- The CDC recommends that public health and clinical professionals focus screening efforts on neighborhoods and children at high risk, based on age of housing (built before 1950) and socioeconomic risk factors
- Public health and clinical professionals should collaborate to develop screening plans responsive to local conditions, using local data.
- In the absence of such plans, universal BLL testing is recommended.
- Jurisdictions should follow the Centers for Medicare & Medicaid Services requirement that all Medicaid-enrolled children be tested at ages 12 months and 24 months or at age 24–72 months if they have not previously been screened.
- Assess all children ages 6 months to 6 years at every well child visit for risk of lead exposure and obtain a blood lead test if the parent/guardian responds “Yes” or “I Don’t Know” to any of the questions listed below.
1. Does your child live in or regularly visit a building with potential lead exposure, such as peeling or chipping paint; recent or ongoing renovation or remodeling; or high levels of lead in the drinking water? Older dwellings (built before 1978) may have lead based paint. Consider day care, preschool, school, and homes of babysitters or relatives. Children with Medicaid, those entering foster care, and recently arrived refugees are at higher risk for lead toxicity.
2. Has your child spent any significant time outside the U.S. in the past year? All children born outside the U.S. and children visiting other countries for extended periods of time should be tested upon arrival or return to the U.S. due to higher lead risk in many countries.
3. Does your child currently have a sibling, housemate, or playmate with an elevated blood lead level, and your child has not been tested?
4. Does your child have developmental disabilities and/or exhibit behaviors that puts him/her at higher risk for lead exposure? Young children and children with developmental disabilities (autism spectrum disorder and Down syndrome) may have behaviors that place them at higher risk for lead exposure. These may include: pica; putting nonfood items (e.g., fingers, toys, jewelry, keys, or soil) in their mouth; mouthing painted surfaces; any behaviors that disturb painted surfaces.
5. Does your child have frequent contact with an adult whose job or hobby involves exposure to lead? An adult may bring home lead from a job or hobby, such as house painting; plumbing; construction; auto repair; welding; battery recycling; lead smelting; jewelry, stained glass or pottery making; fishing (lead in sinkers); making or shooting firearms; and collecting lead or pewter figurines.
6. Does your family use traditional medicine, health remedies, cosmetics, powders, spices, or food from other countries? Lead can be in items such as Ayurvedic medicines, alkohl, azarcon (Alarcon, luiga, rueda, coral), greta, litargirio, ghasard, pay-loo-ah, bala goli, Daw Tway, and Daw Kyin; cosmetics including kohl, surma, and sindoor; and some candies and products from other countries, particularly Mexico.
7. Does your family cook, store, or serve food in crystal, pewter, or pottery from other countries? Lead exposure risk from pottery is higher with old, cracked/chipped, and painted china and in pottery from other countries particularly from Latin America or Asia. Also, imported samovars, urns, and kettles could be soldered with lead.