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For Healthcare Providers
For Healthcare Providers
IMPORTANT UPDATES
New requirements for blood lead testing of young children: By law, Michigan now requires blood lead testing for all children at 12 months and 24 months of age and at other intervals based on exposure risk. This approach is commonly called “universal blood lead testing”. It is the physician’s responsibility to test or order the test.
The law updates the Public Health Code, adding MCL 333.5474d and amending MCL 333 9206(1). Administrative rules (R 330.301-304) for implementation of the law were made official on April 30, 2025.
For more information go to:
- Questions and answers for the public and parents/guardians about universal blood lead testing
- Questions and answers for physicians about universal blood lead testing
WHO NEEDS A BLOOD LEAD TEST?
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Children
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Pregnant and Breastfeeding Persons
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Adults
- Michigan now requires blood lead testing of all young children at specified ages and with selected lead exposure risk factors. The requirements include:
- It is the physician's responsibility to test or order the test.
- Children must be tested at 12 months and 24 months of age or by 72 months of age (age 6) if there is no record of a previous test.
- Children must also be tested as follows:
- Between 48 to 60 months of age (age 4) if they live in one of the 82 cities and townships designated by MDHHS as high risk. Visit Additional Blood Lead Testing for High-Risk Jurisdictions to view the complete list of areas listed in the administrative rules.
- At least once between their most recent test and age 72 months if they are at high risk because they live in a home:
- Build before 1978 or
- Where other children with elevated blood lead levels live.
- Within three months of when a physician or parent determines that they are at high risk. Risk factors to consider are described at MDHHS Quick Reference Guide for Providers.
- Testing requirements do not apply if the parent/guardian objects to the test.
- Physicians must ensure that the child's blood lead test results are included in the child's immunization certificate.
- Children who are refugees ages 6 months through 16 years. CDC recommends a blood lead test within 90 days of arrival in the US.
- Retest after 3-6 months for refugee children < 6 years (Immigrant, Refugee, and Migrant Health (CDC.gov)).
- The American College of Obstetricians and Gynecologists (ACOG) recommends health care providers evaluate risk factors for lead exposure in pregnant and lactating patients and perform blood lead testing if any risk factors are identified (Lead Screening During Pregnancy and Lactation Committee Opinion (ACOG.org)).
- MDHHS has a Blood Lead Risk Assessment questionnaire for Pregnant & Breastfeeding Persons in the Pregnant and Nursing Persons Factsheet.
- There is no public health recommendation for routine blood lead testing for nonpregnant or breastfeeding adults. Blood lead testing in adults should be based on clinical judgement and exposure history, including potential exposure associated with jobs and hobbies.
- The Michigan Occupational Safety and Health Administration (MIOSHA) has established lead standards for workers in general industrial and construction jobs. Both standards define minimum safety precautions, including regular testing, that employers must provide for employees exposed to lead on the job.
Important notes on blood lead testing:
- Blood lead tests via capillary sampling are for screening only, all elevated capillary samples require venous confirmatory testing.
- At a blood lead level of 45 µg/dL or greater, any treatment should be performed in consultation with Michigan’s Poison Control Center. Hospitalization and/or chelation should be considered. Other children who may have also been exposed should be tested. The family should NOT return to the lead-contaminated home.
Michigan Care Improvement Registry (MCIR)
The Blood Lead Module is a component of a patient's MCIR record. If the patient has had a blood lead test, the results will be displayed in the record, as well as how to interpret the results with corresponding recommended actions.
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Provider Resources
- Pediatric Blood Lead Level Guidance for Healthcare Providers
- Brochure Guide for Providers Applying Universal Testing Laws to Practice
- Childhood Lead Poisoning Prevention (CLPPP) Learning Module - CE available
- MDHHS CLPPP Policy on Definition of Elevated Blood Lead Test Result
- MDHHS MiTracking - Michigan Environmental Public Health Tracking
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Patient Resources
- How to Find Out if You Have a Service Line Made of Lead
- Lead Plumbing Checklist
- Adult exposure to lead
- Is your child safe from lead poisoning?
- Know the facts about lead
- Serve Up a Healthier Future
- Pregnant and breastfeeding persons
- Take home lead
- What you should know about lead paint bookmark
- Lead safety tips bookmark
- Universal testing factsheet
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Other Agency Resources