Children are lead poisoned by absorbing lead they are exposed to in their environments. So the first thing to do in response to an elevated blood lead level is to identify and eliminate or reduce the child's exposure to the sources of lead that have caused the elevated blood lead level.
Sources are identified through an investigation of the child's home. An investigation consists of a detailed questionnaire, a visual inspection of the premises, with a special eye to potential hazards, and possibly testing for lead content of paint, dust, ceramics, etc. 1
The investigation of a home for lead sources may be done by the local health department or lead program. However, that is not the only option and sometimes not an option at all. State and local health departments often do not have the jurisdiction to intervene unless a child's blood lead level is 20 or 25 μg/dl or greater.
According to lead consultant Marianna Koval, many state and local health departments are struggling to provide basic services in a time of massive budget cuts. As a result, a state or local health department may have ill-trained staff and use old, inaccurate testing equipment. Unfortunately, sometimes relying on a health department can be dangerous.
For example, the New York City Department of Health visits the home of any child who