Lead Poisoning in Children - Part II: Screening Guidelines

Lead Poisoning in Children: Early Detection, Intervention and Prevention

Part II: Screening Guidelines

Part II Objectives:

Upon completion of Part II you will be able to:

  • Identify Minnesota C&TC Screening Guidelines
  • Identify correct procedures for BLL testing
  • List 3 risk factors for blood lead poisoning
  • Identify 2 prevention strategies
  • Discuss the role of nutrition in blood lead poisoning

C&TC/EPSDT

Blood lead testing is the only acceptable laboratory test for screening and confirming lead poisoning. Venipuncture is preferred for specimen collection, but capillary testing is acceptable if care is taken to properly clean and prepare the finger. Capillary samples are easier to contaminate because of the possibility of lead containing dust and dirt on the hand or under the fingernails.

All capillary BLLs of 5 mcg/dL or higher must be followed with a confirmatory venous test. The higher the capillary screening blood lead test result, the more urgent the need for a venous confirmatory test.

The Minnesota Child and C&TC Program Requirements for BLL test once at 12 months and once at 24 months of age. If a child (up to age 6 years) does not have a documented BLL screening, then a BLL must be done. The Lead Risk Assessment Questionnaire does not satisfy this requirement. View the C&TC Schedule of Age-Related Screening Standards.

The MDH Blood Lead Screening Guidelines for Minnesota were officially released in March 2000, and updated in March, 2011. It is recommended that providers obtain blood lead screening tests for

  • Children residing in specific geographic areas that have a high rate of elevated blood lead cases
  • Children matching specific demographic groups that have a high rate of elevated blood lead

These guidelines are endorsed by the Minnesota Medical Association (MMA), the Minnesota Chapter of the American Academy of Pediatrics (AAP), the Minnesota Academy of Family Physicians (MAFP), and BlueCross BlueShield BluePlus of Minnesota.

Pregnancy

In June 2004, MDH developed Blood Lead Screening Guidelines for Pregnant Women in Minnesota (PDF) which was updated in August 2015. It is designed to assist providers in screening and treating pregnant women for elevated blood lead levels, thus ensuring both the mother and her child receive interventions to reduce their lead exposure. These guidelines are endorsed by the Minnesota Chapter of the American College of Obstetricians and Gynecologists (ACOG).

The guideline has been sent to all the OB/GYN physicians, midwives, and nurse practitioners in Minnesota.



Go To >> Part II: Risk Assessment Guidelines