BLL Test Results
(μg/dL) |
Venous Confirmation -Retest Within | Recommended Actions based on BLL | Venous Retest –
After Recommended Actions |
< 5 | None | • Provide dietary counseling (calcium & iron) and environmental education
• Follow-up blood lead monitoring at recommended intervals |
Retest according to
Blood Lead Screening Plan |
5 – 9 | 3 mo | Above Actions, plus:
• Complete history and physical exam • Lab work: iron status, hemoglobin, hematocrit • Refer to health department for environmental investigation • Recommend lead hazard reduction in home • Neurological, behavioral, and developmental monitoring • Abdominal x-ray (if lead ingestion is suspected with bowel decontamination) • Environmental assessment to identify potential lead sources |
3 months for first 2 – 4 tests
6 – 9 months after BLL are declining |
10 – 19 | 1 – 3 mo | 1 – 3 months for first 2 – 4 tests
3 – 6 months after BLL are declining |
|
20 – 24 | 1 – 3 mo | 1 – 3 months for first 2 – 4 tests
1 – 3 months after BLL are declining |
|
25 – 44 | 2 wk – 1 mo | 2 weeks – 1 month for first 2 – 4 tests
1 month after BLL are declining |
|
45 – 59 | ASAP
48 hours |
Above Actions, plus:
• Environmental investigation of the home and lead hazard reduction • Oral chelation therapy • Consider hospitalization if lead-safe environment cannot be assured |
Every 24 hours
or as medically indicated |
Every 24 hours
or as medically indicated |
|||
60 – 69 | ASAP
24 hours |
||
≥ 70 | Stat as emergency test | Above Actions, plus:
• Hospitalize and commence chelation therapy in conjunction with consultation from a medical toxicologist or a pediatric environmental health specialty unit |
Every 24 hours
or as medically indicated |