Lead Poisoning Prevention Guidance for Health Care Providers | Vermont Department of Health
Archived: 2026-04-23 17:18
Lead Poisoning Prevention Guidance for Health Care Providers | Vermont Department of Health
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Lead Poisoning Prevention Guidance for Health Care Providers
Children's Environmental Health
Guide for Child Care Providers
Guide for Parents and Caregivers
Guide for Schools
Chemical Disclosure Program for Children's Products
Lead Poisoning Prevention Guidance for Health Care Providers
Lead Poisoning Prevention Guidance for Parents and Caregivers
This information is for health care providers.
The Healthy Homes Lead Poisoning Prevention Program works with you to ensure that all 1- and 2-year-old children are tested for lead, as required by law. We also provide guidance for people who are pregnant or breastfeeding and adults who are exposed to lead.
Vermont’s definition of an elevated blood lead level is any reported level. Research highlights that there is no safe level of lead and even low levels impair development in children and cause other health effects in adults. Therefore,
any level of lead in the blood is considered elevated
.
The information on this page is also available in PDF form for easy referencing or printing:
Download the Lead Poisoning Prevention Toolkit
Overview of State Law Requirements
Vermont law
requires you to:
Test all children for lead at 12 months and 24 months of age.
Give a copy of
What Your Child’s Lead Test Means
to parents or caregivers when their child is tested for lead.
Report all blood lead results for Vermont residents to the Department of Health, if you have a LeadCare II analyzer.
Testing Requirements and Guidelines
When to test if a child doesn’t have symptoms
These criteria are for testing asymptomatic children at well child visits and do not apply to children previously or currently have elevated lead levels:
Test all children at
12 months
and
24 months
.
Test all children ages 36 to 72 months who have
not been previously tested
.
For refugees:
test all children ages 6 months to 16 years old upon entry to the U.S.
Perform a follow-up blood lead test on all refugee children ages 6 months to 6 years old within three to six months, regardless of initial test result.
For other at-risk populations:
test children who are international adoptees, immigrants, children of migrant workers, in foster care, and are diagnosed with pica or special health needs that increase hand-to-mouth behavior.
Find out how to collect and analyze capillary samples
When to test if a child of any age has symptoms
Blood lead testing should be considered part of a diagnostic work-up of any child, regardless of age, if they:
Ingested an object that may contain lead
Have signs or
symptoms consistent with lead poisoning
Live in an older home undergoing renovations
Live with someone who has a blood lead level of 5 µg/dL or greater
Are an at-risk population (children who are international adoptees, immigrants, children of migrant workers, in foster care, and are diagnosed with pica or special health needs that increase hand-to-mouth behavior)
Find out how to collect and analyze capillary samples
When to confirm with a venous test
Confirm capillary levels
at or above 3.5 µg/dL
with a venous test.
Monitor capillary levels
between the detection limit and 3.4 µg/dL
over the next 6 months.
The higher the capillary test result, the more urgent the need for a confirmatory venous test. Please confirm as early as possible. See the guidelines in the table below.
The Health Department provides education and initiates case management for all venous confirmed lead levels.
For detected lead levels less than 3.5 µg/dL, we send a letter with educational materials.
For venous lead levels 3.5 – 4.9 µg/dL, we provide education over the phone.
For lead levels 5 µg/dL and higher, we offer an environmental inspection of the child’s home.
If Capillary Blood Lead Level is:
Confirm with Venous Test Within:
The health department will:
Not detected
Confirmation not needed
Any detected level* – 3.4 µg/dL
Within 6 months (capillary sample or venous)
Send a letter to the family recommending another blood lead test within 6 months
3.5 – 9 µg/dL
Within 3 months
Send a letter to the family recommending a venous blood test within 3 months
10 – 19 µg/dL
Within 1 month
Send a letter to the family recommending a venous blood test within 2 weeks to 1 month
20 – 44 µg/dL
Within 2 weeks
Send a letter to the family recommending a venous blood test within 2 weeks
45 – 59 µg/dL
48 hours
Call the family recommending a venous test as soon as possible
60+ µg/dL
Immediately as an emergency test
Call the family recommending an immediate venous test
*Detection limit varies across laboratories from <1 μg/dL to 3.3 μg/dL.
