RECOMMENDATIONS FOR BLOOD LEAD TESTING OF CHILDREN IN WASHINGTON STATE
The Department of Health recommends screening children using the below algorithm at 12 and 24 months of age.

Does the child have any of the following risk factors:

LEAD RISK EXPOSURE
EXAMPLES:

•

Lives in or regularly visits any house built before 1950.*

•

Lives in or regularly visits any house built before 1978 that has recent or ongoing renovations or remodeling.

•

From a low income family (defined as incomes <130% of the poverty level.)**

•

Known to have a sibling or frequent playmate with elevated blood lead level.

•

Is a recent immigrant, refugee, foreign adoptee, or child in foster care.

•

Has a parent or principal caregiver who works professionally or recreationally with lead. (See sidebar for examples.)

•

Uses traditional, folk, or ethnic remedies or cosmetics (such as Greta, Azarcon, Ghasard, Ba-baw-san, Sindoor or Kohl.)

** Apple Health in Washington Medicaid covers children with family incomes up to 300% of the federal poverty level. If family income
is unknown, testing should be offered.

• Work or visit gun range
• Mining, smelting,
battery recycling
• Making lead fishing
weights or ammunition
• Stained glass
• Soldering and welding
Consumer Products:

UNK

Perform lead testing

• Remodeling and
demolition
• Painting

* Screening may not be indicated if the home has previously undergone lead abatement or tested negative for lead after remodeling.

YES

Occupations and
Hobbies:

NO

Healthcare providers should consider testing child per clinical judgment, if:
•

Parents have concern or request testing (including older children that have risk of exposure.)

•

Child lives within a kilometer of an airport or lead emitting industry or on former orchard land.

•

Child with pica behavior.

•

Child with neurodevelopmental disabilities or conditions such as autism, ADHD, and learning delays.

• Pottery or porcelain
with lead glaze
• Informally imported
foods, candies and
spices
• Antique furniture and
inexpensive jewelry

Healthcare providers are encouraged to use the Department of Health’s Lead Risk Index Map to better understand which
areas in their community are at higher risk for lead exposure. See https://fortress.wa.gov/doh/wtn/WTNIBL/
Interpretation and Medical Management of Blood Lead Levels:
If blood lead level is ≥5 mcg/dL: See PEHSU Recommendations on Medical Management of Childhood Lead Poisoning

DOH 334-382
November 2015