At least 25 percent of American homes were built before 1978 and may contain lead-based paint (LBP). LBP degrades into fine, virtually invisible lead dust that children can ingest and/or inhale. Because most children do not exhibit discernible physical symptoms of lead poisoning, routine screenings at an early age (12 and 24 months) are essential to healthy brain development.
While the CDC stresses that there is no safe blood lead level for children, the lead reference level is 3.5 µg/dL. An initial lead screening that reveals a BLL of 3.5 or greater should trigger a second, confirmatory venous test. If the second test also registers a BLL of 5 or higher, the child will receive nurse case management. Nurse case management works directly with the provider.
To stress, the CDC is emphatic in that there is no safe lead level. The 3.5 µg/dL reflects the 97.5th percentile of children screened for lead levels whose BLL is below that number (3.5). Based on NHANES, the reference level may drop as the nation’s lead programs succeed in protecting children from lead exposure. CDC YouTube video addresses this issue at: “Mission unleaded: How to test children for lead with maximum accuracy”.
No, however . . . . Head Start does have such a mandate for its pre-school aged students.
In the state of Tennessee, lead poisoning, for both children and adults, is a reportable condition, mandated by the Department of Health. The Reportable Disease Matrix outlines lead reporting requirements on page five. Health Care Provider List
If there is no documented record of a blood lead level, the child should undergo a capillary screening. Any time a parent/guardian answers “Yes” or “I don’t know” to any of the questions on the Risk Assessment Questionnaire, the child should be screened. Foreign-born children should be screened within 90 days of their arrival in the United States and again three to six months after their arrival.
If a provider tests onsite using a LeadCare II device, that practice is responsible for reporting its results to University of Tennessee Extension via their online LeadIn reporting system. Those pediatric offices that draw capillary blood samples and send them to a laboratory for analysis do not report; rather, the laboratory is responsible for sending those results. In either case, all test results must be submitted.
Yes! Most children are exposed to lead in their own home or that of a close relative, meaning that all children in a given family may have elevated blood lead levels.
Yes – and no. Statistically, 95 percent of adults with lead poisoning are exposed in an occupational setting. Of the remaining number, most are exposed during home renovations. However, children are typically poisoned in their home, which they share with their parents. The hand-to-mouth behavior of children renders them vastly more susceptible to lead poisoning.
Parents may be exposed to lead due to their occupation. However, there are ways they can keep their home and family safe. Find out more from the CDC.
Yes, household pets can become poisoned in much the same manner as children. Cattle are also at high risk for lead poisoning, usually from contact with aging farm equipment left in their pastures. When old batteries deteriorate and leak, cattle may lick them and ingest lead.
Send an email to leadtrk@utk.edu, explaining the change you need made, or call UT Extension at 865-974-8744.
Yes! Several Tennessee practices operate on this screening schedule; however, a heel stick is the recommended capillary procedure for children under 12 months of age.
No, beyond an environmental investigation for qualifying patients with confirmed EBLLs, the program does not include testing services.
Chattanooga, Knoxville, and Memphis may have some very limited HUD funding for eligible residences, but, sadly, the general response is “No.”
The Department of Health’s Director of Pediatric Case Management, Amanda Ingram (Amanda.D.Ingram@tn.gov).
The Tennessee Childhood Lead Poisoning Surveillance Dashboard is now available with up-to-date lead poisoning data.
Absolutely, and it’s free! Email us at pbformdhelp@utk.edu