When to follow up with a venous retest
If venous blood level is:
Do a follow-up venous test within:
Late follow-up within (when blood lead level is declining):
Not detected
Venous retest is not required
Any detected level* – 3.4 µg/dL
6 – 9 months
3.5 – 9 µg/dL
3 months
6 – 9 months
10 – 19 µg/dL
1 – 3 months
3 – 6 months
20 – 44 µg/dL
2 weeks – 1 month
1 – 3 months
45+ µg/dL
Initiate chelation and retest in 7 – 21 days
As clinically indicated
*Detection limit varies across laboratories from <1 μg/dL to 3.3 μg/dL.
See the
Clinical Treatment Guidelines for Venous Confirmed Blood Lead Levels
for children ages 6 to 72 months.
When to test pregnant or breastfeeding people and adults
Because evidence of lead exposure is often not apparent, it’s important to assess lead risks for pregnant and breastfeeding patients regardless of
clinical signs
. Use the
Blood Lead Risk Assessment for Pregnant and Breastfeeding People
to determine when to have them tested.
If adults are exhibiting
symptoms of lead poisoning
and have
jobs or hobbies
that increase their lead exposure risk), then consider having them tested.
Examples of jobs include manufacturing, construction, automotive repair, or mining
Examples of hobbies include making stained glass, target shooting, casting bullets, making ceramics, furniture refinishing, or home renovations
How to collect and analyze capillary samples
A high percentage of patients referred to a hospital lab do not follow through with a lead test. We recommend collecting and analyzing blood samples through one of these options:
The Health Department Lab can mail
free
test kits to your practice with a 3- to 4-day turnaround for results.
Order free blood lead testing supplies
.
Remember to fill out the
blood lead test requisition
form when returning samples to the Lab.
Be sure to follow instructions for proper
capillary sample collection
. Watch the video below that shows how to collect capillary samples properly.
If you’re at a larger practice, consider a Lead Care II analyzer for point-of-care testing. These machines offer results within minutes.
Have another clinic laboratory analyze capillary samples you collect in office.
Reporting Requirements and Guidelines
Most analytical laboratories report directly to us. However, if you have a LeadCare II analyzer, you are required to report all blood lead results for Vermont residents. Please
contact us
for more information and procedures for reporting results.
Tips to improve testing rates at your practice
Each year, we send a report to you so that you can see how your practice’s testing rate compares to the state average.
Contact us
for your latest report.
We know that well child visits can be busy. Here are some tips for improving test rates at your practice:
1. Designate a lead screening champion
Assign a staff member to run lead screening at your practice.
Monitor and
track the monthly percentage of patients overdue for lead testing
to see trends and areas for improvement.
2. Use your Electronic Health Record (EHR)
Set
automatic reminders
for lead testing at
12- and 24-month well child visits
.
Include
alerts to follow up
with patients who miss their 12- or 24-month well child visits.
3. Access and use the Patient Profile Lead Tab
Have
two designated staff members
sign up for access.
Use the Lead Tab to
pull population-level reports
on children who have not been tested.
Continue to
track and share monthly data
.
Run
regular reports
to find:
Patients who are coming in due for testing.
Patients who are overdue.
Use reports to:
Offer lead testing
during acute visits
.
Reach out
to patients ages
36 to 72 months
who have never been tested.
4. Improve access to screening
In-office screening:
Use point-of-care (POC) testing to improve compliance.
Many patients referred to outside labs
do not follow through
with testing.
Health Department Lab:
Take advantage of
free testing kits
and mailing services
.
Recommended for practices without POC testing capabilities.
LeadCare II Analyzer:
Consider purchasing a POC analyzer if you have a large practice.
Keep the
Health Department Lab
as a backup in case of recalls or downtime.
Make sure reporting happens
regularly
(weekly or bi-weekly).
How to access blood lead results through Patient Profile
Patient Profile, commonly called the Immunization Registry, is a confidential, web-based system that collects and shares data related to immunizations, as well as results from childhood hearing, newborn metabolic, blood lead and developmental screening.
Access to the
Blood Lead Program
will allow you to view patient records or run reports:
Individual Patient Record
– provides a complete history of reported blood lead results for a patient
Screening Tests Needed Report
– lists patients in your practice who are due or overdue for their 12-month or 24-month lead tests, and patients between ages 36 and 72 months who have never had a lead test
Venous Follow-Up Tests Needed
– lists patients in your practice who need venous confirmation tests and those who are in case management
New Users
If you are a new user, please sign the
Provider Confidentiality Agreement
and fax it to 802-863-7483 or email it to
[email protected]
.
