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In the Montgomery County Medical Society

ODH Decreased Blood Lead Reference Level to CDC Guidance

Montgomery County Medical Society Provided by MCMS Administration

The Ohio Department of Health has decreased the blood lead reference level to 3.5 ug/dl from 5 ug/dl, aligning with CDC guidance. This lower BLRV will identify more children for additional lead education, medical monitoring, and environmental assessments, and highlights a need for enhanced community partnerships to decrease risks associated with continued lead exposures. Public Health Dayton & Montgomery County is seeing an increase in evaluations for children whose lead levels are at or above the new lower cut-off. For guidance on when to provide screening of lead levels see Requirements for Ohio Children less than 6 Years of Age” (*please note, the BLL on the Blood
Lead Testing Requirement document should now read ≥3.5 µg/dL instead of 5 µg/dL).

Public Health Dayton & Montgomery County will serve in follow-up of positive test results: For venous blood lead levels which are 3.5 µg/dL to < 10.0 µg/dL , PHDMC will interview families, complete a comprehensive lead risk questionnaire, and provide education on minimizing lead exposures. 4. For lead levels which are 10 µg/dL or higher, PHDMC will conduct family interviews, complete the lead risk questionnaire, and provide education for families on risk minimization for lead poisoned children and pregnant moms of lead poisoned children. In addition, PHDMC will conduct an on-site environmental investigation and if necessary, do lead risk assessments of residential units, childcare facilities, or schools to evaluate possible sources of lead poisoning. If lead hazards are identified, PHDMC will issue and enforce lead hazard control orders to the property owner.

PHDMC recommends the following actions for healthcare providers:

  1. Early counselling of families, even prenatally, about sources of lead and steps families can take
    to prevent children from being exposed.
  2. Screening children to identify children with blood lead levels (BLLs) at or above the reference
    value of 3.5 µg/dL. Ohio law requires all healthcare providers to administer blood lead tests to
    children at age 1 and 2, or up to age 6 if no previous test has been completed and risk factors
    are present.
  3. Appropriate medical follow-up for children with BLLs at or above 3.5 µg/dL. The updated
    Medical Management Recommendations for Ohio Children Receiving
    Blood Lead Tests
    ” has the most recent information about the urgency for you as the healthcare
    provider to order confirmatory venous testing, medical management recommendations for
    various BLLs, and the timing of retesting after recommended actions