Lead Poisoning Prevention Guidance for Health Care Providers

Blood Lead Test

The Healthy Homes Lead Poisoning Prevention Program works with health care providers to ensure that all children are tested for lead. Vermont law requires that all children are tested for lead at 12 months and 24 months.

Criteria for Testing Asymptomatic Children

These criteria are for testing asymptomatic children at well child visits and do not apply to children previously or currently lead poisoned:

  • Test all children at 12 months and 24 months.
  • Test all children ages 36 to 72 months who have not been previously tested.
  • For refugees: test all children ages 6 months to 16 years old upon entry to the U.S. Perform a follow-up blood lead test on all refugee children ages 6 months to 6 years within three to six months, regardless of initial test result.
  • Other at-risk populations: International adoptees, immigrants, children of migrant workers, children in foster care, and children diagnosed with pica or special health needs that increase hand-to-mouth behavior.

Review the Pediatric Blood Lead Testing and Case Management Guidelines
View the Pediatric Blood Lead Testing Flowchart—from initial test through clinical treatment

Confirmation of Capillary Blood Lead Tests

Capillary levels at or above 5 µg/dL (micrograms per deciliter) need to be confirmed by venous sampling. The Health Department provides education and initiates case management for venous confirmed elevated blood lead levels. The higher the capillary test result, the more urgent the need for a confirmatory venous test. It is preferable to confirm as early as possible.

Capillary Blood Lead Levels Confirm with Venous Test Within
5 – 9 µg/dL 1 – 3 months
10 – 44 µg/dL 1 week – 1 month
45 – 59 µg/dL 48 hours
60 – 69 µg/dL 24 hours
70+ µg/dL Immediately as an emergency test
Other Indications to Test for Lead

Blood lead testing should be considered part of a diagnostic work-up of any child, regardless of age, with any of the following symptoms:

  • Developmental problems/delays or behavioral problems—such as aggression, hyperactivity, attention deficit, school problems, learning disabilities, excessive mouthing or pica behavior, or other behavior disorders
  • Ingestion of an object that may contain lead
  • Symptoms or signs consistent with lead poisoning—including irritability, headaches, vomiting, seizures or other neurological symptoms, anemia, loss of appetite, abnormal pain, cramping or constipation
Reporting Requirements for Blood Lead Test Results

All blood lead results on Vermont residents are required by state law to be reported to the Vermont Department of Health. Most analytical laboratories report directly to the Health Department.

If you have a Lead Care II machine, you are required by state law to report all blood lead results on Vermont residents to the Health Department. Please call the Healthy Homes Lead Poisoning Prevention Program at 802-863-7220 or 800-439-8550 (toll-free in Vermont) for more information and procedures on how to report results.

Lead Resources for Health Care Providers
Title Description
Pediatric Blood Lead Testing & Case Management Guidelines

Review Health Department guidelines for blood lead testing and case management procedures from the initial blood lead test through clinical treatment for venous confirmed blood lead levels ≥ 5 µg/dL.

Pediatric Blood Lead Testing & Case Management Guidelines Flowchart

This visual guide outlines testing and case management procedures from the initial blood lead test through clinical treatment for venous confirmed blood lead levels ≥ 5 µg/dL.

Vermont Immunization Registry (IMR) Access the Vermont Immunization Registry to view your patients' blood lead test results. Complete the Confidentiality Agreement (below) to gain access to the Lead Tab.
Vermont Immunization Registry (IMR) Access and Confidentiality Agreement

Fill out this form to gain access to the Lead Tab of the Vermont IMR. Be sure to check the "Blood Lead" box, and email the completed form to AHS.HealthyHomes@vermont.gov.

Blood Lead Analysis and Sample Collection Resources

Check this resource sheet for options available to health care providers for blood lead testing and analysis.

Capillary Blood Lead Specimen Collection Instructions

View instructions on how to prepare, collect and submit a capillary blood lead sample to the Health Department Laboratory.

Blood Lead Testing Medicaid Payment Guidelines

Learn how to code blood lead testing for Medicaid.

Lead Poisoning Prevention Guidance for Parents

This web page has a variety of information and resources for parents on sources of lead, lead poisoning prevention, lead testing and lead-safe practices.

Lead in Paint

This fact sheet for parents has information on how to find out if a home has lead-based paint and how to reduce a child’s risk of lead poisoning.

Lead in Soil

This fact sheet for parents has information on possible sources of lead in soil, how to test soil for lead, and how to protect children.

Lead in Drinking Water

This web page has information about lead in drinking water and how to test for it and a fact sheet for parents.

Lead and Your Job: What Adults Should Know About Lead Poisoning

This fact sheet is for a parent who works with lead and explains how to reduce occupational lead exposure and how to reduce a child’s exposure to "take home" lead.

Poster: Lead-Free Kids for a Healthy Future

Display this 11x17 poster that outlines keeping homes lead-safe, testing children for lead, and getting the facts on lead poisoning in your office.

Pregnancy and Lead Poisoning This fact sheet has information on the health effects of lead on pregnant women and fetuses, how to protect fetuses before birth, and possible lead exposures.
Blood Lead Exposure Risk Assessment for Pregnant and Breastfeeding Women Use this brief questionnaire when assessing lead risks for pregnant women.
Lead Hazards and Lead Poisoning Refer to this web page for information on potential lead exposures.
Lead Poisoning Prevention

This fact sheet for parents is on the basics of lead poisoning prevention.

Blood Lead Testing and Reporting Rule Refer to this rule for requirements on when to test for lead and how to report blood lead test results.
Your Child's Lead Test This fact sheet for parents explains the difference between capillary and venous lead tests, what the result means, and what to do when they receive the result.
Resources for Refugees and New Americans

Fact Sheets

We offer Arabic, Nepali and Somali translations of these materials: Lead Poisoning Prevention, Your Child's Lead Test, and Finding Lead in Your Home.

Videos

We offer Healthy Homes: Prevent Lead Poisoning videos in Arabic, Nepali and Somali.

Read the Childhood Lead Poisoning Prevention Reports to the Legislature

VT Tracking logo
Explore Vermont Childhood Lead Poisoning Data


questions?

Call the Healthy Homes Lead Poisoning Prevention Program at 802-863-7220 or 800-439-8550 (toll-free in Vermont).