10/28/2021: Lab Advisory: CDC Updates Blood Lead Reference Value

CDC's Laboratory Outreach Communication System (LOCS)

Audience: Laboratories Performing Blood Lead Testing

Level: Laboratory Advisory

The U.S. Centers for Disease Control and Prevention (CDC) recently updated its blood lead reference value (BLRV) from 5 µg/dL to 3.5 µg/dL in response to the Lead Exposure Prevention and Advisory Committee (LEPAC) recommendation made on May 14, 2021. The BLRV is intended to identify children with higher levels of lead in their blood compared to most children, based on the 97.5th percentile of the blood lead level (BLL) distribution in U.S. children ages 1–5 years.

The new BLRV of 3.5 μg/dL may create challenges for laboratories that perform blood lead testing. Laboratories may encounter increased workloads because of additional repeat and confirmatory testing. Some laboratories may need to

  • Reduce lower reporting limit policies
  • Adopt new repeat testing practices
  • Improve limits of detection of laboratory-developed tests
  • Acquire new instrumentation
  • Validate new laboratory-developed tests
  • Clarify minimum volume requirements for pediatric capillary samples
  • Update data handling systems to report blood lead levels to the tenth of a µg/dL (i.e., X.X µg/dL) if they currently only report BLLs in integer values
  • Take extra steps to prevent common lead contamination in laboratory consumables and the laboratory environment to prevent false positives in reporting at these lower levels

Online resources: 

For questions about the latest analytical method documentation, contact CDC’s Division of Laboratory Sciences Inorganic and Radiation Analytical Toxicology Branch.

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Thank you,

The Laboratory Outreach Communication System

Laboratory Outreach Communication System (LOCS) | Division of Laboratory Systems (DLS)

Center for Surveillance, Epidemiology, and Laboratory Services (CSELS)

Centers for Disease Control and Prevention (CDC)