Health Care Providers

Health care providers play an important role in preventing lead exposure by identifying children who are at risk for lead poisoning.  Children who are at high risk for lead exposure should be screened at 12 and 24 months, in accordance with Virginia policy. Women who are pregnant should be educated about sources of lead, and screened if they are at an increased risk for lead exposure.  VDH is committed to supporting health care providers with preventing lead poisoning in children across the Commonwealth.

Important Updates

Policies

Blood Lead Testing Criteria:

Children in any of the following risk categories should have their blood tested at 12 and 24 months:

    1.  The child is eligible for or receiving benefits from Medicaid or the Special Supplemental Nutrition Program for Women, Infants and Children (WIC);
    2. The child is living in or regularly visiting a house, apartment, dwelling, structure, or child care facility built before 1960;
    3. The child is living in or regularly visiting a house, apartment, dwelling, structure, or child care facility built before 1978 that has (i) peeling or chipping paint or (ii) recent (within the last six months) ongoing or planned renovations;
    4.  The child is living in or regularly visiting a house, apartment, dwelling, or other structure in which one or more persons have blood lead testing yielding evidence of lead exposure;
    5. The child is living with an adult whose job, hobby, or other activity involves exposure to lead;
    6. The child is living near an active lead smelter, battery recycling plant, or other industry likely to release lead;
    7. The child's parent, guardian, or other person standing in loco parentis requests the child's blood be tested due to any suspected exposure; or
    8. The child is a recent refugee or immigrant or is adopted from outside of the United States.

A child up to 72 months in those categories who hasn't previously been tested (or who has experienced a change that has resulted in an increased risk of exposure to lead), or the sibling of a child who has an elevated blood lead level should also be tested.

Virginia Blood Lead Testing Reporting Guidelines:

On October 20, 2016, the Virginia Department of Health modified its disease reporting requirements:

“Lead, reportable levels” means any detectable blood lead level in children 15 years of age and younger and levels greater than or equal to 5 μg/dL in persons older than 15 years of age.

There are two primary ways to report a blood lead level to the Department of Health:

  1. Visit Virginia’s Confidential Morbidity Report Portal
  2. Fax the report to 804-864-8102

Case Management and Follow-Up:

Both health care providers and Local Health Department staff should please refer to the guidance found in the Virginia Blood Lead Testing and Case Management Guidelines for recommended case management and follow-up actions.

Supplemental Information

Guidance for Special Populations

Pregnant and Lactating Women

Elevated lead levels in pregnancy have been associated with adverse outcomes for both maternal and fetal health. It can cause:

  • Increased risk of stillbirth and miscarriage
  • Increased risk of the baby being born preterm
  • Increased risk of the baby having a low birthweight
  • Damage to the baby’s brain, kidneys, and nervous system
  • Future developmental and learning problems in the baby

Pregnant individuals who are at increased risk for lead exposure should be screened for lead.

Pregnant individuals are at an increased risk of being exposed to lead if they:

  • Live in a home built before 1978.
  • Are a recent immigrant or refugee.
  • Use imported pottery or ceramics to prepare and store food.
  • Have old plumbing and pipes in their home.
  • Live with someone who has a job or hobby that may expose them to lead, such as welding, metalwork, building renovation, stained glass, casting, or soldering.
  • Developed pica during their pregnancy.
  • Use traditional folk remedies or cosmetics.

There are some simple steps pregnant individuals can take to protect themselves and their baby from the harmful effects of lead, such as:

  • Wet-wipe and wet-mop around window sills and home entrances.
  • Washing their hands often.
  • Removing their shoes before entering their home.
  • If a family member has a job or hobby that exposes them to lead, asking them to take off their shoes before coming inside and change their clothes immediately after coming home.
  • Pregnant individuals should not remodel their home, sand paint, or remove paint with a heat gun.

Breastfeeding and Lead Exposure

Individuals who have been or are currently exposed to lead can expose their fetus or infant to lead during pregnancy and lactation through blood and breast milk, which can have long-term effects on the neurodevelopment of their child.

Please utilize the resources linked below for guidance on medical management of an elevated blood lead level during lactation.