Purpose
The purpose of this announcement is to provide an update that the Center for Disease Control (CDC) 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.
PA Department of Health (DOH) adopted the new lower BLRV on January 1, 2022. All Early Intervention Program will use the lowered reference value of 3.5 ug/dl.
Early Intervention professionals will continue to ensure consistency in the identification, screening, evaluation and tracking services for children at risk for elevated lead levels or confirmed to have elevated lead levels.
This announcement replaces guidance issued by the Bureau of Early Intervention Services and Family Supports (BEISFS) in an announcement dated August 31, 2016; Lead Exposure in Infants/Toddlers and Preschoolers.
Background
No blood lead level is safe. Exposure to lead, even at low levels, can cause intellectual, behavioral, and academic deficits. Lead exposure can cause developmental delays, immunological conditions, growth delays, hearing loss, cardiovascular conditions, irritability, hyperactivity, endocrine effects, inattentiveness, brain damage, cardiovascular problems, and death. The most vulnerable population to the effects of lead exposure are children under the age of six. The leading cause of lead poisoning is lead dust from lead-based paint, which was used in most homes until 1978. Young children are exposed to lead through normal everyday activities such as crawling on the floor and putting their hands, toys, or other objects in their mouths. Children can also be exposed through contact with contaminated ground and other objects in the home that contain lead. Pennsylvania's Act 212 of 1990, section 305 established categories of infants and toddlers that are at risk for developmental delays. It includes children with confirmed levels of lead poisoning as set by the Department of Health (DOH).
Discussion
The Office of Child Development and Early Learning (OCDEL) is required by federal and state regulations to ensure that Infant/Toddler and Preschool Early Intervention programs identify, locate, and evaluate children who are at-risk for developmental delays. Infant/Toddler and Preschool Early Intervention programs must collaborate with pediatricians, primary care physicians, healthcare professionals, and other professionals that work with children and families to ensure that children suspected of exposure to lead are referred to an Early Intervention program. In addition, Infant/Toddler and Preschool Early Intervention programs must continue to maintain their partnership with the DOH Community Health Nurses to ensure that referrals of children impacted by lead are made to the Early Intervention Program. Children referred to the Early Intervention program for suspected exposure to lead are potentially eligible for Early Intervention services and must be offered a developmental screening and/or a developmental evaluation to determine if they are eligible for Early Intervention services.
An infant or toddler that has a confirmed blood lead level of> 3.5 ug/dl and is not eligible for Early Intervention services based on a developmental evaluation, is automatically eligible for at-risk tracking services.
Additional information on resources and materials related to childhood lead poisoning and other household hazard can be obtained through the Department of Health toll-free Lead Information Line at 1-800-440-LEAD.
Next Steps
All Infant/Toddler and Preschool Early Intervention programs shall update any guidance around lead levels, educate all their staff regarding the updated lead levels and will continue to collaborate with their local pediatricians, primary care physicians, healthcare professionals and other professionals working with children and families to ensure timely referrals of children suspected of lead exposure and their families to Early Intervention services.
More information about blood lead testing can be found by calling 1-800-440-LEAD. If you have questions about this guidance, please call your local health department or 1-877-PAHEALTH
(1-877-724-3258).
Comments and Questions regarding this Announcement should be directed to the Office of Child Development and Early Learning, Bureau of Early Intervention & Family Supports at ra-ocdintervention@pa.gov.