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Preventing Lead Poisoning in Young Children: Tables

Table 1-1. Interpretation of Blood Lead Test Results and Followup Activities: Class of Child Based on Blood Lead Concentration

Class Blood lead concentration (µg/dL) Comment
I < or = to 9 A child in Class I is not considered to be lead-poisoned.
IIA 10-14 Many children (or a large proportion of children) with blood lead levels in this range should trigger communitywide childhood lead poisoning prevention activities (Chapter 9). Children in this range may need to be rescreened more frequently.
IIB 15-19 A child in Class IIB should receive nutritional and educational interventions and more frequent screening. If the blood lead level persists in this range, environmental investigation and intervention should be done (Chapter 8).
III 20-44 A child in Class III should receive environmental evaluation and remediation (Chapter 8) and a medical evaluation (Chapter 7). Such a child may need pharmacologic treatment of lead poisoning (Chapter 7).
IV 45-69 A child in Class IV will need both medical and environmental interventions, including chelation therapy (Chapter 7 and Chapter 8).
V > or = to 70 A child with Class V lead poisoning is a medical emergency. Medical and environmental management must begin immediately (Chapter 7 and Chapter 8).

Table 3-1. Industries Identified by Surveillance for Elevated Blood Lead Levels, California and New York, 1991

Industry Description Standard Industrial  Classification Number
Secondary smelting and refining of nonferrous metals 3341
Storage batteries (lead batteries) 3691
Valve and pipe fittings (except plumber's brass goods) 3494
Plumbing fixture fittings and trim (brass goods) 3432
Brass/copper foundry 3362
Glass products, made of purchased glass 3231
Motor vehicle parts and accessories 3714
Firing range workers 7997,9221
Pottery, nec 3269
Chemical and chemical preparations 2899
Bridge, tunnel, and elevated highway construction 1622
Automotive repair shops 7539
Industrial machinery and equipment 5084
Inorganic pigments 2816
Primary batteries, dry and wet 3692

Sources: Baser and Marion, 1990; Maizlish et al., 1990.

Table 6-1. Priority Groups for Screening

Children, ages 6 to 72 months, who live in or are frequent visitors to deteriorated housing built before 1960.

Children, ages 6 to 72 months, who live in housing built before 1960 with recent, ongoing, or planned renovation or remodeling. 

Children, ages 6 to 72 months, who are siblings, housemates, or playmates of children with known lead poisoning. 

Children, ages 6 to 72 months, whose parents or other household members participate in a lead-related occupation or hobby. 

Children, ages 6 to 72 months, who live near active lead smelters, battery recycling plants, or other industries likely to result in atmospheric lead release.

Table 6-2. Assessing the Risk of High-Dose Exposure to Lead—Sample Questionnaire

Does your child—

1. Live in or regularly visit a house with peeling or chipping paint built before 1960? This could include a day care center, preschool, the home of a babysitter or a relative, etc. 

2. Live in or regularly visit a house built before 1960 with recent, ongoing, or planned renovation or remodeling? 

3. Have a brother or sister, housemate, or playmate being followed or treated for lead poisoning (that is, blood lead > or = to 15 µg/dL)? 

4. Live with an adult whose job or hobby involves exposure to lead (see Chapter 3)? 

5. Live near an active lead smelter, battery recycling plant, or other industry likely to release lead?

Table 6-3. Class of Child and Recommended Action According to Blood Lead Measurement

Class Blood Lead Concentration (µg/dL) Action
I < or = to 9 Low risk for high-dose exposure: rescreen as described in text.

High risk for high-dose exposure: rescreen as described in text.
IIA 10-14 Rescreen as described in text.

If many children in the community have blood lead levels > or = to 10, community interventions (primary prevention activities) should be considered by appropriate agencies (see Chapter 9).
IIB 15-19 Rescreen as described in text.

Take a history to assess possible high-dose sources of lead.

Educate parents about diet, cleaning, etc. Test for iron deficiency. Consider environmental investigation and lead hazard abatement if levels persist.
III 20-44* Conduct a complete medical evaluation. Identify and eliminate environmental lead sources.
IV 45-69* Begin medical treatment and environmental assessment and remediation within 48 hours.
V > or = to 70* Begin medical treatment and environmental assessment and remediation IMMEDIATELY.

*Based on confirmatory blood lead level.

Table 6-4. Suggested Timetable for Confirming Capillary Blood Lead Results with a Venous Blood Lead Measurement

Blood Lead Level (µg/dL) Time Within Which Blood Lead Level Should Be Obtained
Not applicable
10-14  Not applicable
15-19 Within 1 month
20-44 Within 1 week
45-69 Within 48 hours
> or = to 70 Immediately

Table 7-1. Chelating Agents Used in Treating Children with Lead Poisoning

Product Name Generic Name Chemical Name Abbreviation
Calcium Disodium Versenate Edetate disodium calcium Calcium disodium ethylenediamine tetraacetate CaNa2EDTA
BAL in Oil Dimercaprol 2,3-dimercapto-1-propanol BAL
Cuprimine D-penicillamine 3-mercapto-D-valine D-penicillamine
Chemet Succimer Meso 2,3-dimercaptosuccinic acid DMSA

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