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• no cause for concern (<10 mcg/dl)
• higher than normal, but does not require medical treatment (10-44 mcg/dl)
• possibly harmful and requires medical treatment (>45 mcg/dl)

• A fingerstick screening lead level of 10-15 mcg/dl or higher, must be repeated by testing blood obtained from a vein in your child's arm (venipuncture).
• Even if blood from a vein is tested, a score of 20 mcg/dl or higher must be repeated (within several days) by a second venipuncture blood test.
• Remember: A venipuncture requires taking blood from your child's arm and although most children do not like this, it is not painful.

• The child lives in or regularly visits a house or structure with peeling or chipped paint that was built before 1960, including day care centers, preschools, or homes of baby sitters and relatives. Most paint manufactured before 1960 contained lead.
• The child lives in or regularly visits a home that is being renovated and was built before 1960.
• The child has a brother, sister, housemate, or playmate who is being followed or treated for lead poisoning.
• The child lives with an adult whose job or hobby involves exposure to lead. Examples of such jobs or hobbies include furniture refinishing, making stained glass, making pottery, using indoor firing ranges, and working in industries such as automotive repair, bridge, tunnel, and elevated highway construction.
• The child lives near an active smelter, battery recycling plant, mine tailing pile, or other industry likely to release lead.
• The child receives medical treatment for removal of a foreign body from the ear, nose, or stomach.
• The child has the habit of swallowing nonfood substances known as pica.
• The child is less than 6 years old and has an unexplained developmental delay, hearing defect, irritability, severe attention deficit, violent tantrums, or unexplained anemia.
• The child lives in a neighborhood at high risk for lead poisoning (identified by zip code).

For children 6 to 36 months of age who are at LOW risk for HIGH dose lead exposure: an initial blood lead (PbB) test at 12 months of age and as follows:

• If PbB test result: <10 mcg/dl retest at 24 months.
• If PbB test result: 10-14 mcg/dl, retest every 3 to 4 months. After 2 consecutive measurements are <10 ug/dl or three are <15 ug/dl, retest child in one year.
• If PbB test result >15 mcg/dl, get the local health department involved and retest every 3 to 4 months.

For children 6 to 36 months of age who are at HIGH risk for HIGH dose exposure, an initial PbB test at 6 months of age and as follows:

• If PbB test result is <10 mcg/dl, rescreen every 6 months. After 2 subsequent consecutive measurements are <10 mcg/dl or three are <15 mcg/dl, testing frequency can be decreased to once a year.
• If PbB test result 10-14 mcg/dl, rescreen child every 3 to 4 months. After 2 subsequent consecutive measurements <10 mcg/dl or three are <15 mcg/dl, testing frequency can be decreased to once a year.

For children 36 to 72 months of age:

• Children who are determined to be high risk and have not been screened, a blood lead level should be performed.
• All children who have had venous blood lead tests >15 mcg/dl or who are a high risk, should be screened at least once a year until their sixth birthday (age 72 months) or later, if indicated (e.g. developmentally delayed with pica).
• Children should also be screened any time history suggests exposure has increased.

Check the following lists to determine if your child may be exposed to lead. The only way to determine the actual lead exposure is by having a blood lead test done.

Have any of the following activities occurred at your residence within the last year?

• Sanding wood floors
• Sanding or dry scraping painted surfaces
• Tearing down old plaster walls
• Removing painted woodwork
• Weatherizing windows
• Dry sweeping carpet or loose paint chips
• Replacing windows
• Wearing dirty work clothes around the house or in the car
• Washing work clothing with other clothing
• Any type of paint removal or furniture repair
• Gardening or yard work with children
• Cleaning air conditioning or heating duct work
• Smoking cigarettes

Do Your Children:

• Chew on or pick at painted objects, woodwork, or plaster?
• Chew on varnished woodwork?
• Eat or play with cigarette butts or ashes?
• Chew on or play with fishing sinkers or lead toys?
• Eat comic books, newsprint, colored paper or magazines?
• Play with or eat soil or loose dirt?
• Chew on objects that may be dirty or painted?
• Eat or play with loose paint chips in the window wells?
• Play or sleep with pets that go outside and get their coats dirty?

