Prevention Tips

The goal is to prevent lead exposure to children before they are harmed. There are many ways parents can reduce a child’s exposure to lead. The key is stopping children from coming into contact with lead. Lead hazards in a child’s environment must be identified and controlled or removed safely.

How are children exposed to lead? Lead-based paint and lead contaminated dust are the main sources of exposure for lead in U.S. children. Lead-based paints were banned for use in housing in 1978. All houses built before 1978 are likely to contain some lead-based paint. However, it is the deterioration of this paint that causes a problem. Approximately 24 million housing units have deteriorated leaded paint and elevated levels of lead-contaminated house dust. More than 4 million of these dwellings are homes to one or more young children. Who is at risk? All children under the age of 6 years old are at risk because they are growing so rapidly and because they tend to put their hands or other objects, which may be contaminated with lead dust, into their mouths. However, children living at or below the poverty line who live in older housing are at greatest risk. Additionally, children of some racial and ethnic groups and those living in older housing are disproportionately affected by lead.

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What can be done to prevent exposure to lead?

It is important to determine the construction year of the house or the dwelling where your child may spend a large amount of time (e.g., grandparents or daycare). In housing built before 1978, assume that the paint has lead unless tests show otherwise.

Talk to your state or local health department about testing paint and dust from your home for lead.

Make sure your child does not have access to peeling paint or chewable surfaces painted with lead-based paint.

Pregnant women and children should not be present in housing built before 1978 that is undergoing renovation. They should not participate in activities that disturb old paint or in cleaning up paint debris after work is completed.

Create barriers between living/play areas and lead sources. Until environmental clean-up is completed, parents should clean and isolate all sources of lead. They should close and lock doors to keep children away from chipping or peeling paint on walls. You can also apply temporary barriers such as contact paper or duct tape, to cover holes in walls or to block children’s access to other sources of lead.

Regularly wash children’s hands and toys. Hands and toys can become contaminated from household dust or exterior soil. Both are known lead sources.

Regularly wet-mop floors and wet-wipe window components. Because household dust is a major source of lead, parents should wet-mop floors and wet-wipe horizontal surfaces every 2-3 weeks. Windowsills and wells can contain high levels of leaded dust. They should be kept clean. If feasible, windows should be shut to prevent abrasion of painted surfaces or opened from the top sash.

Prevent children from playing in bare soil; if possible, provide them with sandboxes. Parents should plant grass on areas of bare soil or cover the soil with grass seed, mulch, or wood chips, if possible. Until the bare soil is covered, parents should move play areas away from bare soil and away from the sides of the house. If using a sandbox, parents should also cover the box when not in use to prevent cats from using it as a litter box. That will help protect children from exposure to animal waste.

First Alert LT1 Premium Lead Test Kit

Lead Heavy Metal Toxicity Home Test Kit

To further reduce a child’s exposure from non-residential paint sources:

• avoid using traditional home remedies and cosmetics that may contain lead;
• avoid eating candies imported from Mexico;
• avoid using containers, cookware, or tableware to store or cook foods or liquids that are not shown to be lead free;
• remove recalled toys and toy jewelry immediately from children. Check Lead Recalls lists.
• use only cold water from the tap for drinking, cooking, and for making baby formula (Hot water is more likely to contain higher levels of lead. Most of the lead in household water usually comes from the plumbing in your house, not from the local water supply.);
• shower and change clothes after finishing a task that involves working with lead-based products such as stain glass work, bullet making, or using a firing range.

Folk Medicine

Lead has been found in some traditional (folk) medicines used by East Indian, Indian, Middle Eastern, West Asian, and Hispanic cultures. Traditional medicines can contain herbs, minerals, metals, or animal products. Lead and other heavy metals are put into certain folk medicines on purpose because these metals are thought to be useful in treating some ailments. Sometimes lead accidentally gets into the folk medicine during grinding, coloring, or other methods of preparation.

People selling a remedy may not know whether it contains lead. You cannot tell by looking at or tasting a medicine whether it contains lead. Consuming even small amounts of lead can be harmful. There is no safe blood lead level. Lead poisoning from folk remedies can cause illness and even death.

What to do if you or your child may have taken a medication that contains lead See your health care provider. He or she can perform a blood test to see whether you have been exposed to lead and if so recommend treatment options. Most adults and children with elevated blood lead levels do not have any symptoms. As blood lead levels increase, so does lead’s effects on health.

