Have Your Child Tested

Blood Levels

A simple blood test can tell you how much lead is in your child’s body. You can call your doctor for advice on testing, contact the Ohio Department of Health’s Childhood Lead Poisoning Prevention Program, or contact your local health department. The Ohio Department of Health (ODH) developed a brochure for parents that does a good job of explaining blood lead tests, Your Child Had a Blood Lead Test, What Does it Mean?.

Who Should be Tested

Children who live in or regularly visit a property built before 1978 that has peeling/chipping paint or recent/ongoing renovation, including childcare centers, preschools, or homes of a babysitter or relative.

If the answer is “yes” or “do not know” to any of six questions:

  • Does your child lives in or regularly visits a home built before 1950
  • Does your child frequently come in contact with an adult who has a hobby or works with lead?
  • Did the child’s mother have known lead exposure during her pregnancy with the child?
  • Is the child or his/her mother an immigrant or refugee?
  • Does your child live near an active or former lead smelter, battery recycling plan, or other industry known to release lead?

How do I get my child tested?

OHHN

A sample of your child’s blood is taken to a lab for analysis to find out how much lead can be measured per deciliter of blood. You can ask your pediatrician to take the blood sample, or your local health department may provide lead testing. The most accurate results are obtained by drawing blood from a blood vessel (usually in the arm).

Finger-stick tests (also called filter-paper tests) are sometimes used because they are easier to administer outside of a doctor’s office or because small children might not sit still to get their blood drawn, but these tests are not as accurate as the venous-draw tests. Only venous-draw tests are accepted by the Ohio Department of Health for confirmation of lead poisoning.

If a Child is Poisoned

The results of your child’s blood lead test will be sent to the Ohio Department of Health’s Ohio Childhood Lead Poisoning Prevention Program. In Ohio, children are considered to have an Elevated Blood Lead Level (EBL) or be lead poisoned if their blood tests show a blood lead level of 5 micrograms per deciliter (µg/DL) or more.

If your child is lead poisoned, the Ohio Department of Health (ODH) will work with you to remove the lead hazards that are poisoning your child and to reduce your child’s blood-lead level.

Parents need to do two things:

1 Remove your child from the source of lead poisoning. The longer your child is exposed the more damage it will do to your child. Even if your child’s blood-lead level is below 5µg/DL, your child is being exposed to lead somewhere and you need to take steps to end that exposure. Without finding and controlling the lead, your child’s blood-lead level could rise and hurt your children more severely. It is common for parents to feel angry, fearful, and even guilty when their children are poisoned. You are not alone in facing what has happened to your child, and you may want to hear about other parents’ experiences and get their advice for finding help for your child. When the time is right, they can help you take action to prevent lead poisoning in your community, too. One helpful resource is the Lead Safe America Foundation. In addition to providing assistance to parents and useful information, the Lead Safe America Foundation has support groups organized through Facebook.

2 Ask your child’s doctor to assess your child’s speech, behavior and cognitive development and, if needed, ask for a referral to available services. Other options include contacting the public health nurse at the health department who contacted you about your child’s lead level or accessing services on your own.

Programs that may be of assistance to your child:

Ohio Help Me Grow serves children under the age of three with developmental delays and disabilities. Parents and caregivers with concerns regarding their child’s development can have their infant or toddler evaluated by an interdisciplinary team at absolutely no cost to the family. If intervention is necessary, individualized services are provided to the child and family. Parents and extended family, friends, neighbors or others may request a referral to Ohio Help Me Grow.

The Children with Medical Handicaps Program (also referred to as BCMH for Bureau of Child and Maternal Health) is a health care program in the Ohio Department of Health (ODH). BCMH provides assistance to children with special health care needs and their families who meet the medical and financial eligibility criteria.

Assistance is provided to children under the age of 21 who have special health care needs and are residents of the State of Ohio. In order to enroll in BCMH, a Medical Application must be submitted by a BCMH-approved physician. Local health department public health nurses can provide a referral to start the enrollment process.

Early Head Start serves pregnant women, infants and toddlers. Early Head Start programs are available to the family until the child turns 3 years old and is ready to transition into Head Start or another pre-K program. The programs help families care for their infants and toddlers through early, continuous, intensive and comprehensive services.

Head Start encourages the role of parents as their child’s first and most important teachers. Programs build relationships with families that support positive parent-child relationships, family well-being and connections to peers and community. See the Head Start Locator to find programs in your community.

