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Standard of Care on Screening for Childhood Lead Poisoning

State regulations impose specific responsibilities on doctors, nurse practitioners and physician's assistants doing periodic health care assessments on children between the ages of 6 months and 6 years. This is an unofficial summary of health care provider's responsibilities.

  • Provide oral or written guidance on lead poisoning at each periodic assessment from 6 months to 6 years.

  • Screen (order a blood test for) children in publicly supported programs at both 12 months and 24 months. Publicly supported programs include Medi-Cal, CHDP, Health Families, and WIC.

  • Assess whether children not in publicly supported programs are at risk of lead poisoning by asking "Does your child live in, or spend a lot of time in, a place built before 1978 that has peeling or chipped paint or that has been recently renovated?"

  • Order a blood test if the answer to the question is "yes" or "don't know".
If a child between the ages of 12 months and 6 years was neither tested nor asked the risk evaluation question at 12 and 24 months, the health care provider must do it as soon as he or she becomes aware it was not done at the appropriate time. The health care provider also should order a blood test if it appears a change in circumstances has put a child at risk.

This standard of care is a minimum. Any child may receive a blood lead test at the provider's discretion or at parental request.
The targeted screening regulation was developed in response to 1991-1994 NHANES data, which estimates that Medicaid enrollees accounted for 83% of U.S. children 1 to 5 years of age with blood lead levels of 20 µg/dL or more. Yet, 81% of young children in Medicaid had not been screened with a blood lead test. Low screening rates mean that most children with elevated lead levels are not identified and therefore do not receive appropriate treatment or environmental intervention.

If you have any comments or questions, please feel free to contact your local
Childhood Lead Poisoning Prevention Program, Childhood Poisoning Prevention Branch Hotline at (510) 622-5006 or contact the Childhood Lead Poisoning Prevention Branch directly at (510) 622-5000.

HERE to read the entire regulations or HERE to read the official version.
Last modified on: 1/24/2008 8:41 AM