About Lead: Screening & Testing

Talk to your child’s primary care provider or contact the local health agency about getting a simple blood test to check for lead exposure. Your primary care provider can help decide whether a blood lead test is needed and can also recommend appropriate follow-up actions.Your medical insurance care manager can also help connect you to a primary care provider if you don’t have one.

Lead is a toxic metal that can harm a child’s growth, behavior, and ability to learn. A blood lead level tells you how much lead is in your child’s blood. Most lead exposures occur when children lick, swallow, or breathe in dust from old lead paint.

Children living in high risk zip codes (which includes all of the City of Cleveland), and children insured by Medicaid, should be tested at age 1 and 2 years, at least once before the age 6. This is required by law. In addition, children who do not meet these criteria should be tested if there is a clinical suspicion of lead exposure based on additional risk factors that can be assessed by a primary care provider. It is worth noting that children who have recently moved to the United States from abroad, especially refugees, should be tested.

Children of all ages who are recent immigrants, refugees, or adoptees should be screened and tested at the earliest opportunity. 

Your primary care provider can assess the need to test older children for lead poisoning based on specific environmental risk factors.

In Cleveland, the most common sources of lead exposure are related to paint and soil in older homes in children with hand to mouth behaviors. Elevated blood lead levels that continue into school-a​ge are unusual and a relatively low blood lead level in a school-aged child does not exclude earlier lead poisoning. This helps to explain why a blood lead test in a school aged child who has difficulty with learning or behavior is not confirmatory – earlier lead poisoning may have been a factor contributing to the child’s current symptoms, even if the child does not currently have elevated lead levels. Hence the importance of timely preventive steps to get blood lead level tested at age 1 and 2 for the high risk population. 

Adults should not routinely be tested for lead. There may be exceptions for some occupational or other risk factors for lead exposure, which can be discussed with your primary care provider. 

Pregnant women should talk to their doctor about exposure to sources of lead. The most important step expectant parents can take to prevent lead poisoning is to find and safely remove lead hazards in their home.

Providers of primary care for children play a key role in the detection of lead poisoning as well as counseling to prevent lead exposure, connecting families to early intervention and supportive services and advocating for public health measures to address the problem. Your child’s primary care provider  will order blood lead testing at 1 and 2 years of age (for all children residing in the city of Cleveland, other high risk zip codes, or insured by Medicaid), will coordinate follow up testing if needed, and assess risks to determine whether it is necessary to test at other times. Your primary care provider can also discuss ways to prevent lead exposure and to protect against the harms of lead exposure – for example, by providing optimal nutrition in your child’s diet and by providing sources of enrichment and support to help your child grow, develop, and learn.

Having blood drawn can be scary, but parents and caregivers can help create a calm environment and build confidence for the child.

Empower yourself: Prior to the appointment, discuss your concerns and questions with their doctor. This can help you have peace of mind about the testing process.

Set realistic expectations: Do not pretend the experience will be painless. Instead of promising that a finger stick or blood draw won’t hurt, reassure your child that the process will be quick, the pain won’t last, and you’ll stay close. 

Schedule wisely: Schedule the test at a time when your child is less likely to be tired or hungry. Eating beforehand will help decrease any chance of lightheadedness. The only exception to eating prior to the appointment is if test requires fasting—in which case, it can help to schedule first thing in the morning, and bring a snack for afterward.

Communicate beforehand: You know your child best. Talking about feelings or practicing calming techniques before the appointment can help. Make a game of staying still. Teach your child to inhale for three seconds and then exhale. Breathing exercises help your child feel in control of his or her body and helps make it easier to draw.

Offer a distraction: During a blood draw, help get your child’s mind—and eyes—off the procedure. If watching would be too stressful for them, distract him or her from staring at the needle.

Go with the flow: Drinking plenty of water is important for blood tests. Unless specially instructed by his or her doctor, encourage your child to drink water before the visit.  Drinking water hydrates veins, which can help make a blood draw easier.

You can’t guarantee the experience will be totally pain free for your child. However, these tips will help increase your chance of an experience that will build confidence.