Lead Poisoning Information for Healthcare Providers

Lead poisoning, a major health concern for children living in Cuyahoga County, poisoned more than 1300 children in 2006.  Almost half (48%) of the children lead poisoned in the state of Ohio in 2006 lived in Cuyahoga County.  The current Centers for Disease Control and Prevention level of concern for lead in blood is 10 µg/dL.  Emerging research shows lower levels of lead has been shown to cause long-term effects like learning disabilities, hearing damage, speech delays, and behavioral problems.  Treatment such as chelation for higher levels of lead have not been shown to reduce the risk for long-term damage.  Truly, the only way to prevent damage from lead is to prevent lead exposure. 

Even though the most common pathway of childhood exposure to lead is in the home, most parents are unaware that lead poisoning is still a problem in our area. Healthcare providers have a key role in educating parents/guardians about the dangers of lead to their children.  Lead is not a normal value test.  Lead levels below 10 indicate that a child has been exposed to lead.  If the environment and behaviors stay the same lead levels will increase.  Parents need to beware of all test results and what they mean. 

In-office Healthcare Provider Presentation

The Board of Health has developed a 1.0 hour in office presentation to update providers and staff about lead poisoning, testing requirements, health department response, and local resources to help families.   The presentation includes lunch and Nurses and Social Workers receive 1.0 hours of continuing education credit.  Physicians can earn 0.5 CME through AAFP.  Click here to learn more about the program.

Testing Requirements

Click here for current Medicaid lead testing information.

Tips to increase testing rates

Only 65% of 1 year olds and 43% of 2 year olds on Medicaid living in Cuyahoga County received a lead test in 2006. The following tips may help you have higher testing rates.

1. Test all children with Medicaid and high-risk children at 12 and 24 months.  Consider testing annually until age 6.

2. Administer the lead risk questionnaire to other children to determine the need for testing. 

3. Create a protocol for lead testing and follow-up for staff to follow routinely.

4. Be aware of lab issues.  Labs located off-site from your office may create transportation issues for parents.  Labs with long wait times may decrease compliance with following orders.  If compliance issues arise, consider offering lead filter paper testing in office.

5. When lead levels are drawn inform parents specifically that the test has been done and the results.  Many times parents assume lead testing is done with other blood tests. 

Reporting and Health department involvement

Labs analyzing lead tests are responsible for reporting all results to the Ohio Department of Health.  To expedite response to elevated blood lead levels you can report the results to the local health department.  Lead levels can be reported by phone or fax. 

Click here for a copy of the Heavy Metal Report Form. 

Health Department Contact Information

For residents of the City of Cleveland contact:
Cleveland Department of Public Health
Phone 216-263- LEAD
Fax:  216-664-3353

For residents of Shaker Heights contact:
Ohio Department of Health
Phone: 614-644-9849

For all other residents of Cuyahoga County contact:
Cuyahoga County Board of Health
Phone: 216-201-2000
Fax:  216-676-1319

Developmental Surveillance for lead poisoned children

Children with EBLS are at risk of learning disabilities and behavioral problems even after lead levels decrease.  Children with a history of elevated lead levels should have ongoing developmental surveillance. 

For children under 36 months:

Lead Poisoning Help Me Grow referral forms.

Referral Form 1

Referral Form 2

For children 36 months or older:

Contact the child's local school district for free developmental screening

Lead Poisoning Prevention Program Page