Blood Lead Level Testing

Allegheny County requires all children be tested for lead exposure at approximately 9-12 months old and then again at approximately 24 months old.

Children who have not had their blood tested at either of those required intervals must be tested as soon as possible before age 6 or prior to entering kindergarten, whichever comes first.

The universal lead testing regulation, Article XXIII(PDF, 644KB), went into effect on January 1, 2018. If you have questions about the regulation, please check out our testing FAQ in English(PDF, 770KB) and FAQ in Spanish(PDF, 695KB).

If you are a pediatric provider, please visit our page for Healthcare Providers.

If you work in a school or as a daycare provider, please see our page for Schools and Daycares.

Testing Exemptions

Parents who object in writing on religious grounds or on the basis of a strong moral or ethical principle similar to a religious belief can opt out of blood testing.

Parents should put their objection in writing by sending a letter to the child's pediatric provider and to their school. The letter should state the reasons for opting out of having the child's blood lead level tested.

Children are not required to have a blood lead level test if a healthcare practitioner determines that blood lead level testing may be harmful to the health of the child. When the healthcare practitioner determines that blood lead level testing is no longer harmful to the health of the child, the child should have their blood lead level tested according the regulation's schedule or the catch-up provision.

How Will My Child be Tested?

Testing your child's blood lead levels is the only way to know if they have been exposed to lead. There are two types of tests used to find out how much lead is in a child's blood:

A capillary test is when blood is drawn by a finger-stick. The result of this screening test is ready within a couple of minutes and a prescription is not needed; however, sometimes the blood collected from a capillary test can give a false high result due to lead on the skin or in the environment (contamination).

If a capillary test is ≥3.5 µg/dL, a venous blood lead test (blood drawn from an arm vein) will need to be taken to confirm the blood lead level. This test needs to be prescribed by a doctor. Some doctors prefer to prescribe a venous test without prescribing a capillary test first. You should discuss the best option for your child with your doctor.

Where Can I Have My Child Tested?

Parents should request the testing from their child's pediatric provider or family doctor.

For under or uninsured children:

What Do the Test Results Mean?

Your child's test results represent the amount of lead found in their blood sample. The amount of lead found in a child's blood is called the blood lead level (BLL). Blood lead tests tell how many micrograms (millionth of a gram) of lead are in each deciliter (tenth of a liter) of a child's blood (µg/dL).

If the result is below 3.5 µg/dL:

  • Your child's blood level is not elevated at this time. It is below the CDC's reference value, which is 3.5 µg/dL.
  • Your child does not need a follow-up test now.
  • If your child is younger than 2 years old, s/he will need another test when s/he is approximately 24 months old.
  • Your child may need another test if s/he moves to a different home, daycare, school, etc. that was built before 1978.
  • Go to our Prevention page to see how to keep your child safe from lead exposure.

If the result is at or above 3.5 µg/dL:

  • Your child's blood level is elevated.
  • If the test was a capillary test (in which blood is drawn from a finger stick) it needs to be confirmed with a venous test, in which blood is drawn from the arm. Capillary samples are easier to contaminate and sometimes the result is not accurate.
  • Confirmatory tests need to be prescribed by your child's doctor. If your child is under- or uninsured, please see ACHD's Resources Guide(PDF, 608KB) for a list of pediatric healthcare resources in Allegheny County that can help.
  • Check the table below to see when your child should get a confirmatory test:

Recommended Schedule for Obtaining a Confirmatory Venous Sample

BLL (µg/dL) Time to confirmation testing
<3.5 No confirmation required
3.5-9 1 week - 1 month
(The higher the BLL on the screening test, the more urgent the need for confirmatory testing.)
10-44 1 week - 1 month
(The higher the BLL on the screening test, the more urgent the need for confirmatory testing.)
45-59 48 hours
60-69 24 hours
≥70 Urgently as emergency test

If the venous test confirms result at or above 3.5 ug/dl, get more information on next steps by visiting My Child Has an Elevated Blood Lead Level.

Post-Testing and School Enrollment Information

After testing, remember to get proof showing that your child has been tested.

When you enroll your child into kindergarten, school nurses will request proof that your child has been tested for lead exposure. Make sure you get proof from your doctor or the lab showing that you child has been tested.

Beginning with the 2018-2019 school year, all children will need to have their blood lead level tested before entering kindergarten.

Children who do not have their blood lead level tested will not be excluded from enrolling in school.

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