Lead Screening Recommendations for Children

Screening Approach

The American Academy of Pediatrics recommends targeted, risk-based screening that depends on local prevalence data and individual risk factors for 2-year-olds 1
The Centers for Disease Control and Prevention's stratified screening strategy is supported by the American Academy of Pediatrics, which recommends screening at ages 1 and 2 years based on risk assessment 1

At the 2-year well-child visit, pediatricians should assess specific risk factors, including whether the child lives in or regularly visits a house built before 1960, especially before 1940 1, 2
Other risk factors to assess include recent renovation or repair work in an older home 2, 3, pica behavior or frequently mouthing objects 4, deteriorating paint or visible paint chips in the home 2, 3, parental occupational lead exposure 2, 3, and use of imported spices, cosmetics, folk remedies, or cookware 2, 3

All children enrolled in Medicaid must receive blood lead screening at ages 12 and 24 months, regardless of risk factors, as required by federal law 5, 6, 7
Medicaid-enrolled children account for 83% of children with blood lead levels >20 μg/dL 5, 6

Venous blood sampling is preferred over capillary sampling to avoid false positives from skin contamination 2, 3
If capillary testing is used initially, any elevated result must be confirmed with venous blood within 48 hours 2, 3

The American Academy of Pediatrics strongly emphasizes that anticipatory guidance about lead exposure prevention should be provided to all families at well-child visits, regardless of screening decisions 1, 2
Primary prevention through environmental control is more effective than treating children after exposure has occurred 1, 2