How to tell if herbal medicines or folk medicines contain lead You only can tell for sure by having the medicine tested in a laboratory. If you have reason to suspect that you may have consumed lead in a folk remedy, see a health care provider for a blood test.

Which folk medicines are known to contain lead Lead has been found in powders and tablets given for arthritis, infertility, upset stomach, menstrual cramps, colic and other illnesses.

Greta and Azarcon (also known as alarcon, coral, luiga, maria luisa, or rueda) are Hispanic traditional remedies taken for an upset stomach (empacho), constipation, diarrhea, vomiting, and used on teething babies. Greta and Azarcon are both fine orange powders that have a lead content as high as 90%.

Ghasard, an Indian folk remedy, has also been found to contain lead. It is a brown powder used as a tonic.

Ba-baw-san is a Chinese herbal remedy that contains lead. It is used to treat colic pain or to pacify young children.

UPDATE: Daw Tway is a digestive aid used in Thailand and Myanmar (Burma). Analysis of Daw Tway samples showed them to contain as much as 970 parts per million (ppm) of lead. The Daw Tway samples also contained high arsenic levels, as great as 7,100 ppm.

Additional information about Daw Tway is available on the Indiana State Department of Health Web site.

Other folk remedies that may contain lead.

Links to non-federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the federal government, and none should be inferred. CDC is not responsible for the content of the individual organization Web pages found at these links.

Candy

The potential for children to be exposed to lead from candy imported from Mexico has prompted the U.S. Food and Drug Administration (FDA) to issue warnings on the availability of lead-contaminated candy and to develop tighter guidelines for manufacturers, importers, and distributors of imported candy.

Lead has been found in some consumer candies imported from Mexico. Certain candy ingredients such as chili powder and tamarind may be a source of lead exposure. Lead sometimes gets into the candy when processes such as drying, storing, and grinding the ingredients are done improperly. Also, lead has been found in the wrappers of some imported candies. The ink of these plastic or paper wrappers may contain lead that leaches into the candy.

People selling these candies may not know whether the candy contains lead. You cannot tell by looking at or tasting a candy whether it contains lead. Consuming even small amounts of lead can be harmful. There is no safe blood lead level. Lead poisoning from candies can cause illness.

What to do if you believe you or your child may have eaten candies that contain lead
See your health care provider. He or she can perform a blood test to see whether you or your child has been exposed to lead, and if so, recommend treatment options. Most adults and children with elevated blood lead levels do not have any symptoms. As blood lead levels increase, so does lead’s effects on health.

How to tell if your candy contains lead
You can tell for sure only by having the candy tested in a laboratory. If you have reason to suspect that you may have consumed lead in candy, see a healthcare provider for a blood test.

How to get more information about lead in candy
The FDA advises that parents, care providers, and others not allow children or pregnant women to eat candy imported from Mexico at this time. More information and advisories on lead in candy can be obtained from the FDA website or 1-888-463-6332.

Toys

Children may be exposed to lead—a well known health hazard. Toys that have been made in other countries and then imported into the U.S. or antique toys and collectibles passed down through generations put children at risk for such exposure. To reduce these risks, the U.S. Consumer Product Safety Commission (CPSC) issues recalls of toys that could potentially expose children to lead.

Lead may be used in two aspects of toy manufacturing.

Paint: Lead may be found in the paint on toys. It was banned in house paint, on products marketed to children, and in dishes or cookware in the United States in 1978; however, it is still widely used in other countries and therefore can still be found on imported toys. It may also be found on older toys made in the United States before the ban.

Plastic: The use of lead in plastics has not been banned. It softens the plastic and makes it more flexible so that it can go back to its original shape. It may also be used in plastic toys to stabilize molecules from heat. When the plastic is exposed to substances such as sunlight, air, and detergents the chemical bond between the lead and plastics breaks down and forms a dust.

How your child may be exposed
Lead is invisible to the naked eye and has no smell. Children may be exposed to it from consumer products through normal hand-to-mouth activity, which is part of their normal development. They often place toys, fingers, and other objects in their mouth, exposing themselves to lead paint or dust.

How to test a toy for lead
Only a certified laboratory can accurately test a toy for lead. Although do-it-yourself kits are available, they do not indicate how much lead is present and their reliability at detecting low levels of lead has not been determined.

What to do if you are concerned about your child’s exposure
If you have any reason to suspect that your child has been exposed to a toy containing lead, remove the toy immediately. Most children with elevated blood lead levels have no symptoms. The only way to tell is to have a blood lead test. Your health care provider can help you decide whether such a test is needed and can also recommend treatment if your child has been exposed.

