Medical Providers and Laboratories

Required Lead Screening Tests for Children Enrolled in the Oregon Health Plan

Children enrolled in the Oregon Health Plan must now have a blood lead test at 12 and 24 months, or before 72 months if never tested. For more information, see OAR 410-130-0246 "Lead Screening".

HRSA-CDC Joint Letter on Childhood Lead Poisoning Prevention and Blood Lead Testing

In a joint letter dated January 10th, 2023, Health Resources & Services Administration (HRSA) and CDC provide information for healthcare providers regarding childhood lead poisoning prevention and blood lead testing.

Reporting of Blood Lead Test Results

By law, Oregon laboratories and clinicians must report ALL blood lead test results to the Oregon Health Authority (OHA) within seven working days.

Blood lead test results of 3.5 ug/dL or higher must be reported to OHA within one working day.

For more on the reporting and investigation requirements, see the Oregon Administrative Rules (OAR) 333-017, 333-018 and 333-019.

Please do not send blood lead test results to OHA through unsecure email. Use ProofPoint to set up a secure OHA email, or use the secure email available through your facility.

Reporting Form

Elevated Blood Lead Test Reporting Form (pdf) Fillable Form (pdf)
If not reporting electronically, use this form to report an elevated blood lead test result to OHA. Send elevated test results to OHA within one-working day via secure fax at 971-673-0457.
Blood Lead Test Reporting Spreadsheet Template (Excel)

Use this spreadsheet for daily or weekly blood lead test reports

Oregon Lead Poisoning Guidelines

Lead Poisoning Investigative Guidelines (pdf) - Oregon-specific lead poisoning disease reporting and follow-up.

Resources

Lead Screening Protocols

Lead Screening Protocol for Children (pdf) (This document references a blood lead level of 5 ug/dL; Oregon's case definition is 3.5 ug/dL)
Clinic Staff Lead Screening Questionnaire - to be administered by clinic staff
Parent Lead Screening Questionnaire (English, Spanish, Russian, and Vietnamese) - to be completed by parent or guardian.
CDC Lead Screening Recommendations for Newly Arrived Refugees - Oregon medical providers should follow these recommendations for refugee children aged 6 mos-16 years.

Medical Management

Children

Medical Information Form (pdf) - to be completed by medical provider for children with elevated blood lead levels. (This document references a blood lead level of 5 ug/dL; Oregon's case definition is 3.5 ug/dL)
Medical Evaluation and Recommendations (pdf) - This document is intended to provide evidence-based guidance for medical providers caring for children with confirmed elevated blood lead levels (EBLLs). (This document references a blood lead level of 5 ug/dL; Oregon's case definition is 3.5 ug/dL)
Management of Childhood Lead Exposure - this website provides recommendations from the Pediatric Environmental Health Specialty Units and the American Academy of Pediatrics.
Recommended Actions Based on Blood Lead Level - CDC summary of recommendations
Early Intervention/Early Childhood Special Education (EI/ECSE) Referral - Children diagnosed with lead poisoning are eligible for EI/ECSE services. Please refer to the Oregon Department of Education's website for more details and the EI/ECSE Universal Referral Form (doc).

Adults

Understanding Blood Lead Testing Results for Adult Exposure to Lead (pdf) - Information on types of blood lead testing and interpretation of test results. Intended for medical providers or county health department staff.
Recommended Adult Medical Evaluation for Lead Exposure (pdf) - Interview form used by medical provider to identify and care for elevated blood lead levels.
Medical Evaluation and Recommendations (pdf) - This document is intended to provide evidence-based guidance for medical providers caring for adults with confirmed elevated blood lead levels (EBLLs).

Oregon Lead Poisoning Data

Memento Morbi: A Monthly Communicable Disease Summary Report
CD Summary of Elevated Childhood Lead Levels in Oregon - May 2019
Childhood Lead Poisoning in Oregon (pdf) - CD Summary, 2013 (Note: confirmation and follow up table is outdated)
Impact of Environmental Exposures in Oregon: Childhood Lead Poisoning (pdf)
Adult Blood Lead Reporting in Oregon, 2006-2010 (pdf)
Environmental Public Health Tracking (EPHT) Lead Data - Oregon specific housing and lead poisoning data.
Childhood Lead Screening in Oregon:2004 Survey of Healthcare Providers (pdf) (this paper references "Level of Concern" of 10 ug/dl, which is outdated

Trainings

Pediatric Lead Exposure: Diagnosis, Management & Prevention - A CME-approved webinar hosted by the NW Pediatric Environmental Health Specialty Unit
Promoting Pediatric Lead Screening in Oregon - A CME-approved webinar hosted by the NW Pediatric Environmental Health Specialty Unit

Publications

From CDC and HHS

NEW: CDC reduced the Blood Lead Reference Level to 3.5 ug/dl -- MMWR Oct. 29, 2021
NEW: "Decreases in Young Children Who Received Blood Lead Level Testing During COVID-19" MMWR - 2021
Steps for Collecting Finger Stick Capillary Blood Using a Microtainer - poster from CDC
"Mission Unleaded" video from CDC's National Center for Environmental Health, Division of Laboratory Services on preventing blood lead sample contamination
Educational Interventions for Children Affected by Lead - 2015
Lead Screening During the Domestic Medical Examination for Newly Arrived Refugees - 2013
Guidelines for Measuring Lead in Blood Using Point of Care Instruments - 2013
Health Effects of Low-Level Lead - National Toxicology Program 2012
CDC Update on Blood Lead Levels in Children - 2012
CDC Recommendations on the new Childhood Blood Lead Level Reference Value (pdf) - 2012
Recommendations for Addressing Low Level Lead Exposure in Children (pdf) - 2012
Guidelines for the Identification and Management of Lead Exposure in Pregnant and Lactating Women (pdf) - 2010
Recommendations for Blood Lead Screening of Medicaid-Eligible Children (pdf)MMWR - 2009
Health Effects of Lead Exposure for Adults and Children
Managing Elevated Blood Lead Levels Among Young Children (pdf) - March 2002

Journal Articles

Health Remedies as a Source of Lead, Mercury, and Arsenic Exposure, New York City, 2010-2019 - American Journal of Public Health 2022
Prevention of Childhood Lead Toxicity (pdf) - American Academy of Pediatrics 2016
Deaths Resulting From Hypocalcemia After Administration of Edetae Disodium (pdf) - Journal of American Academy of Pediatrics 2006
Death of a Child After Ingestion of a Metallic Charm - MMWR 2006
Lead Exposure in Children: Prevention, Detection and Management (pdf) - American Academy of Pediatrics 2005
Lead Poisoning from Ingestion of a Toy Necklace - MMWR 2004

Educational Materials

Clinical Management of Lead Exposure in Pregnant and Lactating Women and the Breastfed Infant - New PEHSU factsheet
CDC Blood Lead Levels in Children Fact Sheet (pdf) - Information for parents on CDC's new reference level.
Heavy Metals and Your Health (pdf) - Frequently asked questions about testing, treating and preventing heavy metal poisoning.
Adult Lead Exposure-What Does My Blood Lead Test Mean? (pdf) - Information on blood lead test results for adults who have elevated blood lead levels.
What Does My Child's Blood Lead Level Mean? (pdf) - Information on childhood blood lead test results and how to prevent exposure to lead.

For additional educational resources, visit the Educational Materials page.