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Childhood Lead Poisoning Guidelines for Clinicians

To assist clinicians with the prevention, detection, and medical management of childhood lead poisoning, the City of Milwaukee Health Department (MHD) reviews current recommendations from leading resources including the U.S. Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the American Congress of Obstetricians and Gynecologists, and issues additional local guidelines when appropriate. These recommendations reflect Milwaukee’s local environmental conditions and risk factors.

For further information or to consult with MHD Childhood Lead Poisoning Prevention Program (MHD CLPPP) nursing staff, contact the MHD CLPPP at (414) 286-5987.

Lead Testing Recommendations

Testing of children: The City of Milwaukee Health Department follows guidelines issued by the State of Wisconsin Department of Health Services in recommending that that all children be tested three times before the age of 3. Children under the age of 6 should be tested if they have no record of a previous test, have a history of lead exposure, or if they are at greater risk for lead exposure based on an assessment of risk factors. Children enrolled in Medicaid or WIC should be tested annually to age 6.

View Wisconsin Blood Lead Screening recommendations (PDF)

Testing of pregnant or lactating women: The City of Milwaukee Health Department follows guidelines issued by the U.S. Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists (ACOG) regarding blood lead testing of pregnant or lactating women. The routine universal testing of all pregnant or lactating women is not recommended. Risk assessment of lead exposure should take place and blood lead testing should be performed if a risk factor is identified.

View ACOG Lead Screening During Pregnancy and Lactation Recommendations

View CDC Guidelines for the Identification and Management of Lead Exposure in Pregnant and Lactating Women (PDF)

Reporting of Blood Lead Testing

State law Wis. Stat. 254.13  (link is external)(PDF) requires that all blood lead test results on Wisconsin residents be reported to the Wisconsin Department of Health Services (DHS). The specific requirements for reporting blood lead results, such as timetable, content, form, etc., are described in Wis. Admin. Rule 181 (link is external)(PDF). The Wisconsin Childhood Lead Poisoning Prevention Program (link is external) implements the reporting rule through a laboratory-based reporting system and works directly with laboratories to assure all blood lead results are reported. Health care providers are responsible for sending complete demographic information as required by Wis. Admin. Rule 181 (link is external) (PDF) to the analytical laboratory with each blood lead sample. This allows the laboratory to include the demographics in the blood lead report.

Medical Case Management of Blood Lead Levels

Childhood Lead Poisoning Case Management: All children who live in the city of Milwaukee and have a blood lead level of 5 micrograms per deciliter (µg/dL) or higher will receive follow-up by the City of Milwaukee Health Department Childhood Lead Poisoning Prevention Program (MHD CLPPP) based on the blood lead level reported. Clinicians are advised to follow the American Academy of Pediatrics (AAP) recommendations for medical case management.

View the MHD CLPPP intervention schedule

View AAP Recommendations on Medical Management of Childhood Lead Exposure and Poisoning (PDF)


Additional Information on Treatment Guidelines

Additional information can be found:

These guidelines updated 5-13-10