Screening For Elevated Blood Lead Levels

Lead, a heavy metal, is toxic to the human body. Individuals exposed to lead may experience an elevated blood lead level, which often does not manifest itself until the damage is done. Lead is a silent menace and can permanently damage the developing brains and other organs of young children, including those still in the womb. Serious effects can include lowered intelligence, behavior disorder, and slowed physical development.

Deteriorated lead-based paint in the home environment is the primary source of lead exposure in Indiana. Young children and pregnant women, who are most vulnerable to the effects of lead poisoning, pick up lead dust from the floor and ingest it through hand-to-mouth activity. In recent years, other sources of lead exposure have drawn increased scrutiny, including soil, water and consumer products imported from countries that have few restrictions on the use of lead, such as pottery, traditional remedies, children’s toys or inexpensive jewelry. In Indiana, lead paint still presents the most common source of lead exposure. Any child living in a house built prior to 1978 may be at risk of lead exposure if there is lead-based paint in the home. The older the home, the more likely there is lead paint.

The Indiana State Department of Health (ISDH) would like to remind healthcare providers that all patients under the age of 72 months should be screened for lead exposure using the risk assessment below. A blood lead test should be administered to those who fall in the high risk category. Medicaid requires that all children eligible for or covered under Medicaid receive a blood lead test at 9 months, 12 months, and 24 months of age. Pregnant women also should be screened if they have risk factors as noted below, per the American College of Obstetricians and Gynecologists (ACOG):

Elevated lead levels in pregnancy have been associated with gestational hypertension, spontaneous abortion, low birth weight, and impaired neurodevelopment. Risk assessment of lead exposure should take place at the earliest contact with pregnant or lactating women, and blood lead testing should be performed if a single risk factor is identified.

Administering a blood lead test is the only way to assess whether or not a child has been exposed to lead hazards in their environment.

Read the full ISDH memo here (PDF file).