Blood lead screening rates in Delaware are dangerously low and have fallen even further since the pandemic. Screening is essential for preventing ongoing lead exposure and ensuring that children who are eligible for services are identified.
Lead Screening: it’s the law!
- Delaware's Childhood Lead Poisoning Prevention Act requires blood lead screening for all children at 12 months of age, and again at 24 months of age, regardless of zip code or other risk factors.
- Screening is defined as a capillary fingerstick in a doctor’s office, or a venous blood test at a laboratory; screening is not a questionnaire.
- Blood lead testing, screening, screening-related services, and diagnostic evaluations are reimbursable under health insurance contracts and group and blanket health insurance.
- All child cares and public schools in Delaware require proof of screening at 12 and 24 months of age for enrollment.
The CDC's Blood Lead Reference Value was lowered to 3.5 µg/dL in October 2021.
- Blood lead levels (BLL) at 3.5 µg/dL or higher are considered “elevated” by the CDC and require action.
- Confirmatory venous testing is required for all screenings where BLL is at or above 3.5 µg/dL.
What you can do as a healthcare provider:
- Follow all of Delaware's screening requirements. Blood lead screening (not a questionnaire) is mandated for all children at 12 months of age, and again at 24 months of age. If you are not screening children at the point of care, please follow up with patients to make sure that they have received their required 12-month and 24-month screenings.
- Notify parents of eligible children of education services. Children birth to age 3 with a blood lead level 5 µg/dL or higher are automatically eligible for federally-funded early childhood education intervention services through IDEA Part C. Early childhood education is vital for assisting children in overcoming the cognitive effects of lead exposure and can even prevent the need for special education during the school years
Contact Child Development Watch:
Kent and Sussex County: 800-752-9393
New Castle County: 800-671-0050
https://dhss.delaware.gov/dhss/dph/birthtothree/
- Advise parents on the need to identify and remove the source of exposure. There is no safe level of lead in children's blood, and the source of any level of blood lead level, even levels below 3.5 µg/dL, should be eliminated from the child's environment. Lead is not just a problem with peeling paint, and there are many sources of exposure.
- Advise parents on the importance of diet. Healthy, low-fat foods high in iron, calcium, and vitamin C, help prevent lead from being absorbed.
Additional Resources:
- WHO guideline for the clinical management of exposure to lead. Geneva: World Health
- Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.
- Prevention of Childhood Lead Toxicity, American Academy of Pediatrics Policy Statement, Pediatrics (2016) 138 (1): e20161493.
- Educational Services for Children Affected by Lead Expert Panel. Educational interventions for children affected by lead. Atlanta: U.S. Department of Health and Human Services; 2015.