How to obtain more information about recalls
The CPSC asks that parents check for possible recalls of their children’s toys and take the toys away immediately if they have been recalled. Photos and descriptions of recalled toys website or call 1-800-638-2772.

CDC’s Role
CDC is committed to providing accurate and reliable education and outreach to the general public, state and local health care professionals. CDC also funds state and local health departments to conduct comprehensive childhood lead poisoning prevention efforts. These efforts include identifying sources of lead exposure.

A working group of nine federal agencies has been convened to develop a comprehensive strategy to control sources of lead in food and consumer products through interagency collaboration and cooperation.

Toy Jewelry

If swallowed or put in the mouth, lead jewelry is hazardous to children. In 2003, a 4-year-old child swallowed a piece of jewelry bought from a vending machine. The child became ill because the jewelry was made of lead. The potential for children to be exposed to lead from this source caused the U.S. Consumer Product Safety Commission (CPSC) to issue on July 8, 2004, a recall of 150 million pieces of metal toy jewelry sold widely in vending machines.

In 2006, there was a death of a child from acute lead poisoning after ingestion of a heart-shaped metallic charm containing lead. The charm had been attached to a metal bracelet provided as a free gift with the purchase of shoes manufactured by Reebok International Ltd. On March 23, 2006, a voluntary recall of 300,000 heart-shaped charm bracelets was announced by CPSC and Reebok.

What to do if I believe my child has put lead jewelry into his/her mouth
See your health care provider. He or she can perform a blood test to see whether your child has been exposed to lead and if so recommend treatment. Most children with elevated blood lead levels do not have any symptoms. However, there is no safe level of lead in blood. As blood lead levels increase, lead has a larger effect on children’s learning and behavior. A blood lead test is the only way you can tell if your child has an elevated lead level.

Effects of wearing toy jewelry
Just wearing toy jewelry will not cause your child to have a high level of lead in his/her blood. However, small children often put things in their mouth. If you have a small child in your household you should make sure the child does not have access to jewelry or other items that may contain lead.

How to obtain more information about recalls
The CPSC asks that parents search their children’s toys for metal jewelry and throw it away. Photos of the jewelry and more information on the recall can be obtained from the visting the CPSC website or 1-800-638-2772. The CPSC also has a new policy addressing lead in children's metal jewelry.

Lead Recalls

The U.S. Consumer Product Safety Commission (CPSC) is charged with protecting the public from unreasonable risks of serious injury or death from more than 15,000 types of consumer products. CPSC announces all recalls on their website.

Only lead recalls are listed here. Click on the links in the menu to the left to see lists of recalled items by product categories. The most recent recalls are listed at the top of each page. Pictures and descriptions are taken directly from the CPSC website. Click on the picture or link to see full descriptions of the recalled items. Many recalls include more than one type of item and have additional pictures available on the CPSC website. These items are marked with double asterisks (**).

Water

WaterSafe Water Test Kit for Lead

How does lead get into my tap water?
Measures taken during the last two decades have greatly reduced exposures to lead in tap water. These measures include actions taken under the requirements of the 1986 and 1996 amendments to the Safe Drinking Water Act and the EPA’s Lead and Copper Rule.

Even so, lead still can be found in some metal water taps, interior water pipes, or pipes connecting a house to the main water pipe in the street. Lead found in tap water usually comes from the corrosion of older fixtures or from the solder that connects pipes. When water sits in leaded pipes for several hours, lead can leach into the water supply.

How do I know if my tap water is contaminated with lead?
The only way to know whether your tap water contains lead is to have it tested. You cannot see, taste, or smell lead in drinking water. Therefore, you must ask your water provider whether your water has lead in it. For homes served by public water systems, data on lead in tap water may be available on the Internet from your local water authority. If your water provider does not post this information, you should call and find out.

Does a high lead level in my tap water cause health effects?
High levels of lead in tap water can cause health effects if the lead in the water enters the bloodstream and causes an elevated blood lead level.

Most studies show that exposure to lead-contaminated water alone would not be likely to elevate blood lead levels in most adults, even exposure to water with a lead content close to the Environmental Protection Agency’s (EPA’s) “action level” for lead of 15 parts per billion (ppb). Risk will vary, however, depending upon the individual, the circumstances, and the amount of water consumed. For example, infants who drink formula prepared with lead-contaminated water may be at a higher risk because of the large volume of water they consume relative to their body size.

What can I do to reduce or eliminate lead in my tap water?
If your tap water contains lead at levels exceeding EPA’s action level of 15 ppb, you should take action to minimize your exposure to the lead in the water.

