BLL Test Results
(μg/dL) |
Venous
Confrmation Retest Within |
Recommended Actions based on BLL
|
Venous Retest
After Recommended Actions |
| < 3.5 |
None |
- Education on the sources and prevention of lead exposure
- Routine assessment focusing on iron and calcium intake
- Follow-up blood lead monitoring at recommended intervals
|
Retest according to
Blood Lead Screening Plan |
| ≥3.5 – 9 |
3 mo |
Above Actions, plus:
- Environmental exposure history to identify potential lead sources
- Refer to health department for environmental investigation of home
- Lab work: iron status, hemoglobin, hematocrit
- Discuss child’s diet and nutrition with focus on calcium and iron and refer to supportive services if needed (WIC)
- Developmental monitoring and referral to support services if needed
|
3 months for frst 2-4 tests
6-9 months after BLL are declining |
| 10 – 19 |
1 mo |
1-3 months for frst 2-4 tests
3-6 months after BLL are declining |
| 20 – 44 |
Within 2 Weeks |
Above Actions, plus:
- Complete history and physical exam
- Environmental investigation of home and refer for lead hazard reduction program
- Consider abdominal x-ray (if lead ingestion is suspected)
- Contact Pediatric Environmental Health Specialty Unit (PEHSU) or Nevada Poison Center (1-800-222-2222) for guidance
|
2 weeks-1 months for frst 2-4 tests
1-3 months after BLL are declining |
| ≥45 |
ASAP Within 48 hours |
Above Actions, plus:
- Complete history and physical exam with detailed neurological exam
- Perform abdominal X-ray and, if needed, bowel decontamination
- Consider hospitalization if lead-safe environment cannot be assured, or source of lead has not been identifed and further exposure possible
- Commence gastrointestinal decontamination or chelation therapy with consultation from medical toxicologist or pediatrician experienced in treating lead poisoning
|
Every 24 hours or as medically indicated |
