Lead Poisoning
Exams and Tests
Diagnosing lead poisoning can be difficult, especially because its symptoms are so general. Lead poisoning may be diagnosed with a blood lead test that measures the amount of lead in the blood. This test does not measure the complete level of lead in the body, but it is the best test available at this time.
Results need to be reported to the local health department if 2 or more blood lead levels are above 10 micrograms per deciliter (mcg/dL). A home inspection is needed to find the source of the lead contamination.
Other tests that can be helpful if lead poisoning is suspected include:
- Complete blood count (CBC), to determine whether you have anemia, which can be caused by lead poisoning.
- Abdominal X-rays, which might show deposits of lead in the bowel.
- Extremity X-rays that may show lines of lead deposited in the bone, which may indicate chronic lead poisoning. See an illustration of an X-ray showing lead poisoning in a child's leg bones
.
- BUN or creatinine tests, which check for kidney (renal) function problems that can be associated with lead poisoning.
- Urine test, which may be given to assess renal damage that might be associated with lead in the body.
Early Detection
Screening programs for lead poisoning check large numbers of children or adults who are likely to be exposed to lead. Screening tests done on 1 to 2 year olds have shown lead in the environment in most places. When children in an area no longer test positive for traces of lead, routine screening of those children is no longer needed. Screening programs in an area would need to be restarted only if something changed that would increase the risk for lead in that area.
Screening programs are set up by the U.S. Centers for Disease Control and Prevention (CDC) and give local and state agencies information to help find which areas are the most likely to be have high lead levels. Age of housing is an important factor in determining risk because older homes tend to have lead-based paint. If lead exposure is likely, then blood tests for infants and young children will be recommended to measure blood lead levels.
Individual screening can be done by your health professional. During a routine health exam, the risk for lead exposure can be evaluated by answering questions about family members' living and working conditions. The health professional may then decide whether blood lead levels should be measured.
Children
Children should be tested, no matter what their age, if they have been exposed to lead or if they have symptoms that could be caused by lead poisoning. Screening tests done on 1 to 2 year olds have shown lead in the environment in most places. When children in an area no longer test positive for traces of lead, routine screening of those children is no longer needed. Screening programs in an area would need to be restarted only if something changed that would increase the risk for lead in that area.
When children from a high risk area move into an area that does not have a high risk, their lead levels rapidly return to normal. The child's symptoms and the risk of exposure to lead in the new area should be considered when making decisions about screening these children.
The U.S. Preventive Services Task Force (USPSTF) does not recommend:14
- Lead poisoning testing for children ages 1 to 5 who don't have symptoms and do not have an increased risk.
- For or against routine testing in children ages 1 to 5 who have a greater risk for higher blood lead levels and don't have symptoms.
Many state and local health departments can provide information on screening recommendations in your area.
In addition, an individual child's risk for lead poisoning can be determined by answering a few screening questions.
Adults
The U.S. Occupational Health and Safety Administration (OSHA) requires companies to test the blood of employees who work with lead. OSHA sets industry standards to protect workers. For more information, contact OSHA, listed in the Other Places to Get Help section of this topic.
Adults who do not work with lead usually are not tested for lead poisoning. If you are pregnant or trying to become pregnant and you or a family member works with lead, you may want to ask your doctor about your risk for lead poisoning. The USPSTF does not recommend routine testing of blood lead levels in pregnant women who don't have symptoms.14
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| Author: | Sydney Youngerman-Cole, RN, BSN, RNC | Last Updated: July 26, 2006 |
| Medical Review: | Michael J. Sexton, MD - Pediatrics R. Steven Tharratt, MD, MPVM, FACP, FCCP - Pulmonology, Critical Care, Medical Toxicology | |
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