Need to reset your password?
Your password will expire every 6 months. Click the button below to reset your password.
You will be asked to enter the email address that is associated with your account.
A link will be emailed to you where you can reset your password.
Reset Your Password
Resources and Patient Information
Resources for you
Pediatric Blood Lead Testing Guidelines
Order Form for Blood Lead Testing Supplies
from the Vermont Department of Health Lab
Blood Lead Test Requisition Form
for samples to be analyzed at the Vermont Department of Health Lab
Capillary Blood Lead Specimen Collection Instructions
and how-to video
Provider Confidentiality Agreement
to gain access to patients’ results via the Patient Profile
Blood Lead Exposure Risk Assessment for Pregnant People
“Lead Dust Can be Anywhere” Poster
to display in your office
Resources for your patients
What Your Child’s Lead Test Means
Tips for Keeping Children Safe From Lead
Pregnancy and Lead Poisoning
Adult Lead Poisoning
Translated Information
How to Prevent Lead Poisoning in Children in:
العربية (Arabic)
|
دری (Dari)
|
English
|
नेपाली (Nepali)
|
پښتو (Pashto)
|
Soomaali (Somali)
Lead Information for Refugees and New Americans (video) in:
العربية (Arabic)
|
English
|
नेपाली (Nepali)
|
Soomaali (Somali)
What Your Child's Lead Test Means in:
العربية (Arabic)
|
မြန်မာစာ (Burmese)
|
中文 (Chinese)
|
دری (Dari)
|
English
|
Français (French)
|
Karen
|
नेपाली (Nepali)
|
پښتو (Pashto)
|
Soomaali (Somali)
|
Español (Spanish)
|
Kiswahili (Swahili)
|
Tiếng Việt (Vietnamese)
Additional Resources
Childhood Lead Poisoning Prevention Reports to the Legislature
Explore Vermont Childhood Lead Poisoning Data
Contact Us
Healthy Homes Lead Poisoning Prevention Program
Phone:
802-863-7220 or 800-439-8550 (toll-free in Vermont)
Fax:
802-863-7483
Email:
[email protected]
Topics:
Child Health and Safety
|
Early Childhood Health
|
Lead Poisoning
Last Updated:
April 9, 2026
Skip to main content
MENU
x
CLOSE
Translations for you
Lead Poisoning Prevention Guidance for Health Care Providers
Children's Environmental Health
Guide for Child Care Providers
Guide for Parents and Caregivers
Guide for Schools
Chemical Disclosure Program for Children's Products
Lead Poisoning Prevention Guidance for Health Care Providers
Lead Poisoning Prevention Guidance for Parents and Caregivers
This information is for health care providers.
The Healthy Homes Lead Poisoning Prevention Program works with you to ensure that all 1- and 2-year-old children are tested for lead, as required by law. We also provide guidance for people who are pregnant or breastfeeding and adults who are exposed to lead.
Vermont’s definition of an elevated blood lead level is any reported level. Research highlights that there is no safe level of lead and even low levels impair development in children and cause other health effects in adults. Therefore,
any level of lead in the blood is considered elevated
.
The information on this page is also available in PDF form for easy referencing or printing:
Download the Lead Poisoning Prevention Toolkit
Overview of State Law Requirements
Vermont law
requires you to:
Test all children for lead at 12 months and 24 months of age.
Give a copy of
What Your Child’s Lead Test Means
to parents or caregivers when their child is tested for lead.
Report all blood lead results for Vermont residents to the Department of Health, if you have a LeadCare II analyzer.
Testing Requirements and Guidelines
When to test if a child doesn’t have symptoms
These criteria are for testing asymptomatic children at well child visits and do not apply to children previously or currently have elevated lead levels:
Test all children at
12 months
and
24 months
.
Test all children ages 36 to 72 months who have
not been previously tested
.
For refugees:
test all children ages 6 months to 16 years old upon entry to the U.S.
Perform a follow-up blood lead test on all refugee children ages 6 months to 6 years old within three to six months, regardless of initial test result.
For other at-risk populations:
test children who are international adoptees, immigrants, children of migrant workers, in foster care, and are diagnosed with pica or special health needs that increase hand-to-mouth behavior.