Your local county board of developmental disabilities may be of assistance. See “How to Get Help” from the Ohio Department of Developmental Disabilities. Another resources, Disability Rights Ohio, provides Questions and Answers about eligibility for services.

If your child is diagnosed with a developmental delay, it is important to share the diagnosis with their pre-school, kindergarten and school system. Your child may need an Individualized Education Program.

The Center for Parent Information and Resources (CPIR) defines an IEP as “…a written statement of the educational program designed to meet a child’s individual needs. Every child who receives special education services must have an IEP.” See CPIR’s Developing Your Child’s IEP and The Short-and-Sweet IEP Overview and Ohio Department of Education’s Chapter 7:1: Individualized Education Program.

How will the Ohio Department of Health help your child?

The Ohio Department of Health (ODH) will help your child in different ways, depending on how severe the poisoning is. Listed below is information taken from medical management recommendations for health care providers and other sources from the Ohio Department of Health (ODH):

If your child has a blood-lead level less than 5µg/DL:

  • ODH or your local health department may explain there is no safe level of lead in the blood, what a blood lead level means and ways you can reduce your child’s lead exposure. They will recommend you monitor your child’s neurologic, psychosocial and language development. If the first test took place when the child was one, another test should be taken at two.
  • A thorough cleaning of your home is encouraged. ODH offers a Vacuum Loaner Program administered through local health departments in Ohio. These specialized vacuum cleaners have a HEPA (High Efficiency Particulate Air) filters that can trap virtually all lead dust. Residents may borrow these vacuum cleaners at no charge.

If your child has a blood-lead level of 5µg/DL to 9µg/DL:

In addition to the above actions, ODH or your local health department will call you and possibly administer a questionnaire to assess the child’s risk of lead poisoning. Results of this risk assessment may guide further actions.

ODH or your local health department may provide lead education, monitor blood lead levels until the level falls below 5µg/DL, complete the child’s history and medical exam, assess iron status, obtain an abdominal x-ray if lead ingestion is suspected and/or make referrals to Women, Infants and Children (WIC) for nutritional support, Help Me Grow (if a potential developmental delay has been identified) and the Children with Medical Handicaps Program (BCMH).

Retesting is recommended at 3 month intervals, then at 6-9 month intervals until the blood lead level falls below 5µg/DL.

If your child has a blood-lead level of 10µg/DL but less than 45µg/DL:

  • In addition to the above actions, the Ohio Department of Health or your local health department may assign your child a case manager from its childhood lead-poisoning prevention program. Your case manager will contact you to help you learn how to prevent further lead-poisoning. You may work with the case manager by phone or schedule a home-visit. The Ohio Department of Health provides information on lead case management.
  • Your child should be retested after one month to make sure that the lead level is going down.
  • Health officials will work to find the source of the lead that has poisoned your child. They may schedule a lead-inspection of your home, or of your child’s school or child-care facility. In addition to the home, they will look at other potential sources of lead in the environment, including the parent’s occupation or hobbies, herbal remedies, pottery, toys, make up and other consumer items.
  • A lead risk assessor may visit your home.
  • If the risk-assessment reveals that lead-hazards in the home (or child-care site, or school) are poisoning your child, the Ohio Department of Health or the local health department will issue a lead hazard control order on the property.

    This lead order will describe each of the lead-hazards that needs to be controlled, and will establish a date for a lead-clearance examination. You will get a copy of the lead order so that you will understand what the owner of the property must do.

  • The owner or manager of the property will have 90 days to complete the removal of the lead-hazard.
  • If your family’s health is at risk, you may be required to leave the property until it passes a lead-clearance examination.
  • If an owner does not comply with the lead order, a sign will be put on the building to warn that it is not safe, and you must leave the property and cannot return until it passes the lead-clearance test.
  • If you are the owner of a home that is put under lead orders, there may be some assistance for you. Refer to OHHN’s resource directory to see what help may be available in your city or county.

If your child’s blood-lead lead level is 45µg/DL, or more:

  • In addition to actions listed above, the blood test will be confirmed by a venous sample (blood extracted through a vein instead of finger stick test).
  • A lead risk assessor will contact you to schedule a public health lead investigation as soon as possible.
  • Consult your physician and follow his/her instructions.
  • This is an medical emergency, and it’s likely your child will be removed from the exposure source. The longer your child is exposed, the more the lead will damage to your child.
  • Hospitalization and chelation therapy may be prescribed. If your home was the source of the lead, the child may not be permitted to return home until the lead hazards are removed by a state licensed lead abatement contractor and the home passes clearance testing.
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