Lead Screening Tests for Preschool-Age Children

Because all preschool-age children are at some risk of getting poisoned by lead, New York State Department of Health (NYSDOH) regulations now provide for lead screening of all children under six years of age.7 During checkups, your child's doctor must specifically assess your child's lead poisoning risk, and discuss lead hazards with you. Even if the doctor determines that your child's risk is low, a blood test must be done at around one year of age and again at about two years of age. More frequent testing may need to be done if the doctor determines that your child is at high risk.

Medicaid covers this testing for enrolled children between 6 and 72 months old. If your child doesn't have a regular pediatrician, or if you don't have health insurance for your child that covers blood lead testing, you can call your local health department (check the local government listings under "Health Department" in the blue pages of your phone directory) to find out where to have the test done at low cost or free, depending on your income.

Be sure to ask the doctor about the test result and what it means, because different lead levels call for different responses. When a child's lead level is only mildly elevated (from 10 to 19 micrograms of lead per deciliter of blood, or 10-19 ug/dl), New York State public health regulations8 call for the doctor to provide nutritional counseling aimed at reducing the child's absorption of lead (children whose diets are deficient in calcium and/or iron can absorb more lead than children who receive adequate amounts of these minerals). The doctor should also suggest various housekeeping and other measures that can reduce the child's exposure to lead, and continue to monitor the child's lead level.

State regulations also mandate that lead levels of 20 ug/dl or more require an inspection of the child's home by a public health worker.9 All blood-lead level measurements are now electronically reported by testing labs directly to a State registry, and then to the local health units responsible for conducting inspections.10 If the inspection uncovers "conditions conducive to lead poisoning" in your rental home, the health department issues a notice and demand to your landlord to abate those conditions by following special safety procedures to complete the abatement tasks that the health department specifies. The abatement work specified may include removal of lead paint; enclosure or encapsulation of lead-painted surfaces; replacement of lead-painted building components such as windows, doors, and wooden trim; or some combination of these methods, depending on the hazards found. The goal of such abatement work is to make the child's home "lead-safe," not necessarily to remove all lead-based paint regardless of its condition. Under State law,11 landlords who fail to comply with a health department notice and demand can be assessed monetary penalties and face additional enforcement actions.