Find out how to collect and analyze capillary samples
When to test if a child of any age has symptoms
Blood lead testing should be considered part of a diagnostic work-up of any child, regardless of age, if they:
Ingested an object that may contain lead
Have signs or
symptoms consistent with lead poisoning
Live in an older home undergoing renovations
Live with someone who has a blood lead level of 5 µg/dL or greater
Are an at-risk population (children who are international adoptees, immigrants, children of migrant workers, in foster care, and are diagnosed with pica or special health needs that increase hand-to-mouth behavior)
Find out how to collect and analyze capillary samples
When to confirm with a venous test
Confirm capillary levels
at or above 3.5 µg/dL
with a venous test.
Monitor capillary levels
between the detection limit and 3.4 µg/dL
over the next 6 months.
The higher the capillary test result, the more urgent the need for a confirmatory venous test. Please confirm as early as possible. See the guidelines in the table below.
The Health Department provides education and initiates case management for all venous confirmed lead levels.
For detected lead levels less than 3.5 µg/dL, we send a letter with educational materials.
For venous lead levels 3.5 – 4.9 µg/dL, we provide education over the phone.
For lead levels 5 µg/dL and higher, we offer an environmental inspection of the child’s home.
If Capillary Blood Lead Level is:
Confirm with Venous Test Within:
The health department will:
Not detected
Confirmation not needed
Any detected level* – 3.4 µg/dL
Within 6 months (capillary sample or venous)
Send a letter to the family recommending another blood lead test within 6 months
3.5 – 9 µg/dL
Within 3 months
Send a letter to the family recommending a venous blood test within 3 months
10 – 19 µg/dL
Within 1 month
Send a letter to the family recommending a venous blood test within 2 weeks to 1 month
20 – 44 µg/dL
Within 2 weeks
Send a letter to the family recommending a venous blood test within 2 weeks
45 – 59 µg/dL
48 hours
Call the family recommending a venous test as soon as possible
60+ µg/dL
Immediately as an emergency test
Call the family recommending an immediate venous test
*Detection limit varies across laboratories from <1 μg/dL to 3.3 μg/dL.
When to follow up with a venous retest
If venous blood level is:
Do a follow-up venous test within:
Late follow-up within (when blood lead level is declining):
Not detected
Venous retest is not required
Any detected level* – 3.4 µg/dL
6 – 9 months
3.5 – 9 µg/dL
3 months
6 – 9 months
10 – 19 µg/dL
1 – 3 months
3 – 6 months
20 – 44 µg/dL
2 weeks – 1 month
1 – 3 months
45+ µg/dL
Initiate chelation and retest in 7 – 21 days
As clinically indicated
*Detection limit varies across laboratories from <1 μg/dL to 3.3 μg/dL.
See the
Clinical Treatment Guidelines for Venous Confirmed Blood Lead Levels
for children ages 6 to 72 months.
When to test pregnant or breastfeeding people and adults
Because evidence of lead exposure is often not apparent, it’s important to assess lead risks for pregnant and breastfeeding patients regardless of
clinical signs
. Use the
Blood Lead Risk Assessment for Pregnant and Breastfeeding People
to determine when to have them tested.
If adults are exhibiting
symptoms of lead poisoning
and have
jobs or hobbies
that increase their lead exposure risk), then consider having them tested.
Examples of jobs include manufacturing, construction, automotive repair, or mining
Examples of hobbies include making stained glass, target shooting, casting bullets, making ceramics, furniture refinishing, or home renovations
How to collect and analyze capillary samples
A high percentage of patients referred to a hospital lab do not follow through with a lead test. We recommend collecting and analyzing blood samples through one of these options:
The Health Department Lab can mail
free
test kits to your practice with a 3- to 4-day turnaround for results.
Order free blood lead testing supplies
.
Remember to fill out the
blood lead test requisition
form when returning samples to the Lab.
Be sure to follow instructions for proper
capillary sample collection
. Watch the video below that shows how to collect capillary samples properly.
If you’re at a larger practice, consider a Lead Care II analyzer for point-of-care testing. These machines offer results within minutes.
Have another clinic laboratory analyze capillary samples you collect in office.
Reporting Requirements and Guidelines
Most analytical laboratories report directly to us. However, if you have a LeadCare II analyzer, you are required to report all blood lead results for Vermont residents. Please
contact us
for more information and procedures for reporting results.
Tips to improve testing rates at your practice
Each year, we send a report to you so that you can see how your practice’s testing rate compares to the state average.
Contact us
for your latest report.
