When to test
Wyoming has a universal screening plan, meaning we recommend testing all children at ages 12 and 24 months. All Medicaid-enrolled children are required to receive blood lead screening tests at ages 12 and 24 months, or age 24-72 months if they have no records of ever being tested.
Types of tests
Children with lead poisoning may not show any visible signs or symptoms. A blood lead test is the best way to determine if a child has been exposed to lead. the patient’s blood lead level (BLL) is measured in micrograms of lead per deciliter of blood (μg/dL). There are two types of blood lead tests, a capillary test and a venous blood draw.
A capillary test (also known as a finger-prick or heel-prick sample) provides quick results, but can be misleading if lead on the skin is captured in the sample. A high capillary test is considered an unconfirmed case of lead poisoning and is usually followed up with a venous draw or second capillary test to confirm the result.
A venous blood test takes blood directly from the vein. It is more reliable since it is less likely to experience contamination during the blood sample. This test is usually performed after a high capillary test since it can cause more discomfort to children and capillary tests are sufficient for determining low levels of lead.
Blood Lead Reference Value (BLRV)
The Centers for Disease Control and Prevention (CDC) currently uses a BLRV of 3.5 μg/dL. The BLRV is a population-based measurement, not a health-based measurement; there is no safe level of lead. The BLRV represents the 97.5th percentile or the top 2.5% of BLLs in the US. It is periodically updated to match the population data
What to do when there is an elevated case
Physicians should follow the CDC recommended actions based on blood lead level.
If a child is found to have an elevated BLL, physicians should recommend follow-up services such as finding and removing lead from their environment, meeting with a nutritionist to create a dietary plan high in iron and calcium, connecting the child to early education services, and scheduling follow-up blood testing to monitor changes. In cases of extremely high BLLs, providers may recommend other types of testing and treatment such as x-rays or chelation therapy.
All blood lead tests, regardless of test type or test result, are required by law (State Statute 35-4-107) to be reported within 7 days of diagnosis. For more information on submitting a report electronically or via fax, please visit our Reportable Diseases and Conditions page.