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Blood Lead Testing for Young Children

Lead exposure is dangerous to children. Lead is toxic and can severely affect their development. It can affect almost every organ and system in a child’s body. It can cause anemia, learning disabilities, hyperactivity, hearing problems, and other health problems.

This resource is about testing blood to screen for lead exposure. Staff may use this resource to understand and meet lead screening guidelines.

What is blood lead testing?

Lead exposure risk

Some social determinants of health are connected to a higher risk of lead exposure. Children are more likely to be exposed to lead if:

  • They live in older rental homes or areas with older plumbing.
  • Their families have lower incomes.
  • They have family members whose work or hobbies expose them to lead.

A blood lead test is the best way to find out if a child has been exposed to lead. Blood lead tests measure how much lead is in a person’s blood — this is their “lead level”.

Head Start programs can play a key role in identifying lead exposure to promote children’s health and development. Every young child who is Medicaid-eligible should be screened for lead exposure with a blood lead test so they can get help as early as possible.

Why is blood lead testing important?

Even low levels of lead can cause long-term harm to a child’s development, learning, and behavior.

Children younger than age 6 have the highest risk for lead poisoning. Preventing lead exposure is essential for children’s health and school readiness.

How is lead testing done?

Lead testing is usually a blood test. Most often, the blood test is a small prick on a fingertip to get a few drops of blood.

When should lead testing be done?

Every state’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) schedule requires blood lead testing for children at 12 months and 24 months old.

Children who are 24 months to 72 months old must be tested if they have no record of a lead test and:

  • Are Medicaid-eligible
  • Live in or regularly visit a building built before 1978, especially if the building has had recent renovations, is being remodeled, or has paint that is in poor condition.
  • Have a sibling or playmate who has or had lead poisoning
  • Have a family member or caregiver with a job or hobby that uses lead

What happens after testing?

There are no safe levels of lead in the blood. Programs should encourage families to work with their health care provider if lead is detected in their child’s blood.

The harm from lead poisoning cannot be reversed. But, if the lead exposure is found early, medication may lower the lead level and improve health outcomes. A health care provider can do more evaluation and provide treatment if needed.

Treatment for lead exposure may include:

  • Advice and resources to help find and get rid of the source of lead to prevent more exposure
  • Nutritional counseling for suggestions about foods that can reduce the amount of lead absorbed into the body
  • Iron supplements
  • Ongoing monitoring of lead levels
  • Referral for developmental testing and monitoring over time to identify concerns and intervene as soon as possible

How can we meet EPSDT lead screening requirements?

Partner with Children’s Health Care Providers

Tell medical providers that all children in Head Start programs must meet the EPSDT requirements for Medicaid-eligible children. Work with each child’s health care provider to get lead tests for all Head Start children.

Strengthen Community Partnerships

Work with your Health and Mental Health Services Advisory Committee (HMHSAC) to contact and build relationships with local health care providers. Ask for providers’ help sharing your Head Start program’s mission and the need for EPSDT screening with their colleagues. Your local health department and state, territorial, or Tribal WIC agency may have more resources to get families access to lead testing.

Work with Your Head Start Collaboration Office

Contact your Head Start Collaboration Office to find and contact pediatric primary care providers and community organizations to do lead testing. They often partner with state agencies and state-wide groups, such as the American Academy of Pediatrics and childhood lead poisoning prevention programs.

Find Resources from Federal Agencies

Get information from federal government agencies that have resources on lead testing, such as:

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