Lead Poisoning Information
for Healthcare Providers

When to screen or test

Physicians and care providers must conduct a blood lead test for any child who is aged 12 months and 24 months.

• Healthcare providers should report their blood lead test results to the Illinois Department of Public Health.
• For children who are older than 24 months, physicians must assess them with a Childhood Lead Risk Questionnaire.
• It is important to reassess children 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 ≥3.5 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

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.

CCDPH Lead Intervention Services

The Cook County Department of Public Health Lead Poisoning Prevention case management program works to limit the negative effects of elevated lead for a child exposed or poisoned by lead.

Here are the specific services we provide if a child has a blood lead level (≥3.5 ug/dl):

• A public health nurse and an environmental lead inspector will conduct an initial home visit.
• A public health nurse 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.

For more information on how to prevent, reduce and/or eliminate the harmful effects of lead for pregnant women, review the resources below:

• Prenatal Lead Risk Questionnaire
• IDPH: Lead Poisoning Prevention – Pregnancy and Lead
• IDPH Lead & Pregnancy Fact Sheet (English | Spanish )

How to report lab results to IDPH

• Any test ≥3.5 μg/dL must be reported to IDPH within 48 hours of
• All tests under 3.5 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 to 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

• Lead Fact Sheet (CCDPH) [English | Spanish]
• IDPH Lead & Pregnancy Fact Sheet [English | Spanish ]

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