Lead Exposure Policy

The “Prevention of Childhood Lead Toxicity" policy statement lists the following recommendations for providers:  

1. Pediatricians are in a unique position to work with public health officials to conduct surveys of blood lead concentrations among a randomly selected, representative sample of children in their states or communities at regular intervals to identify trends in blood lead concentrations. These periodic surveys are especially important for children who live in highly contaminated communities, such as smelter communities or regions with a historically high prevalence of lead exposure. 
2. Pediatricians, heath care providers, and public health officials should routinely recommend individual environmental assessments of older housing, particularly if a family resides in a housing unit built before 1960 that has undergone recent renovation, repair, or painting or that has been poorly maintained. 
3. Pediatricians and public health officials should advocate for the promulgation and enforcement of strict legal standards based on empirical data that regulate allowable levels of lead in air, water, soil, house dust, and consumer products. These standards should address the major sources of lead exposure, including industrial emissions, lead paint in older housing, lead-contaminated soil, water service lines, and consumer products. 
4. Pediatricians should be familiar with collection and interpretation of reports of lead hazards found in house dust, soil, paint, and water, or they should be able to refer families to a pediatrician, health care provider, or specialist who is familiar with these tools. 
5. Pediatricians, women’s health care providers, and public health officials should be familiar with federal, state, local, and professional recommendations or requirements for screening children and pregnant women for lead poisoning. 
6. Pediatricians and other primary care providers should test asymptomatic children for elevated blood lead concentrations according to federal, local, and state requirements. Immigrant, refugee, and internationally adopted children also should be tested for blood lead concentrations when they arrive in the United States because of their increased risk. Blood lead tests do not need to be duplicated, but the pediatrician or other primary care provider should attempt to verify that screening was performed elsewhere and determine the result before testing is deferred during the office visit. 
7. Pediatricians and other primary care health providers should conduct targeted screening of children for elevated blood lead concentrations if they are 12 to 24 months of age and live in communities or census block groups with ≥25% of housing built before 1960 or a prevalence of children’s blood lead concentrations ≥5 μg/dL (≥50 ppb) of ≥5%. 
8. Pediatricians and other primary care providers should test children for elevated blood lead concentrations if they live in or visit a home or child care facility with an identified lead hazard or a home built before 1960 that is in poor repair or was renovated in the past 6 months.
9. Pediatricians and primary care providers should work with their federal, state, and local governments to ensure that a comprehensive environmental inspection is conducted in the housing units of children who have blood lead concentrations ≥5 µg/dL (≥50 ppb) and that they receive appropriate case management.