U.S. Department
of Health and Human Services
ACF
Administration for Children and Families
Information Memorandum
To: Head Start and Early Head Start Grantees and Delegate Agencies
Subject: Lead Screening
In May 2000, the Office of Head Start (OHS) issued an Information Memorandum regarding the "Childhood Lead Poisoning Prevention Collaboration" (ACYF-IM-HS-00-13). The purpose of this Information Memorandum is to reiterate the importance of lead screenings and to clarify the requirements for lead toxicity screening for Head Start children.
The United States has made progress in reducing lead exposure among children. However, the issue remains a serious environmental health hazard for those living in poverty and young children under the age of six. Estimates based on screenings show that low-income and Medicaid-eligible children are nearly five times more likely to have harmful blood lead levels than the general child population.
Lead, a poisonous metal, contains a neurotoxin that is harmful to fetuses and developing young children. Extremely high levels can result in seizures, coma, even death. Lead poisoning is a serious yet preventable condition that is particularly damaging to young children; it can affect a child’s brain, kidneys, bone marrow and other body systems. There can be adverse health effects even at low blood lead levels. According to the Centers for Disease Control and Prevention (CDC), a "threshold" has not yet been determined regarding the minimum level of lead that could result in negative cognitive and behavioral development. This is of concern since children often do not display obvious symptoms of elevated lead levels. Therefore, the best way to detect elevated lead levels is through a blood test.
Children may be exposed to lead poisoning from a variety of environmental sources. The primary source in young children is through contaminated dust from deteriorating lead-based paint in older homes. Newly immigrant children may be at risk due to cultural traditions that commonly use lead-glazed cooking vessels and lead-based home remedies. Occupational exposure, another potential source, introduces lead into the home or a woman’s womb from individuals who work with the metal daily.
Low-income families are disproportionately at risk as these families tend to live in older housing which may contain lead-based paint or lead plumbing. The Centers for Medicare & Medicaid Services (CMS) require that all low-income, Medicaid-eligible children be screened for lead toxicity using a blood test. In 2001, the Journal of the American Academy of Pediatrics estimated 60% of children with elevated lead levels were Medicaid recipients and 83% of children with lead levels greater than 20ug/dL were on Medicaid (Journal of the American Academy of Pediatrics, December 2001). For this reason, all children who qualify for Medicaid are considered "at risk" for the Early and Periodic Screening, Diagnostic, and Treatment program (EPSDT) blood risk assessment.
For additional information regarding lead toxicity screening for Medicaid-eligible children, visit http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Early-and-Periodic-Screening-Diagnostic-and-Treatment.html .
Information on lead poisoning prevention can be found at http://www.cdc.gov/nceh/lead/ as well as the Head Start Early Childhood Learning and Knowledge Center at .
Thank you for working to ensure the health of our nation’s children.
/ Patricia E. Brown /
Patricia E. Brown
Acting Director
Office of Head Start