We know that well child visits can be busy. Here are some tips for improving test rates at your practice:
1. Designate a lead screening champion
Assign a staff member to run lead screening at your practice.
Monitor and
track the monthly percentage of patients overdue for lead testing
to see trends and areas for improvement.
2. Use your Electronic Health Record (EHR)
Set
automatic reminders
for lead testing at
12- and 24-month well child visits
.
Include
alerts to follow up
with patients who miss their 12- or 24-month well child visits.
3. Access and use the Patient Profile Lead Tab
Have
two designated staff members
sign up for access.
Use the Lead Tab to
pull population-level reports
on children who have not been tested.
Continue to
track and share monthly data
.
Run
regular reports
to find:
Patients who are coming in due for testing.
Patients who are overdue.
Use reports to:
Offer lead testing
during acute visits
.
Reach out
to patients ages
36 to 72 months
who have never been tested.
4. Improve access to screening
In-office screening:
Use point-of-care (POC) testing to improve compliance.
Many patients referred to outside labs
do not follow through
with testing.
Health Department Lab:
Take advantage of
free testing kits
and mailing services
.
Recommended for practices without POC testing capabilities.
LeadCare II Analyzer:
Consider purchasing a POC analyzer if you have a large practice.
Keep the
Health Department Lab
as a backup in case of recalls or downtime.
Make sure reporting happens
regularly
(weekly or bi-weekly).
How to access blood lead results through Patient Profile
Patient Profile, commonly called the Immunization Registry, is a confidential, web-based system that collects and shares data related to immunizations, as well as results from childhood hearing, newborn metabolic, blood lead and developmental screening.
Access to the
Blood Lead Program
will allow you to view patient records or run reports:
Individual Patient Record
– provides a complete history of reported blood lead results for a patient
Screening Tests Needed Report
– lists patients in your practice who are due or overdue for their 12-month or 24-month lead tests, and patients between ages 36 and 72 months who have never had a lead test
Venous Follow-Up Tests Needed
– lists patients in your practice who need venous confirmation tests and those who are in case management
New Users
If you are a new user, please sign the
Provider Confidentiality Agreement
and fax it to 802-863-7483 or email it to
[email protected]
.
Need to reset your password?
Your password will expire every 6 months. Click the button below to reset your password.
You will be asked to enter the email address that is associated with your account.
A link will be emailed to you where you can reset your password.
Reset Your Password
Resources and Patient Information
Resources for you
Pediatric Blood Lead Testing Guidelines
Order Form for Blood Lead Testing Supplies
from the Vermont Department of Health Lab
Blood Lead Test Requisition Form
for samples to be analyzed at the Vermont Department of Health Lab
Capillary Blood Lead Specimen Collection Instructions
and how-to video
Provider Confidentiality Agreement
to gain access to patients’ results via the Patient Profile
Blood Lead Exposure Risk Assessment for Pregnant People
“Lead Dust Can be Anywhere” Poster
to display in your office
Resources for your patients
What Your Child’s Lead Test Means
Tips for Keeping Children Safe From Lead
Pregnancy and Lead Poisoning
Adult Lead Poisoning
Translated Information
How to Prevent Lead Poisoning in Children in:
العربية (Arabic)
|
دری (Dari)
|
English
|
नेपाली (Nepali)
|
پښتو (Pashto)
|
Soomaali (Somali)
Lead Information for Refugees and New Americans (video) in:
العربية (Arabic)
|
English
|
नेपाली (Nepali)
|
Soomaali (Somali)
What Your Child's Lead Test Means in:
العربية (Arabic)
|
မြန်မာစာ (Burmese)
|
中文 (Chinese)
|
دری (Dari)
|
English
|
Français (French)
|
Karen
|
नेपाली (Nepali)
|
پښتو (Pashto)
|
Soomaali (Somali)
|
Español (Spanish)
|
Kiswahili (Swahili)
|
Tiếng Việt (Vietnamese)
Additional Resources
Childhood Lead Poisoning Prevention Reports to the Legislature
Explore Vermont Childhood Lead Poisoning Data
Contact Us
Healthy Homes Lead Poisoning Prevention Program
Phone:
802-863-7220 or 800-439-8550 (toll-free in Vermont)
Fax:
802-863-7483
Email:
[email protected]
Topics:
Child Health and Safety
|
Early Childhood Health
|
Lead Poisoning
Last Updated:
April 9, 2026