You should begin by asking your water authority this question:

1. Does my water have lead in it above EPA’s “action level” of 15 parts per billion (ppb)?

If the answer is no, your water does not contain lead at current levels of concern.
If the answer is “yes,” also ask the next question:

2. Does the service pipe at the street (“header pipe”) have lead in it?

This information is very important. It determines which of the next two actions (A or B) you should follow to protect your household’s health.

A) If the pipe in the street (“header pipe”) does NOT have lead, the lead in your tap water may be coming from fixtures, pipes, or elsewhere inside your home.

Until you eliminate the source, you should take the following steps any time you wish to use tap water for drinking or cooking, especially when the water has been off and sitting in the pipes for more than 6 hours:

a. Before using any tap water for drinking or cooking, “flush” your water system by running the kitchen tap (or any other tap you take drinking or cooking water from) on COLD for 1–2 minutes;

b. Then, fill a clean container(s) with water from this tap. This water will be suitable for drinking, cooking, preparation of baby formula, or other consumption. To conserve water, collect multiple containers of water at once (after you have fully flushed the water from the tap as described).

B) If the pipe at the street (“header pipe”) DOES contain lead, lead in the tap water may be coming from that pipe or connected pipes (it may also be coming from sources inside your home).

Until the lead source is eliminated, you should take the following steps any time you wish to use tap water for drinking or cooking, especially when the water has been off and sitting in the pipes for more than 6 hours. Please note that additional “flushing” is necessary:

a. Before using any tap water for drinking or cooking, run high-volume taps (such as your shower) on COLD for 5 minutes or more;

b. Then, run the kitchen tap on COLD for 1–2 additional minutes;

c. Fill a clean container(s) with water from this tap. This water will be suitable for drinking, cooking, preparation of baby formula, or other consumption. To conserve water, collect multiple containers of water at once (after you have fully flushed the water from the tap as described).

3. In all situations, drink or cook only with water that comes out of the tap cold. Water that comes out of the tap warm or hot can contain much higher levels of lead. Boiling this water will NOT reduce the amount of lead in your water.

4. You can also reduce or eliminate your exposure to lead in drinking water by consuming only bottled water or water from a filtration system that has been certified by an independent testing organization to reduce or eliminate lead. See resources below.

5. Children and pregnant women are especially vulnerable to the effects of lead exposure. Therefore, for homes with children or pregnant women and with water lead levels exceeding EPA’s action level of 15 ppb, CDC recommends using bottled water or water from a filtration system that has been certified by an independent testing organization to reduce or eliminate lead for cooking, drinking, and baby formula preparation. Because most bottled water does not contain fluoride, a fluoride supplement may be necessary.

Also, be aware that some bottled waters have not been tested and may not be appropriate for consumption. Contact independent testing organizations that certify bottled water. See resources below.

6. Make sure that repairs to copper pipes do not use lead solder.

Advice for lead safe water practices following plumbing work in housing with lead water lines or lead solder. These practices include:

1. Testing water following plumbing work in older housing, please contact your state lead program for information about water testing in your area;

2. Inspecting the aerator on the end of the faucet and removing any debris such as metal particles and;

3. Flushing water lines before using the water for drinking or cooking.

Home owners may also consider full replacement of lead water lines by removing the private lines running from the water meter into their homes. This precaution has not been adequately studied however because the data available to CDC included too few homes having had full replacement of lead water lines. Contact your water authority for information about replacing water service lines.

If my water has high lead levels, is it safe to take a bath or shower?
Yes, bathing and showering should be safe for you and your children, even if the water contains lead over EPA’s action level. Human skin does not absorb lead in water.

This information applies to most situations and to a large majority of the population, but individual circumstances may vary. Some situations, such as cases involving highly corrosive water, may require additional recommendations or more stringent actions. At all times, your local water authority remains your first source for testing and identifying lead contamination in your tap water. Many public water authorities have Web sites that include data on drinking water quality, including results of lead testing. Links to such data can be found at the following EPA Web site.

Resources

Toxic Truth: A Scientist, a Doctor, and the Battle over Lead

Please visit the following sites for more information:

General:
Blood Lead Levels in Residents of Homes with Elevated Lead in Tap Water---District of Columbia, 2004. MMWR. April 2, 2004; 53(12):268-270.

