Blood Lead Testing in Missouri
Missouri Lead Testing Requirements (RSMo 701.340-701.342)
- All children under 72 months of age should be screened for lead risk factors using the Healthy Child and Youth (HCY) Lead Risk Assessment Guide. If a parent/guardian answers yes, or no response to any question, the child should receive a blood lead test.
- All parents of a child under age 4 shall be provided lead education annually, and every child under age 4 shall be offered a blood lead test annually.
- All children receiving Medicaid benefits must have lead testing at 12 and 24 months of age.
Missouri Lead Testing Recommendations
- All siblings of a child with an elevated blood lead level should be tested.
- Pregnant women at risk for lead poisoning should be offered a blood lead test.
- Newborns of women who had suspected or elevated blood lead levels during pregnancy should be tested.
- Children and pregnant women who reside in a pre-1978 home undergoing renovation may require more frequent blood lead testing during and after renovations are completed.
- Missouri Department of Health and Senior Services Recommended Actions are located here.
High-Risk Area Requirements for Childcare Facilities (RSMo 701.344)
- Every childcare facility affiliated with a school system, a business organization, or a nonprofit organization shall, within 30 days of enrolling a child, require the child’s parent or guardian to provide evidence of lead poisoning testing in the form of a statement from the health care professional that administered the test or provides a written statement that states the parent’s or guardian’s reason for refusing such testing.
- See maps indicating these designated areas.
Prenatal Lead Testing Information
- Pregnant women and women who work with lead should discuss lead risk exposure with their physician as part of the first prenatal visit.
- Women should be screened by their physician using the Prenatal Assessment Questionnaire to determine whether she and the fetus are at risk for lead poisoning.
- If a positive answer is given, the mother is considered at risk for lead poisoning and is recommended to have a blood lead test.
Methods of Testing
The physician should determine the choice of a sample collection method (venous or capillary). Capillary sampling can perform well as an initial testing tool. If the capillary results are 3.5 μg/dL or greater, the capillary results should be confirmed with a venous blood draw. See the Missouri Guidelines for the Assessment and Management of Childhood Lead Poisoning available here.