If a child's blood lead level is:

Management

Comment

<10 µg/dL (capillary or venous)

Follow routine screening chart.

Test high-risk children at the ages of 12, 18, 24, 36, 48, and 60 months.

Test low-risk children at the ages of 12 and 24 months.

Not considered lead-poisoned.

10-14 µg/dL (capillary or venous)

Retest within 3 months until two tests <10 µg/dL or three tests <15 µg/dL.

Provide information regarding appropriate nutrition and cleanliness, including safe removal of paint chips and dust.

>15 µg/dL (capillary)

Confirm with a venous blood lead test as shown below:

• 15-19 within 2 weeks
• 20-44 within 1 weeks
• 45-69 within 2 days
• >70 immediately

Refer to dietician for nutritional evaluation.

Environmental investigation by public health agency after two venous levels of 15-19.

Contact public health agency at 1-800-972-2026 to determine if environment is lead-safe.

15-19 µg/dL (venous)

Venous retest within 3 months.

Refer to dietician for nutritional evaluation.

Environmental investigation by public health agency after two venous levels of 15-19.

Contact public health agency at 1-800-972-2026 to determine if environment is lead-safe.

20-44 µg/dL (venous)

Pediatric evaluation.

Venous retest in 4-6 weeks.

Test for iron deficiency.

At 25-44, may consider oral chelation if environment is lead-safe and blood lead level persists in this range.

Refer to dietician for nutritional evaluation.

Environmental investigation by public health agency.

Contact public health agency at 1-800-972-2026 to determine if environment is lead-safe.

45-69 µg/dL (venous)

Pediatric evaluation.

Test for iron deficiency.

Inpatient or outpatient chelation (consult experienced physician for guidance on chelation).

Refer to dietician for nutritional evaluation.

Environmental investigation by public health agency. Home must be lead-safe if child is present during and after treatment.

Contact public health agency at 1-800-972-2026 to determine if environment is lead-safe.

>70 µg/dL (venous)

Pediatric evaluation.

Test for iron deficiency.

Inpatient chelation (consult experienced physician for guidance on chelation).

Medical emergency – immediate treatment in pediatric intensive care unit.

Refer to dietician for nutritional evaluation.

Environmental investigation by public health agency. Home must be lead-safe before child returns home.

Contact public health agency at 1-800-972-2026 to determine if environment is lead-safe.