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Lead-Safe Wisconsin: Pediatric Lead Testing and Reporting

Children are at risk for lead poisoning when they’re exposed to lead hazards, often lead dust or lead-based paint in homes and child care centers built before 1978.

Lead poisoning doesn’t typically cause noticeable symptoms. The only way to know if a child has experienced lead poisoning is through a blood lead test.

Three children laying on their belly in the snow smiling.

Fewer kids received blood lead level testing during COVID-19

A 2021 report from the CDC (Centers for Disease Control and Prevention) found that many children in Wisconsin missed their recommended blood lead testing during the height of the COVID-19 pandemic. The number of kids in the state who were tested dropped 75% from April 2019 to April 2020.

Wisconsin is working with primary care providers to improve blood lead testing, so we can identify and help more kids poisoned by lead.

See data on the number of kids in Wisconsin tested each year, by age.

The Wisconsin Blood Lead Screening Recommendations (PDF) encourage health care providers to test children who are at the greatest risk for lead poisoning. In the cities of Milwaukee and Racine, testing for all children is recommended.

Children living in the cities of Milwaukee and Racine

Universal testing of children in the cities of Milwaukee and Racine is recommended because of the large number of old houses in those cities. The recommendations say each child should have a blood lead test three times before they turn 3—at 12 months, 18 months, and 24 months.

Children ages 3 through 5 should be tested each year if they meet one or more of the following criteria:

Children living outside the cities of Milwaukee and Racine

Health care providers should use the four questions below when deciding whether a child who lives outside the cities of Milwaukee and Racine is at risk for lead poisoning and needs to be tested.

The “Four Easy Questions” include:

  1. Does the child live in or visit a house built before 1950 (including child care centers and homes of friends or relatives)?
  2. Does the child live in or visit a house or building built before 1978 that’s recently undergone or currently undergoing renovations (including child care centers and homes of friends or relatives)?
  3. Does the child have a sibling or playmate with lead poisoning?
  4. Is the child enrolled in Medicaid or WIC?

Blood lead level testing locations

Talk with your health care provider about getting a blood lead test for your children. If you do not have a healthcare provider, contact your local health department or WIC clinic to discuss their available services for blood lead testing.

Information for parents on blood lead testing

Information for health care providers on blood lead testing

According to the Centers for Medicare & Medicaid Services, all Medicaid children are considered at high risk for lead poisoning. That’s why there is a federal rule requiring children enrolled in Medicaid to receive blood lead testing. It’s part of the program’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT, also known as HealthCheck) services.

Children in Medicaid must receive a blood lead test at 12 months and 24 months. If they’re older than 24 months—and up until they turn 6—they must receive a blood lead test if they don’t have a record of a previous test.

Children enrolled in Medicaid in Wisconsin are three times more likely to be lead poisoned than children who don’t have Medicaid. Children from low-income families in Wisconsin are at greater risk for lead poisoning—largely because they have limited housing options. If all children on Medicaid receive age-appropriate testing, it is likely that additional children will be identified as lead poisoned and have access to the interventions they need.

Data on testing for children in Medicaid

The Wisconsin Medicaid Program works with the Wisconsin Childhood Lead Poisoning Prevention Program (WCLPPP) to collect data on blood lead testing and lead poisoning among children in Medicaid. Despite the testing requirement, the data show that many Wisconsin children enrolled in Medicaid are not tested at the correct ages.

According to the 2021 data:

1-year-olds
Total enrolled: 27,354
Total tested: 16,971
Percent tested: 62%

2-year-olds
Total enrolled: 35,707
Total tested: 13,840
Percent tested: 39%

3- to 5-year-olds not tested previously
Total enrolled: 26,518
Total tested: 2,492
Percent tested: 9%

The Wisconsin Blood Lead Registry, or Lead Registry, is a web-based tool that lets primary care providers and other health care professionals check a child’s blood lead testing history online at any time. The Lead Registry is linked to the Wisconsin Immunization Registry and updated with new blood lead test results each week by the WCLPPP. That includes tests performed at all locations, including WIC and Head Start sites, and doctors’ offices.

The Lead Registry can help health care providers easily identify children who haven’t been tested for blood lead poisoning or are due for a follow-up test.

If your organization would like access to the Lead Registry, choose someone to be your site administrator. That person should complete these forms:

Your site administrator will need to fill out one user agreement form for each person who wants Registry access. When they’re finished, they can email the completed forms to DHSLeadPoisoningPrevention@dhs.wisconsin.gov or fax them to 608-267-0402.

For more information about the Lead Registry, email pamela.campbell@dhs.wisconsin.gov or call 608-267-3901.

State law Wis. Stat. § 254.13 (PDF) requires all blood lead test results on Wisconsin residents be reported to DHS. For specific requirements, like the timetable and form, read Wis. Admin. Code ch. 181 – Reporting of Blood Lead Test Results (PDF).

The WCLPPP implements the reporting rule through a lab-based system. It also works directly with labs to make sure all results are reported.

Under Wis. Admin. Code ch. 181 – Reporting of Blood Lead Test Results (PDF), health care providers are responsible for sending complete demographic information to the lab with each blood lead sample. This lets the lab include the demographics in their reports.

Health care providers that perform onsite blood lead testing using LeadCare II are responsible for reporting results to the WCLPPP. You can use the Blood Lead Lab Reporting form, F-00017 in these cases or something similar for reporting.

For more information on reporting blood lead test results for children, email DhsLeadPoisoningPrevention@dhs.wisconsin.gov or call the WCLPPP at 608-266-5817. For more information on reporting results for adults, email dhsocchealth@dhs.wisconsin.gov or call 608-266-1120.

Last revised July 11, 2023