County of Santa Cruz Health Services Agency, Blood Lead Levels

There are two methods that can be used to test a child for lead poisoning. Those methods are 1) capillary (fingerstick), which allows a large number of children to be screened, and 2) venous (blood taken from the vein that is very accurate.) The following chart informs you as to what actions the local Health Department Childhood Lead Poisoning Prevention Program (CLPPP) staff will provide when results are received from either method. The blood lead levels given are measured in micrograms per deciliter (one millionth of a gram).

Blood Level	Fingerstick Method	Venous Method
5-9 µg/dL	At this level the provider should consider retesting in six months. Provider should also consider ordering neurodevelopmental screening, adding a notation of the BLL to the child’s medical record for future neurodevelopment monitoring, and testing other family members.
5-9 µg/dL	Santa Cruz County CLPPP staff will provide: Telephone consultation Mailed educational Materials	Santa Cruz County CLPPP staff will provide: Telephone consultation Mailed educational Materials
10-14 µg/dL	Retest with in 3 months.	Retest within 3 months.
10-14 µg/dL	Santa Cruz County CLPPP staff will provide: Telephone consultation Facilitate a venous blood test for confirmation.	Santa Cruz County CLPPP staff will provide: Telephone consultation Lead education literature Facilitate retest in 3 months
15-19 µg/dL	Your child needs a venous blood test in 1 to 3 months. Consider testing hemoglobin and hematocrit levels.	Retest in 1 month. Consider testing hemoglobin and hematocrit levels. * If your child has a second blood lead test result in this range CLPPP staff will proceed according to actions for blood lead levels between 20-44 ug/dL.
15-19 µg/dL	Santa Cruz County CLPPP staff will provide: Telephone consultation Facilitate a venous blood test for confirmation Possible home visit by CLPPP staff	Santa Cruz County CLPPP staff will provide: Telephone consultation Lead education literature Facilitate retest in 1-2 months Possible home visit by CLPPP staff
20-44 µg/dL	Your child needs a venous blood test as soon as possible.	Retest from 1 week to 1 month.
20-44 µg/dL	Santa Cruz County CLPPP staff will provide: Telephone consultation Facilitate a venous blood test for confirmation Arrange for home visit by CLPPP staff	Santa Cruz County CLPPP staff will provide: Telephone consultation Public Health Nurse home visit Medical case management Environmental home investigation Referral to appropriate support agencies Lead education literature Facilitate retest from 1 week to 1 month CLPPP staff will consult with medical provider
Above 45-69 µg/dL	Your child needs an URGENT venous blood test for confirmation within 24-48 hours.	Your child needs a full medical checkup and possible medical treatment NOW! * Long-term lead poisoning, such as with a retained bullet, may result in persistent highly elevated BLLs and thus require modified follow-up.
Above 45-69 µg/dL	Santa Cruz County CLPPP staff will provide: Telephone consultation Facilitate venous blood test for confirmation within 24-48 hours. Consider home visit by CLPPP staff Lead education literature	Santa Cruz County CLPPP staff will provide: Immediate PHN home visit Medical case management Environmental lead investigation Referral to appropriate agencies Consider chelation treatment Facilitate retest as appropriate Lead education literature
> 70 µg/dL	This is an EMERGENCY! If your child is exhibiting flu-like symptoms, dehydration or seizure activity go directly to the Emergency Room and tell them about the blood-lead test.
	Your child needs a venous blood test for confirmation, immediately!	Blood lead levels over 70ųg/dL are considered a medical emergency!
	Santa Cruz County CLPPP staff will provide: Telephone consultation Facilitate immediate venous blood test for confirmation.	Santa Cruz County CLPPP staff will provide: Facilitate hospitalization Medical case management Environmental investigation Referral to appropriate agencies Monitor chelation treatment Facilitate retest as appropriate Lead education literature

		Mailing Address: County of Santa Cruz Health Services Agency 1080 Emeline Avenue, Santa Cruz, CA 95060 \| Phone: 831 454 4000 \| Fax: 831 454 4770 Hearing Impaired TDD: 831 454 2123 \| copyright© 2000 County of Santa Cruz
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