Addendum: Following the release of the MMWR, "Blood Lead Levels in Residents of Homes with Elevated Lead in Tap Water -- District of Columbia, 2004", some reports have suggested erroneously that the Centers for Disease Control and Prevention has determined that lead in residential tap water at concentrations as high as 300 parts per billion is ‘safe’. CDC would like to reiterate the key message from the 2004 article that because no threshold for adverse health effects in young children has been demonstrated (no safe blood level has been identified), all sources of lead exposure for children should be controlled or eliminated. Lead concentrations in drinking water should be below the U. S. Environmental Protection Agency’s action level of 15 parts per billion.

EPA Ground Water & Drinking Water
This site includes comprehensive information on lead in drinking water. Safe Drinking Water Hotline: 1-800-426-4791.

Water Fluoridation:
CDC Oral Health Resources
This site includes water fluoridation fact sheets, frequently asked questions, and publications.

Bottled Water and Water Filters: NSF International
A nonprofit organization that certifies bottled water and water filters. Consumer Affairs Office toll-free hotline: 1-800-673-8010.

International Bottled Water Association
The trade association that represents the bottled water industry. Information Hotline: 1-800-WATER-11.

At Risk Populations

Pregnant Women

Are you Pregnant?

Prevent Lead Poisoning. Start Now.

Lead Poisoning is caused by breathing or swallowing lead. Lead can pass from a mother to her unborn baby

Too much lead in your body can:

• Put you at risk for miscarriage
• Cause your baby to be born too early or too small
• Hurt your baby’s brain, kidneys, and nervous system
• Cause your child to have learning or behavior problems

Lead can be found in:

• Paint and dust in older homes, especially dust from renovation or repairs
• Candy, make up, glazed pots, and folk medicine made in other countries
• Work like auto refinishing, construction, and plumbing
• Soil and tap water

Now is the time to keep your baby safe from lead poisoning. Here’s what you can do:

1. Watch out for lead in your home.
Most lead comes from paint in older homes. When old paint cracks and peels, it makes dangerous dust. The dust is so small you cannot see it. You can breathe in lead dust and not even know it. Home repairs like sanding or scraping paint can make dangerous lead dust. Pregnant women should not be in the house during cleaning, painting, or remodeling a room with lead paint.

2. Talk to your doctor.
Talk to your doctor about any medicines or vitamins you are taking. Some home remedies and dietary supplements may have lead in them. It is also important to tell your doctor about any cravings you are having such as eating dirt or clay, because they may have lead in them.

3. Avoid certain jobs or hobbies.
Some jobs or hobbies involve lead exposure. Also, avoid take-home lead dust if a household member works with lead. Such work includes construction or home renovation/repair in older homes, and battery manufacturing or recycling. It is a good idea to have the household member change into clean clothing before coming home. Keep work shoes outside and wash all work clothes separately from the rest of the family.

4. Eat foods with calcium, iron, and vitamin C.
These foods may help protect you and your unborn baby.

• Calcium is in milk, yogurt, cheese, and green leafy vegetables like spinach.
• Iron is in lead red meat, beans, cereals, and spinach.
• Vitamin C is in oranges, green and red peppers, broccoli, tomatoes, and juices.

Use caution when eating candies, spices, and other foods that have been brought into the country by travelers, especially if they appear to be noncommercial products.

5. Store food properly.
Some dishes may contain lead. It is important to store and serve your food properly.

• Avoid using imported lead-glazed ceramic pottery produced in cottage industries.
• Avoid using pewter or brass containers or utensils to cook, serve, or store food.
• Avoid using leaded crystal to serve or store beverages.
• Do not use dishes that are chipped or cracked.

International Adoption and Prevention of Lead Poisoning

Prospective parents adopting a child from overseas need information to safeguard the health of the child. This site contains information for adopting parents, adoption agencies, and health care providers.

The U.S. Department of State records show that from October 1, 2008, to September 30, 2009, a total of 12,753 internationally adopted children immigrated to the United States. The largest numbers of these children were originally from Ethiopia, mainland China, South Korea, and Russia. The risk for lead exposure is much higher in many countries from which children are adopted than in the United States. Each country sets its own policies on regulations for environmental exposures, and some countries have stronger regulations than others.

Main sources of exposure to lead differ from country to country Children’s exposure to sources of lead varies by country. Even within a country, lead exposure may vary by ethnic group or income level. In the United States, lead-based paint and lead-contaminated dust and soil are the primary sources of high-dose childhood-lead exposure.

