To better protect children from the harms of lead and to prevent lead exposure, the Washington State Department of Health (DOH) is lowering the state blood lead action level from 5 micrograms per deciliter (μg/dL) to 3.5 μg/dL.
This action level aligns with federal guidance and identifies children with lead levels that are higher than 97.5% of 1–5-year-old U.S. children. There is no safe blood lead level, and even low levels of exposure can harm a child’s health and development.
Blood lead testing continues to be critical for addressing childhood lead exposure. Because young children are particularly vulnerable to the damaging effects of lead exposure, DOH recommends testing all children with risk factors as outlined in the clinical algorithm.
Lead exposure is more common among children living in poverty, refugees or recent arrivals, and children living near current or former industrial areas. Additionally, federal regulations require all children enrolled in Medicaid to receive blood lead tests at 12 and 24 months of age, or once between 24 to 72 months of age if no record of a previous test exists.
Though you may hear that lead is not an issue for Washington children, the fact is that we have some of the lowest testing rates in the nation and therefore do not have enough data to accurately assess the burden of lead exposure.
DOH recommends providers conduct confirmatory and follow-up testing starting at ≥3.5 μg/dL, to align with the new action level. Please follow the Pediatric Environmental Health Specialty Unit’s Recommendations on Management of Childhood Lead Exposure.
While your local health jurisdiction’s response may vary depending on capacity and resources, you can support families of any child exposed to lead by providing DOH materials (available at doh.wa.gov/lead-publications), offering education about potential exposure sources, monitoring the child’s development, and continuing to test children to ensure their blood lead levels are going down.
Laboratories (including facilities that use point-of-care machines) must report all blood lead test results for patients of all ages to the DOH. The required reporting timeframes for blood lead levels tests outlined in the Notifiable Conditions rule WAC 246-101-201 have not changed: report blood lead levels ≥5 μg/dL within two days and all other test results within 30 days.
For more guidance, visit Blood Lead Testing Information for Health Care Providers | Washington State Department of Health and contact the Childhood Lead Poisoning Prevention Program at [email protected] or 360-236-4280 for assistance reporting or with any other questions.
Thank you for all you do to protect and improve the health of Washington families.
