Lead Safe Screening & Testing Program

As the region’s most trusted health improvement collaborative, Better Health Partnership (BHP) works to achieve exceptional health value while eradicating health disparities across Northeast Ohio.

BHP brings together health care, social services, and other sectors to share best practices and accelerate data-informed improvements in equitable population and community health.

CONTACT BHP:
5420 Lancaster Dr., Building C
Brooklyn Heights, OH 44131
216.250.1077
betterhealthpartnership.org
info@betterhealthpartnership.org

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 ages one (1) and two (2) years, or at least once before the age of six (6) as 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.

Elevated blood lead levels that continue in school-a​ge children 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.

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.

Talk to your child’s primary care provider or contact a 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 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.

While no amount of lead in the blood is safe, the U.S. Centers for Disease Control and Prevention (CDC) states that blood with 3.5 micrograms of lead per deciliter (µg/dL) or higher constitutes lead poisoning. 
Parents and caregivers should ask their doctor for the specific result of their child's last blood test, and should discuss with their doctor what the result means.

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

• Prior to the appointment, 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 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 the test requires fasting, in which case, it can help to schedule first thing in the morning, and bring a snack to eat afterward.

• Before the appointment, have your child drink plenty of water unless otherwise instructed by their doctor. Drinking water hydrates veins, which can help make a blood draw easier.

  Communicate with your child. 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 their body and make it easier to draw.

  Offer a distraction to help get your child’s mind—and eyes—off the procedure.

If your child’s test results reveal blood lead levels of 3.5 micrograms of lead per deciliter (µg/dL) or higher, testing may be repeated to confirm the results (if the initial test was performed by finger stick, a blood draw from a vein is required to confirm the level).

Children under three (3) years of age found to have confirmed blood lead levels of 5ug/dL or greater will result in a default automatic referral to early intervention support services. Any child found to have a blood lead level of 10ug/dL or higher triggers a lead investigation performed by the Ohio Department of Health or other local health department to determine the source of lead exposure. This includes a risk assessment of the child’s home, along with other places where the child spends a significant amount of time.

Your child’s primary care provider plays a key role in the detection of lead poisoning and can provide counseling to prevent lead exposure by connecting your family to early intervention and support services.

Your child’s primary care provider will order blood lead testing, 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 share ways you can protect against the harms of lead exposure. For example, providing optimal nutrition in your child’s diet.