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Lead Poisoning Information
for Healthcare Providers
In Illinois, the Lead Poisoning Prevention Act and Lead Poisoning Prevention Code requires that any physician treating children aged 6 months through 6 years must screen or test children for lead exposure before entering childcare, preschool, or kindergarten. IDPH also recommends, evaluation and testing for pregnant persons.
Evaluating Children Aged 6 or Younger
When to screen or test
Physicians and care providers must evaluate all children aged 6 or younger for lead poisoning using the Childhood Lead Risk Questionnaire.
Childhood Lead Risk Questionnaire
Physicians and care providers must conduct a blood lead test for any child who:
- has a “yes” or “I don’t know” answer on the Childhood Lead Risk Questionnaire
- lives in a designated high-risk ZIP Code
- who is Medicaid-eligible
The Illinois Department of Public Health (IDPH) recommends children meeting criteria for testing be tested at 12 and 24 months (see IDPH Childhood Blood Lead Evaluation and Testing Recommendations). It is important to reassess annually in case a family has relocated to another home.
How blood should be drawn
The most reliable measure of a child’s blood lead is a venous test (see CDC Lead Testing Recommendations).
- Capillary draws may be used for screening, with the understanding that a capillary specimen can be contaminated by lead dust from a child’s hands.
- CDC does not recommend using a filter paper test, as it also can be contaminated by environmental lead.
- All capillary and filter paper results of ≥5 μg/dL should be repeated using a venous test collected into a lead-free tube.
If a child has an elevated lead level, what should a healthcare provider do next?
The CDC recommends that providers conduct medical evaluation including the following:
- Detailed history of symptoms, existence of pica, siblings with lead poisoning, potential sources of lead and previous blood lead results
- Description of age and condition of all housing where the child spends time
- Assess exposures to renovation in housing
- Occupational histories of adults in the household to determine if the child is exposed to lead brought home from the workplace
- Physical examination, with special attention to neurologic, psychosocial and language development.
- Learning or developmental delays should prompt further assessment and referrals to appropriate programs
- Evaluation of nutritional status, especially of calcium and iron
Children with higher BLLs may need chemical treatment. The U.S. Food and Drug Administration approves the use of succimer (Chemet®) for treating children with BLLs greater than 45 μg/dL. These children need to be monitored more closely for at least one year until the BLL decreases. They should be seen by a physician every other week for eight weeks, then once a month for six months.
Additionally, healthcare providers should:
- Educate parents on the meaning of the BLL and potential health effects.
- Discuss proper nutrition.
- Refer patients to other agencies to provide additional services.
When should lead-poisoned children be retested?
Follow-up testing should take place, according to the IDPH recommendations on lead level.
CCDPH Lead Intervention Services
For children with elevated blood lead levels (≥5 μg/dL)
The CCDPH Lead Poisoning Prevention case management program works to limit the negative effects of elevated lead for a child exposed or poisoned by lead. For children with blood lead levels ≥5 μg/dL, first an initial home visit is conducted by a CCDPH Public Health Nurse with a CCDPH Environmental Lead Inspector. CCDPH Public Health Nurses will collaborate with primary care providers about medical issues and follow-up activities.
Follow-up activities may include:
- home assessment
- education of care providers
- referral for primary health care including treatment of the elevated lead
- nutrition counseling
- developmental screening
- referral for Early Intervention (EI) services
- tracking of blood lead levels to ensure adequate treatment
Lead Poisoning and Pregnancy
Lead can be transferred to a mother’s unborn baby if she is exposed to lead during pregnancy. Lead exposure during pregnancy can lead to premature birth, low birth weight, or delayed or slowed growth. Lead also puts the baby at risk for miscarriage.
Prenatal Lead Risk Questionnaire
For more information on how to prevent, reduce and/or eliminate the harmful effects of lead for pregnant women, review the resources below:
- Lead Poisoning and Pregnancy: Understanding Risks and Preventing Harm Presentation
- IDPH: Lead Poisoning Prevention – Pregnancy and Lead
- IDPH Lead & Pregnancy Fact Sheet (English | Spanish)
How to report lab results to IDPH
- Any test ≥5 μg/dL must be reported to IDPH within 48 hours of
- All tests under 5 μg/dL must be reported to IDPH within 30 days of the last day of the month that the test was administered.
- Providers should confirm with their lab that they electronically report all results to IDPH.
- If the state lab processes the test results, then providers do not need file duplicate reports.
- Ultimately, the provider is responsible for reporting and must ensure that all lead reports are submitted to IDPH.
Lead Poisoning Prevention Materials
Updated October 25, 2023, 12:40 PM
