Lead Guidance for Providers

Frequently Asked Questions

Testing

IMPORTANT: Providers are required to report ALL Lead Tests. (Reportable Conditions information) 

 

TABLE 1.  Recommended time for venous blood test confirmation after receiving elevated capillary result (from CDC, 2022). 

Blood Lead Level (µg/dL)

Time to Confirmation Testing

≥3.5 – 9 

Within 3 months

10 – 19 

Within 1 month

20 – 44 

Within 2 weeks

≥ 45

Within 48 hours

If a patient receives a venous blood lead result at or above 3.5 µg/dL, a follow-up test should be administered.
 

TABLE 2. Recommended follow-up testing time after receiving an elevated blood lead level from a venous test (from CDC, 2022)

Blood Lead Level (µg/dL)

Follow-Up Testing and Re-testing

<3.5

Retest at 1 and 2 years old.

≥3.5 – 9 

3 months                              

10 – 19 

1-3 months

20 – 44 

2 weeks-1 month

≥ 45

As soon as possible

TABLE 3. Recommended clinical guidelines based on venous blood test results.

Blood Lead Level (µg/dL)

 

<3.5

Talk to patient and family about nutrition to ensure the child is getting enough iron, calcium, and vitamin C. Make sure the child gets screened based on Medicaid guidelines. 

≥3.5 – 19

Ensure child is getting enough iron, calcium, and vitamin C. Encourage other siblings to be tested. Schedule appropriate follow-up tests. If the child's first venous test results in a value equal to or greater than 10 μg/dL and less than 20 μg/dL, a second venous blood draw is needed. The second venous blood draw should be taken approximately three months following the first venous blood draw. If the second test results in a value at 10 μg/dL or higher, an environmental investigation of the child's home should be scheduled.

20-44

Perform complete history and physical exam, assessing for signs and symptoms of lead poisoning. Consider performing an abdominal x-ray to check for lead-based paint chips and any other forms of lead that may have been ingested.

≥ 45

Begin chelation therapy. Perform a complete physical and neurological exam. Perform an abdominal x-ray to check for lead-based objects ingested. If the patient exhibits signs or symptoms of lead poisoning (including confusion, weakness, seizures, coma, nausea, vomiting, and abdominal pain) admit them to the hospital.