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Updated Lead Testing Recommendations: 

Milwaukee Health Providers

To better protect the health of children in the community, the City of Milwaukee Health Department (MHD) has updated its lead testing recommendations.

Due to Milwaukee’s large population, high prevalence of lead paint, and the deterioration of older homes, MHD urges families and healthcare providers to adopt a more aggressive testing schedule than the state's recommendations.

These updated guidelines are designed to better protect children from lead exposure and other lead hazards commonly found in Milwaukee's older housing stock.

Updated Lead Testing Recommendations
 

MHD now recommends lead testing for all children around 12, 18, and 24 months, followed by annual testing at ages 3, 4, and 5.

These recommendations exceed state guidelines due to Milwaukee's higher levels of lead exposure risk, including a large population, a high number of homes with lead paint, and the need for repairs in older homes.

Frequently Asked Questions (FAQs):

This FAQ is designed to help medical providers understand and implement the City of Milwaukee Health Department's updated lead testing recommendations for Milwaukee residents.

Providers can reference them during well-child visits, when discussing lead testing with families, or when addressing concerns about lead exposure. They are also useful for staff training or communications with community partners.

 

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  Why is lead testing important in Milwaukee?

 

Lead poisoning remains one of the most serious health threats to young children in Milwaukee, particularly those aged 1-2 years. From 2018 to 2022, nearly 1 in 10 Milwaukee children under age 6 had a blood lead level at or above the CDC’s reference value of 3.5 µg/dL. However, only about half of Milwaukee’s children under 2 have ever been tested for lead, leaving many cases undetected. Early testing helps identify lead exposure and can prevent further harm.  

Lead-based paint and lead-contaminated dust are strongly linked to lead poisoning. In Milwaukee, 88% of residential housing was built before lead paint was banned in 1978.  

  Why did MHD remove its previous screening criteria?

 

Screening questionnaires have been found to be inaccurate in predicting lead poisoning, particularly in high-risk areas like Milwaukee. Universal testing provides a more effective means of identifying children at risk, ensuring earlier interventions and better health outcomes.  

  What can medical providers do to ensure adherence to this testing schedule?

 

Healthcare providers play a critical role in educating families about the importance of regular lead testing. MHD is working closely with providers to integrate the updated testing recommendations into electronic health records (EHRs) to support easier implementation during well-child visits.  

  What should providers do if a child tests positive for elevated blood lead levels?

 

Healthcare providers should follow CDC guidelines based on initial capillary screening and confirmed venous blood lead levels (BLLs).   

 - More information: CDC: Recommended Actions Based on Blood Lead Level.   

MHD contacts a child's parent or caregiver if their blood lead level is above 3.5 µg/dL and recommends follow-up testing. MHD also provides clinical case management, environmental investigation, and lead hazard abatement for cases with a venous blood lead level ≥15 µg/dL, as required by state law. Services may be offered at lower levels when funding is available. For questions, contact MHD’s lead team at (414) 286-2165.  

Note that state law Wis. Stat. 254.13 requires all blood lead test results on Wisconsin residents to be reported to DHS.

For more information on reporting requirements, visit the DHS website.   

  How can families with limited resources afford the additional tests?

 

Most insurance plans, including Medicaid, cover lead testing. Approximately 77% of children under 6 in Milwaukee are enrolled in Medicaid, which fully covers the cost of testing.  

  What are the most common sources of lead exposure?

 

In Milwaukee, the primary source of lead exposure is lead-based paint found in homes built before 1978. Other sources include:  

- Lead-contaminated dust and soil.  

- Drinking water from lead service lines.  

- Toys, jewelry, and hobbies that involve lead-containing materials.   

For a complete list of potential sources of lead, visit the CDC's lead resource page.  

  What steps can providers take to reduce barriers to testing?

 

MHD recognizes many families face barriers to well-child visits and lead testing. Providers can help by:  

- Coordinating with community partners to raise awareness and provide transportation or other services that facilitate clinic visits. Medicaid offers transportation services if arranged by families at least two business days before the appointment.  

- Educating families about the serious health impact of lead poisoning and the importance of early and frequent testing.  

- Referring families to community resources that can help reduce lead exposure  

  How does MHD plan to continually evaluate the effectiveness of these recommendations?

 

MHD will regularly review lead testing data and work with the Milwaukee Health Care Partnership to adjust testing guidelines based on emerging data. Any updates to the recommendations will be shared on this page.  

For further questions or clarification, please get in touch with MHD’s lead team at (414) 286-2165.

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