Lead Screening Policy & Guidance - Comprehensive Follow-up Services

Office of Environmental Health

The Screening Policy & Guidance for Preventing Childhood Lead Poisoning in Arizona

Table of Contents	The AZ Childhood Lead Screening Policy	Lead Poisoning/Prevention

Health Effects	Pathways to Lead Exposure	Sources of Lead Exposure

Childhood Lead Poisoning in AZ	Anticipatory Guidance	Blood Lead Screening Recommendations

Diagnostic Testing For Children w/ Elevated Blood Lead Levels	Follow-Up Testing For Children w/ Elevated Blood Lead Levels	Reporting of Elevated Blood Lead Levels and Follow-Up Svcs

Comprehensive Follow-Up Svcs	Clinical Mgmt	Environmental Case Follow-Up

Mgmt of Lead Hazards	References	Appendix A

Appendix B [PDF 79K] (Acrobat Reader^™ needed for viewing)	Appendix C-1	Appendix C-2

Comprehensive Follow-up Services

Comprehensive services are best provided by a team that includes the health-care provider, care coordinator, ADHS staff, social worker, housing specialist, and others. Because childhood lead exposure is likely to be associated with poor and deteriorating communities, children with elevated blood lead levels also may have problems such as inadequate housing, lack of routine medical care, and poor nutrition. Children also may need educational services. The team can ensure the provision of these services. The attached resource guide provides resource names and telephone numbers for potential team members (See Appendix A). Clinical management, environmental investigation, and lead hazard control are discussed later in this booklet.

Screen Readable Version

Blood Lead Levels (BLLs) (µg/dL)	ACTION
< 10	Reassess or rescreen in 1 year. No additional action necessary unless exposure sources change.
10-14	Provide family lead education. Provide follow-up testing. Refer for social services, if necessary.
15-19	Provide family lead education. Provide nutritional counseling and correct iron deficiency, if necessary. Provide follow-up testing. Refer for social services, if necessary. If BLLs persist (i.e., 2 venous BLLs in this range at least 3 months apart) or worsen, proceed according to actions for BLLs 20-44 µg/dL.
20-44	Provide coordination of care. Provide clinical management. Provide environmental investigation. Provide lead hazard control
45-69	Within 48 hours, begin coordination of care, clinical management, environmental investigation, and lead hazard control
>70	Hospitalize child and begin medical treatment immediately. Begin coordination of care, clinical management , environmental investigation, and lead-hazard control immediately.

A downloadable version of The Screening Policy & Guidance for Preventing Childhood Lead Poisoning in Arizona [PDF 586K] is available. The download is in PDF format. It is necessary to have Acrobat Reader^™ on your machine to view the download.

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