There is no level of lead in the blood that is safe — and children are especially vulnerable from the time they begin to crawl until six years of age because their brains are still developing. Children exposed to lead are at higher risk for diminished cognitive capacity and neurobehavioral disorders. The resulting learning disabilities can dramatically impact academic performance and social skills.
Providers have a responsibility to inform parents that children can be harmed by exposure to lead, especially deteriorating or disturbed lead-based paint and the dust from it. Please provide this anticipatory guidance to parents with children starting at six months and up to six years old.
Most children who have been exposed to lead show no physical symptoms. Testing by capillary or venous sample is the only way to detect lead in the body, and a venous blood test is the most accurate. All Medi-Cal recipients should be tested for lead at 12 and 24 months of age.
If a child requires a venous blood draw:
- Notify the parent/guardian that they may need to go to another location for the lab draw and to allow adequate planning time.
- If a blood draw cannot be completed, you are required to document the reason in the member’s medical record (e.g., “Patient’s parent/guardian refused blood draw”).
- Offer the parent/guardian tips to help their child during the lab draw, such as:
- Giving the child their favorite stuffed animal or toy to hold.
- Listening to music or watching videos on a phone or tablet.
- Practicing deep breathing exercises with their child.
For more details, see the “Blood Lead Screening Guideline” in the Pediatrics section of HPSM’s Clinical Guidelines. For guidance on lead screening for refugees, see the Centers for Disease Control and Prevention (CDC) website.