Internationally, children can be exposed to lead from:

• Ceramic or metal dishes or pots used for cooking or eating,
• Contamination from living with a person who is exposed on the job,
• Contamination from nearby mining and smelting,
• Cosmetics,
• Cottage industries (e.g., breaking up batteries or metal ore),
• Drinking water from metal pipes or metal storage containers
• Food, spices, and candies (from the ingredients or the packaging),
• Industrial emissions,
• Leaded gasoline exhaust in high-traffic areas, and
• Traditional medicines.

Publications on country-specific sources of lead can be found here:

• International Response
• Lead Exposure Case Studies

Risk of elevated blood-lead levels
There is no safe level of lead in the body. Because lead poisoning often occurs with no obvious symptoms, it frequently goes unrecognized. The level of blood lead that is currently considered high is a concentration of 10 or more micrograms per deciliter of blood. Evidence exists that lead in the body, even at low levels, can cause health problems and affect a child’s behavior or how they learn in school. At very high levels, in extreme cases, it can cause seizures or death.

Parents or prospective parents of adopted children

Why should I be concerned?
Concern exists about children adopted from overseas who may have been exposed to lead before they came to the United States. Recently in the United States, a small number of internationally adopted children have been found to have high levels of lead in their bodies.

As a group, foreign-born adopted children tend to have higher levels of lead in their blood than children born in the United States. Children can be exposed to lead in different ways in various in countries.

How do I know if my child was exposed to lead? Most children with elevated blood-lead levels do not have any symptoms.
The only way to know for sure is to have your child tested with a simple blood test.

How can I check for lead in my child?
Ask your child’s doctor to test your child for lead in their blood. You may want to contact your state or local Childhood Lead Poisoning Prevention Program.

Who can I contact for blood-lead testing or other information about the health of my internationally adopted child?
You can contact either your doctor or your local health department if you have concerns about lead in your child’s blood or other health concerns. Guidelines from the American Academy of Pediatriatics inform doctors about the full medical checkup for internationally adopted children.

Some doctors and medical clinics focus on the special issues of children who are born in or adopted from countries around the world. The American Academy of Pediatrics currently lists 90 physicians who specialize in the health care needs of children born outside the United States

International Adoption Agencies

Adoption agencies play an important role in increasing awareness of lead exposure among internationally adopted children. Under current regulations and routine practice, elevated blood-lead levels among foreign-born children may not be detected.

Adopting parents lack information on the hazards of lead exposure that could help them improve their children’s growth, development, and prospects for the future.

It is important that adoption agencies provide lead-exposure fact sheets with health information, including information on accessible testing sites, to prospective parents.

Adoption agencies should also encourage adopting parents and doctors to test foreign-born children for lead exposure when they arrive in the United States. top

Health Care Providers

International Childhood Lead Exposure
Children immigrating to the United States through international adoptions have health issues as diverse as the cultures into which they were born. Although recent research is sparse, evidence suggests that a significant proportion of immigrant and adopted children have elevated blood-lead levels. Risk of elevated blood-lead levels varies by country of origin. According to one study, 40% of children from Cuba and Haiti, 37% from Asia, 27% from Vietnam and Africa, and 25% from the Near East had elevated blood-lead levels. Overall, approximately 11.3% of adopted foreign-born children have elevated blood-lead levels.

Medical Testing before Immigration to United States
Blood-lead testing is not required before immigration to the United States. Before arrival in the United States, all immigrants are required to have a medical examination in their country of origin by a physician approved by the local U.S. Embassy or Consulate. This medical examination focuses primarily on detecting serious disabilities and contagious diseases.

Recommendations for Screening and Medical Management of Children with Elevated Blood-Lead Levels
=Screening for blood-lead level is recommended upon arrival to the United States, and at 12 and 24 months of age. Physicians should follow their state and local guidelines on health screening of children living conditions that place them at a high risk for lead exposure. International adoptees are considered high risk for elevated blood lead levels. You can also contact the Childhood Lead Poisoning Prevention Program in your state for additional information.

Additional Resources

Child Welfare Information Gateway: Intercountry Adoption
The Child Welfare Information Gateway is a service of the Children’s Bureau, Adminstration for Children and Families, U.S. Department of Health and Human Services.

U.S. Department of State
This site provides information and guidance to U.S. Citizens seeking information about international adoptions.

U.S. Bureau of Citizenship and Immigration Services
This site provides information on intercountry adoptions and the immigration process.

Joint Council on International Children’s Services (JCICS)
JCICS is a non-profit international adoption organization that works to promote ethical practices in intercountry adoption. This site provides information relevant to international adoption agencies, community based-organizations, parent support groups, and medical clinics.