Who Should Have Blood Lead Testing

To assist providers in understanding lead risk in the communities they serve, the Department of Health created a Lead Exposure Risk Index Model. The model combines lead risk from housing and poverty and displays it on the map. There are many other factors that influence lead exposure not included on the map but may be added if high quality data becomes available.
The Department of Health recommends testing children for elevated blood lead levels with any of the following risk factors:
  • Lives in or regularly visits any house built before 1950.
  • Lives in or regularly visits any house built before 1978 with recent or ongoing renovations or remodeling.
  • From a low income family.
  • Known to have a sibling or frequent playmate with an elevated blood lead level.
  • Is a recent immigrant, refugee, foreign adoptee or child in foster care. 
  • Has a parent or principal caregiver who works professionally or recreationally with lead.  Examples: remodeling/demolition; painting; works in or visits gun ranges; mining; battery recycling; makes fishing weights or shotgun pellets; stained glass; pottery; soldering or welding. 
  • Uses traditional, folk or ethnic remedies or cosmetics; Examples include: Greta; Ghasard; Ba-baw-san; Sindoor and Kohl.   
Healthcare providers should consider testing additional children per clinical judgement, including:
  • Children who have parents with concerns or request testing.
  • Older children who may be at risk, including those with hobbies that potentially expose them to lead or use traditional, folk or ethnic remedies or cosmetics imported from abroad. Also, refugee children up to age 16.
  • Children living within a kilometer of an airport, lead emitting industry or on former orchard land. Information about lead emitting industries can be found on EPA's website. Information about former orchards is available on the Washington State Department of Ecology's website. 
  • Children with pica behavior.
  • Children with neurodevelopmental disabilities or conditions such as autism, ADHD and learning delays.
  • Children with families who use imported ceramics, foods, spices, candies from Mexico (such as those with chili powder or tamarindo).
*Content from Department of Health's Clinical Algorithm for Targeted Childhood Lead Testing  and Expert Panel Childhood Lead Screening Guidelines. Refer for more information.