Free Lead Dust Tests
Maine CDC offers free home lead dust test kits to families with young children or children on the way. Order a free home lead dust test kit. Watch our video to see how to do the test.
In-Office Blood Lead Testing
At a glance
- A blood lead test is the only way to find out if a child has lead poisoning.
- A child with lead poisoning may not have visible signs or symptoms.
- Parents can talk to their child’s healthcare provider about getting a blood lead test if their child may have been exposed.
New Blood Lead Testing Guidelines
Follow Maine CDC guidelines and test all children for lead poisoning at 1 and 2 years of age. Effective October 1, 2022, providers should confirm all capillary blood lead levels 3.5 ug/dL or higher with venous samples.
Blood Lead Testing Requirements
Maine CDC provides services based on venous lead levels 3.5 ug/dL or higher. The initial blood lead screening test may be either a venous or capillary sample. An elevated capillary sample (>3.5 ug/dL) must be confirmed with a venous sample.
Testing Children by Age
Maine law requires blood lead tests for all children at 1 and 2 years of age. For children 3-5 years covered by MaineCare, conduct a mandatory blood lead test if not previously tested; if previously tested, we recommend conducting a blood lead test yearly unless risk assessment questionnaire is negative. For children not covered by MaineCare, we recommend conducting a blood lead test yearly unless risk assessment questionnaire is negative.
- Risk Assessment Questionnaire
Ask a parent or guardian to answer the following questions to help identify at-risk children under 6 years of age. If a child's parent or guardian answers 'yes' or 'don't know' to any of the questions below, test the child for lead.
- Does your child spend more than 10 hours per week in any house built before 1950?
- Does your child spend more than 10 hours per week in any house built before 1978 that was renovated or remodeled within the last 6 months?
- Does your child spend time with an adult whose job exposes him/her to lead? (Examples: construction, painting, metalwork)
- Does your child have a sibling or playmate that has been diagnosed with lead poisoning?
- Determining Who to Test
Test at-risk populations annually through 5 years of age, and as clinically indicated, even if the risk assessment questionnaire is negative. At-risk populations.
- Recent immigrants or international adoptees
- Children whose parents immigrated to the U.S.
- Children with pica behavior
- Children with neurodevelopmental disabilities or conditions such as autism that put them at higher risk for hand-to-mouth behavior
- Children entering foster care
Recently arrived refugee children.
- Perform a blood lead test for children 6 months to 16 years upon entry to the U.S.
- Within 3-6 months of initial test, conduct follow-up test for children 6 months to 6 years, regardless of initial test result.
- Consult U.S. CDC Recommendations for Lead Poisoning Prevention in Newly Arrived Refugee Children. Download a copy of the Recommendations
- Determining When to Run a Confirmation Test
- Confirm capillary screening test results 3.5 ug/dL or higher with a venous test.
- The higher the capillary test result, the more urgent the need for a confirmatory venous test.
- Confirmatory testing is not required when an initial screening test uses a venous sample.
- The sooner a provider confirms a capillary blood lead test with a venous specimen, the sooner the Maine CDC can initiate services to identify and eliminate the sources of lead exposure.
- How to Submit Samples to the State Lab
- Collect either a capillary or venous specimen. To prevent false positive capillary samples, wash and scrub the finger or toe that you will be testing with soap. Use a surgical brush or soft toothbrush.
- For free blood collection supplies and mailers, providers may call the State of Maine Health and Environmental Testing Lab (HETL) at 207-287-2727.
- How to Submit Results of Your In-Office Blood Testing
- Perform capillary blood lead analysis using a CLIA waived in-office blood lead testing device
- Report test results to the Maine CDC Childhood Lead Poisoning Prevention Program (MCLPPP).
- Providers must have approval from the MCLPPP before they can begin in-office testing.
- For providers interested in beginning in-office testing, in-off.
- Information about In-Office Blood Lead Testing
Maine law allows approved providers to perform in-office blood lead testing of children under age 6 years using a CLIA-waived, direct-read blood lead analyzer and to electronically report all test results to the Maine Childhood Lead Poisoning Prevention Program.
- Currently, the only CLIA-waived, in-office, direct-read blood lead testing device is the LeadCare II, made by Magellan Diagnostics.
- Providers must have approval from the Maine Childhood Lead Poisoning Prevention Program before they can begin in-office testing. The purpose of the approval is to ensure 1) that in-office blood lead testing will remove barriers to testing; and 2) that providers using in-office testing will be able to have complete, timely, and electronic reporting of all test results directly to Maine Childhood Lead Poisoning Prevention Program.
- All elevated blood lead levels still require a venous confirmation through the State Health and Environmental Testing Laboratory. See the Capillary Lead Test Confirmation Schedule (See Below) for more information.
- For questions about the law, approval process, or data reporting requirements, contact:
Dr. Maggie Bordeau, Public Health Physician,
Childhood Lead Poisoning Prevention Program
207-592-2432
margaret.bordeau@maine.gov
Find resources
Blood Lead Testing Guidelines (PDF)
| Capillary Blood Lead Level | Confirm with Venous Test Within |
|---|---|
| 3.5 - <10 ug/dL | As soon as possible, but no later than 3 months |
| 10 - <20 ug/dL | As soon as possible, but no later than 1 month |
| 20 - <45 ug/dL | As soon as possible, but no later than 2 weeks |
| 45+ | Immediately, but no later than 48 hours |
| Blood lead level | Follow-up venous test schedule | Recommended actions based on confirmed venous BLL |
|---|---|---|
| 3.5 - <10 ug/dL | Within 3 months* |
|
| 10 - <20 ug/dL | Within 2 months* |
|
| 20 - <45 ug/dL | Within 1 month* |
|
| 45+ ug/dL Urgent Action Needed | Immediately (place order as STAT) |
|
Maine CDC’s Response to High Blood Lead Levels
The Maine CDC will respond when a child aged 0 to less than 72 months has a confirmed venous blood lead level at or above 3.5 ug/dL.
| Maine CDC’s Response | 3.5 - <5 ug/dL | 5 - <10 ug/dL | 10 - <45 ug/dL | 45+ ug/dL |
|---|---|---|---|---|
| Offer free home lead dust test and if dust levels are high, provide environmental investigation and case management services described below | X | |||
| Conduct environmental investigation of the child’s home to identify and remove lead hazards | X | X | X | |
| Provide case management services to: discuss outcomes of investigation, prevent further exposure, and monitor blood lead level | X | X | X | |
| Offer home visit from a public health nurse | As needed | X | X | |
| CDS referral (lead poisoning is a qualifying diagnosis for CDS) | X | X | X | |
| Coordinate with providers and Northern New England Poison Center on urgent evaluation for chelation therapy and investigation of the child’s home environment for lead hazards | X |