At a glance

CDC supports Massachusetts and other state and local health departments, or their bona fide agents, through cooperative agreements to support childhood lead poisoning prevention activities. Read about the program's successes.

Massachusetts state roadside sign

About the program

The State of Massachusetts received $565,000 through cooperative agreement EH21-2102 from the Centers for Disease Control and Prevention (CDC) in the third funding year. The funds address childhood lead poisoning prevention and surveillance programmatic activities being conducted from September 30, 2023, to September 29, 2024.

The strategies focus on:

  • Ensuring blood lead testing and reporting
  • Enhancing blood lead surveillance
  • Improving linkages to recommended services

To learn more about these efforts in Massachusetts, contact the program below.

Massachusetts Department of Public Health

Massachusetts Childhood Lead Poisoning Prevention Program

250 Washington Street

Boston, MA 02108

Phone: 617-624-5757

Success story: funding year 2

Reducing lead exposure for Afghan refugees resettling in Massachusetts


In 2021, approximately 2,000 Afghan refugees resettled in Massachusetts. The Massachusetts Childhood Lead Poisoning Prevention Program (MA CLPPP) needed to educate resettlement agencies, refugee families with children younger than age 6 years, healthcare providers, and other community groups about the harmful effects of lead exposure and ways to prevent it. MA CLPPP's challenge was to provide timely, easily understood, and culturally sensitive messaging to these groups. This was especially important for Afghan families who were already facing resettlement in a new country.


In October 2021, MA CLPPP prioritized and adjusted case management and outreach practices for Afghan families. After learning about Afghan cultural and religious practices, MA CLPPP conducted the following activities:

  • Met with experienced health advocates, such as the Western States Pediatric Environmental Specialty Unit and Alameda County Lead Poisoning Prevention Program, to learn about best practices for outreach to Afghan families
  • Presented to the Massachusetts Office of Refugee and Immigrants, the Division of Global Populations, and community partners to teach them about lead exposure in high-risk populations and non-paint sources like surma
  • Provided families with recommendations for alternate safe products to use in place of lead-tainted surma
  • Connected with resettlement agencies and community health centers to improve communication and coordination of services
  • Created new fact sheets in Arabic, Dari, Hindi, Pashto, and Urdu and published them on the MA CLPPP website


As of October 2022, MA CLPPP identified and provided case management services to 26 Afghan children who had blood lead levels (BLLs) ≥10 µg/dL. MA CLPPP triggered a mandatory home inspection for 20 children who were younger than 6 years. MA CLPPP action levels for blood lead levels range from 3.5 to 10 µg/dL, depending on guidelines.) Thirteen homes were inspected, which included three homes with exposed siblings. CLPPP code enforcement lead inspectors identified lead hazards in six homes and issued orders to conduct abatement. Seven homes were free from lead hazards. Four families moved out of state before CLPPPP could conduct an environmental investigation. For these cases, CLPPP staff contacted partner CLPPPs in each state to alert them that the families may need additional care upon arrival. The majority (90%) of the 20 younger children's BLLs decreased within 1–4 months of their initial blood lead test. The remaining six children who were older than 6 years were monitored for medical re-screening by MA CLPPP to ensure clinical consultation and care by their physicians.

MA CLPPP personnel created partnerships and a model to rapidly respond to future refugee resettlements through enhanced cultural sensitivity awareness, communication skills, and collaborations with federal, state, and community-based organizations.

Funding for this work was made possible in part by NUE2EH001456 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Success story: funding year 1

Massachusetts uses new method to calculate accurate screening rates


While U.S. Census data are useful, data are only collected every ten years. Therefore, lead screening rates based on census data may be inaccurate since populations can vary significantly over a decade. Conducting lead program activities based on data every collected every 10 years can result in programs making incorrect decisions that could leave children in need without services. Massachusetts was interested in identifying high-risk populations at a more localized level to help with outreach and prevention efforts and to develop more precise population estimates.


Massachusetts state law requires that childhood blood lead test results be reported to the Department of Public Health, Bureau of Environmental Health’s Childhood Lead Poisoning Prevention Program (CLPPP), which allows the program to record the number of children screened accurately. Identifying the number of children eligible for lead screening compared to the number screened requires an accurate estimate of children’s total population and age distribution in a community. Population estimates in the intercensal years were previously based on data collected during the last U.S. Census in 2010. Because significant demographic shifts in populations can occur over a 10 period, the Bureau of Environmental Health partnered with the University of Massachusetts to use scientifically approved and validated methods to estimate population by age, sex, and race/ethnicity for every year, census tract, and community in Massachusetts during 2010‑2020 (U.S. Census years).


CLPPP applied the new population estimates to screening rates for 2017 and determined the following:

  • 48 small to medium-sized communities (median population=10,765) decreased screening rates from above or near the state average to below the state average by at least 5%.
  • The overall state screening rate decreased from 76% to 73%.

CLPPP is using this information to target new outreach efforts to medical care providers and local health practitioners:

  • Prioritizing educational in-service training for pediatric practices within the 48 communities.
  • Contacting providers regarding requirements and best practices for screening, reporting (including in-house, point-of-care device test results), and parent education.
  • Updating and providing Childhood Lead Screening Community Progress Reports.
  • Reminding providers to conduct venous follow-up testing for children with elevated capillary tests; and
  • Providing services and education to reduce lead exposures and to increase screening.

Funding for this work was made possible in part by EH17-1701 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.