• Paint: The most common source of lead exposure for children is lead-based paint. This paint was also used on some older toys and furniture. Lead was finally banned from house paint in 1978. Three quarters of all houses built before 1960 contain lead-based paint. When paint chips or peels, young children can pick up these particles and chew them.
• Dust: More commonly, children swallow dust and soil contaminated with lead paint. Home remodeling and sanding especially, put a great deal of lead powder into dust and soil. Be aware of remodeling being done near your home.
• Soil: may have lead in it from exterior lead paint chips and dust, lead-based insect sprays and highway pollution (due to past use of lead in gasoline).
• Food: Food may be contaminated if it is:
• grown in soil that contains lead
• stored in poorly glazed pottery
• kept in open cans with lead seams
• kept in lead crystal prepared by someone who has lead dust on his or her hands.
• Air: The almost complete phasing out of leaded gasoline in the U.S has markedly reduced the amount of lead present in the air from automobile exhaust.
• Folk Remedies and Cosmetics Containing Lead:
• Hispanic: azarcon, greta, alarcon, coral, rueda, liga, Maria Luisa
• Asian: pay-loo-ah, chuifong tokuwan, ghasard, bali goli, kandu, hau ge fen
• Middle Eastern/Indo-Pakistani: maha yogran guggulu, surma, kohl, alkohl, saoot, satrinj, bint dahab
• Occupational and Recreational Lead Sources:
• Metal welders, cutters, shipbreakers, bridge and highway construction workers
• Lead smelter workers, refiners and miners
• Storage battery manufacturers, repairers and recyclers
• Painters, construction workers (sanding, scraping, spraying, demolition of lead-painted sites)
• Auto radiator repairers
• Firing range instructors or enthusiasts, shot or bullet makers or recasters
• Plumbers, solderers, wire and cable workers, type founders, auto mechanics and factory workers
• Potters, glazers, enamelers, artists, stained glass makers (occupational and hobbiest)
• Home and furniture repairers, remodelers (occupational and hobbiest)
• Manufacturers of rubber products or electronics, jewelers, pipefitters, printers
• Workers with high exposure to lead gasoline exhaust fumes (rare in US today)
• Water: may pick up lead as it flows through plumbing with lead pipes, fixtures or solder. Lead is found in low levels in some drinking water because lead-based solder on old water pipes may add lead to water. Lead-based solder was not banned for use with water pipes until 1986.

• if your plumbing has lead pipes or copper pipes with lead solder and particularly if water sits in these pipes for several hours, allowing lead to dissolve into the water.
• if your home is more than five years old or has soft or acidic water (Some home treatment devices may also make water more corrosive.)

• When water stands in pipes more than a few hours, "flush" each cold-water faucet by letting the water run for two or three minutes.
• Flushing the toilet, showering or doing laundry with cold water will also move water through the plumbing system. This can reduce the amount of time needed to flush cold water faucets from up to three minutes to 30 seconds or less.
• Do not cook with or drink water from the hot water faucet. Especially avoid using hot tap water for making baby formula.

• Make sure your child is not exposed to peeling paint. Pay special attention to windowsills.
• Rinse your child's hands and face before he/she eats.
• Rinse toys and pacifiers frequently.
• If your child sucks his/her thumb or fingers, rinse his/her hands frequently.
• Wet-mop your hard surface floors using a high phosphate detergent, like dishwasher soap. (mix 2 tablespoons of high phosphate detergent in one gallon of water).
• Close off rooms that are being remodeled and provide good ventilation (creates lead dust that adds to the total amount of lead in house dust).
• If you have leaded paint on the outside of your house, keep lead dust from being tracked into your house. Have a washable mat at each door entry so everyone who enters wipes his or her feet. If the soil around your house is definitely contaminated with lead, have a rule that people take off their shoes before coming into your house.
• If the soil around your home is contaminated with lead, replace it or plant bushes next to the walls so children cannot play there.
• Keep children away from deteriorating areas, loose paint, holes in the wall, and bare soil.
• The ground cover should act as a barrier between the child and the contaminated soil. This cover can be disrupted by dogs digging holes. Provide fenced areas and deep sand pits for dogs to dig.
• Do not store food or drink in pottery that may not have been fired correctly.
• Make sure that your child is not being exposed to lead through contact with adults who have occupations or hobbies that involve lead.
• If you need water for cooking or for preparing formula, use only water from the cold water tap. If the water has not been used for several hours, let the water run for 2 minutes before you use it. (Lead dissolves more in warm water or standing water.) If you are concerned, have your water tested for lead.

• Good sources of Iron include: lean red meats, chicken, fish, leafy green vegetables (spinach, broccoli, and beet greens), dried beans (peas and lentils), dried fruit (raisins, prunes and apricots) and iron-enriched breads and cereals.
• Good sources of Calcium include: milk, orange juice fortified with calcium, cheese, yogurt, leafy green vegetables (turnip and collard greens), kale, salmon and sardines.
• Decrease fats and oils by avoiding the following foods:
• fried food such as french fries, fried chicken and potato chips
• pastry, cakes, and other baked goods
• butter, oil, and lard
• hamburgers, bologna, salami, and bacon (fatty meats)

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