood Exposure to Lead (Exit DHS, PDF, 337
KB) The authors of this paper, published in the journal of the American
Academy of Pediatrics, provide information to help clinicians understand
blood lead levels less than 10 μg/dL, identify gaps in knowledge concerning lead
levels in this range, and outline strategies to reduce childhood
exposures to lead. They also summarize scientific data relevant to
counseling, blood lead screening, and lead-exposure risk assessment.
The specific recommendations for clinicians are:
Understand the laboratory error range for blood lead
values and, if possible, select a laboratory that achieves routine
performance within ±2 μg/dL.
Obtain an environmental history on all children they
examine, provide families with lead-prevention counseling, and follow
blood lead screening recommendations established for their areas.
As circumstances permit, consider referral to
developmental programs for children at high risk for exposure to lead
and more frequent re-testing of children with blood lead levels
approaching 10 μg/dL.
In addition, clinicians should direct parents to
agencies and sources of information that will help them establish a
lead-safe environment for their children.
These same health care practices by clinicians listed
reiterated by the Centers for Disease Control and Prevention (CDC)'s Advisory Committee on Childhood Lead Poisoning
Prevention for children regardless of their blood lead level. In
January, 2010, the
recommended that CDC lower the reference level
(Exit DHS, PDF, KB) from 10mcg/dL to
accepted their recommendation (Exit DHS, PDF, KB)
and lowered the reference level to 5mcg/dL in May of
Screening for Elevated Blood Lead Levels (Exit
The American Academy of Pediatricians (AAP) delivered a policy statement
in 2005 that reiterates the
AAP Medicaid blood lead testing mandate (Exit DHS, PDF, 131 KB)
because most children with
lead poisoning are Medicaid recipients and most have not been tested.
Elevated Blood Lead Levels Among Young Children (Exit
DHS) Recommendations from the
Center for Disease Control Advisory Committee on Childhood Lead Poisoning
Prevention Program. It provides basic standards and principles of medical case
Developmental Surveillance and Screening of Infants and Young Children (Exit
DHS; PDF, 132 KB) Provides
recommendations for screening infants and young children and
intervening with families to identify developmental delays and
disabilities in the primary care setting to assure access to early
Protocol for Lead Poisoning (PDF, 22 KB)
Clinical management protocol developed by Dr. Margaret Layde,
Medical College of Wisconsin. Includes medical, public health and
environmental interventions for elevated blood lead levels.
Guidelines for Lead Exposure in Children (Exit
PDF, 1 MB) This statement reviews the pharmacology of
available chelating agents used for the treatment of severe lead
Public Health Departments Local Public Health
Departments perform follow-up to children with elevated blood lead
levels. The link provides contact information for local public
health department personnel.
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Page - Lead-Safe Wisconsin
October 03, 2014