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Standard of Care on Screening for Childhood Lead Poisoning

State regulations impose specific responsibilities on doctors, nurse practitioners, and physician assistants doing periodic health care assessments on children between the ages of 6 months and 6 years. This is a brief summary of health care provider's responsibilities. These regulations apply to all physicians, nurse practitioners, and physician assistants, not just Medi-Cal or Child Health and Disability Prevention (CHDP) providers.

Anticipatory Guidance: At each periodic assessment from 6 months to 6 years.

  • Screen (blood lead test) GettyImages-515310348.jpg

    • Children in publicly supported programs* at both 12 months and 24 months.
    • Children age 24 months to 6 years in publicly supported programs* who were not tested at 24 months or later.
      * Examples of publicly supported programs include Medi-Cal, CHDP, and the Women, Infants, and Children Program (WIC).
  • Assess: If child not in publicly supported program

    • Ask: "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 remodeled?"
    • Blood lead test: If the answer to the question is "yes" or "don't know."
  • Other indications for blood lead test

    • Suspected lead exposure
    • Parental request
    • Recent immigrant from country with high levels of environmental lead
    • Change in circumstance has put child at risk of lead exposure

Follow-up: The Management Guidelines summarizes follow-up activities once a child is found to have an elevated blood level.

Why Assess and Screen?

If you have any comments or questions, please feel free to contact your local Childhood Lead Poisoning Prevention Program or contact the Childhood Lead Poisoning Prevention Branch directly at (510) 620-5600.

Read the entire code of regulations.

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