Changes to pediatric blood lead testing guidelines

Maine CDC has updated its pediatric blood lead testing guidelines and services. Effective March 2015, for children less than 6 years old, providers should:

• confirm all capillary blood lead levels > 5 µg/dL with venous samples, and
• follow-up on all venous blood lead levels > 5 µg/dL.

These changes align Maine CDC's recommendations with the reference value for pediatric blood lead of 5 µg/dL set by the U.S. CDC in 2012. The reference value is the 97.5th percentile of the blood lead distribution in children 1-5 years of age in the U.S., which is currently 5 µg/dL. 

For more on the reference value:http://www.cdc.gov/nceh/lead/acclpp/blood_lead_levels.htm.

Maine CDC initiates a tiered response on all venous blood lead levels > 5 µg/dL. Services range from providing free home lead dust testing, to comprehensive, professional environmental lead investigations.

Providers are reminded that Maine law requires children who are covered by MaineCare be tested for lead at ages 1 and 2 years. All other children less than 6 years old should be tested unless an annual risk assessment for lead exposure is negative.

Visit http://go.usa.gov/3xmfF to get the complete updated confirmation, follow-up and screening guidelines, including the annual risk assessment questionnaire. 

In-office blood testing

The Maine Childhood Lead Poisoning Prevention Program is pleased to announce rules adopted Nov. 5 now allow providers two options for blood lead testing:


1. Continue to submit blood lead samples to the State Health and Environmental Testing Laboratory; or

2. Perform capillary blood lead analysis using a CLIA waived in-office blood lead testing device, such as a LeadCareII, and directly report all test results to Maine Childhood Lead Poisoning Prevention Program.

Providers must have approval from the Maine Childhood Lead Poisoning Prevention Program before they can begin in-office testing.

The intent of the law is to increase blood lead testing of children under age 6 years by removing barriers to testing, such as travelling to an off-site location to have blood drawn. Using a direct-read blood lead analyzer, providers will be able to perform a capillary blood lead test and within minutes report the result to the patient’s parent/guardian. (Note: All elevated blood lead levels will require a venous confirmation through the State Health and Environmental Testing Laboratory.)

For more information, visit http://go.usa.gov/YhnT