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 LeadCare II analyzer, 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.

Accessing Your Patients' Blood Lead Test Results

New Users: Please sign the Provider Confidentiality Agreement and fax to 802-863-7483 or email to AHS.HealthyHomes@vermont.gov.

Patient Profile, commonly called the Immunization Registry, is an application that is a confidential, web-based system that provides a means for collecting and sharing data related to immunizations as well as results of childhood hearing screening, newborn metabolic screening, blood lead screening, and developmental screening.

Access to the Blood Lead Program will allow you to view patient records or run reports:

  • Individual Patient Record – provides a complete history of reported blood lead results for a patient
  • Screening Tests Needed Report – lists patients in your practice who are due or overdue for their 12-month or 24-month lead tests, and patients between the ages of 36 and 72 months who have never had a lead test
  • Venous Follow-Up Tests Needed – lists patients in your practice who need venous confirmation tests and those who are in case management

The Health Deaprtment uses a user-controlled password system called Password Central. This system was created to ensure system security and compliance with HIPAA regulations. Participating in Password Central is required, so we encourage you to sign up as soon as possible. Enrollment should take less than five minutes. Use the link below, and enter your username and current password to enroll in Password Central.

launch password central

***If you have any questions regarding your current username or password, please contact the Agency of Digital Services Service Desk at (toll free) 855-828-6620, option 1.***
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.

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).