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Why Did the Lead
Poisoning Reporting Rule Change?
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The Arizona
Department of Health Services (ADHS) changed the reporting rule on
December 12, 2000. The changes improve the ADHS’ ability to
characterize disease patterns statewide, and to serve patients and
reporting entities.
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What Are the New
Reporting Rule Requirements?
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- Clinical laboratory
directors must report all blood lead test results to the ADHS.
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Physicians must report all elevated blood lead levels of >10
micrograms per deciliter (µg/dL) for children and >25
µg/dL for
adults.
- All reports must include specific information on patient demographics,
the laboratory that ran the test, and the ordering physicians.
- Reports of severe blood lead levels, specifically
>45 µg/dL in
children and >60 µg/dL in adults, must be reported by physicians and
laboratories within 1 working day. All other elevated blood lead levels
must be reported within 5 working days. Laboratories must report all
non-elevated results <10 µg/dL in children and <25
µg/dL in adults
at least once every month.
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What Changes Were
Made to the Lead Poisoning Reporting Rule?
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Clinical laboratory
directors are now required to report all blood lead tests results. The
previous rule required the reporting of only elevated blood lead levels,
which were >10 micrograms per deciliter of blood or greater (µg/dL).
Requiring laboratory directors to report all blood lead results to the
ADHS enables the ADHS to assess disease prevalence rates and screening
rates to characterize the scope of the lead poisoning problem in Arizona
and thus to identify risk areas and design effective prevention
programs. Physicians still report only elevated blood lead levels, as in
the previous rule.
The adult blood lead level that is reportable by physicians is now 25 µg/dL. The previous rule required the reporting of all elevated blood
lead levels of >10 µg/dL. The ADHS made this change in response to the
National Institute for Occupational Safety and Health's identification
of 25 micrograms per deciliter of blood as the level of concern for
adults. Although physicians are no longer required to report adult lead
level results of less than 25 micrograms per deciliter of blood, the
ADHS still receives this information from clinical laboratory directors
for tracking purposes.
More timely reporting of elevated blood lead levels. The previous
rule required reporting the elevated blood lead level within 5 days of
detection. Now the rule requires both physicians and laboratory
directors to report blood lead levels at or above 45 micrograms per
deciliter in children and at or above 60 micrograms per deciliter in
adults within 1 working day of detection. All other elevated blood lead
levels must be reported within 5 working days. Laboratories must report
all non-elevated results <10 µg/dL in children and <25
µg/dL in
adults at least once every month. The ADHS made these changes to ensure
timely medical and environmental case follow-up in accordance with U.S.
Centers for Disease Control and Prevention guidelines. The rule also
provides that a physician or laboratory director may designate a
representative to make the reports to the ADHS on behalf of the
physician or laboratory director.
Additional demographic and contact information. The current rule
requires both physicians and laboratory directors to report additional
fields of information regarding the individuals tested for blood lead,
the physicians ordering the tests, the laboratories performing the
tests, and the blood draws. Many physicians and laboratory directors are
currently providing much of this additional information to the ADHS as a
courtesy. The ADHS needs this additional information in order to provide
more effective case management and follow-up services. The ADHS has also
eliminated the reporting requirement for race or ethnicity.
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How Do I
Report Blood Lead Test Results?
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Reports may be
phoned, mailed or faxed to the ADHS. If faxing, please call ahead to
ensure confidentiality. Optional report forms are available from this
office. Laboratories may report electronically, using specifications
designed by the ADHS. The reporting rules are published in the Arizona
Administrative Code. Copies of the rules are available from this office.
The ADHS website for lead poisoning prevention also provides report
forms and copies of the rules.
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What Happens Once a
Blood Lead Test Is Reported?
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The ADHS conducts
case follow-up for elevated venous or confirmed capillary results.
Non-elevated results are used to characterize screening and disease
prevalence statewide.
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| Children |
10 µg/dL - 19
µg/dL: Prevention counseling by phone
and educational materials and reminders for follow-up testing;
>20 µg/dL: Environmental investigations, which include in-home
interview and environmental sampling to identify sources,
specific intervention advice and prevention counseling, resource
referrals, reminders for follow-up testing and summaries to the
physician. |
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| Adults |
>25 µg/dL: Prevention counseling and referral to
state OSHA, if applicable. |
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A downloadable version of New Lead Poisoning
Reporting Requirements [PDF 45K] is available. The download is in PDF
format. It is necessary to have Acrobat
Reader™ on your machine to view the download. |
