New Hampshire is now a ‘Universal’ pediatric blood lead level testing state that requires all children to have a blood lead level test at age one and again, a second test, at age 2.
Contact a Public Health Nurse
Public Health Nurses, working within NH Division of Public Health Services, Healthy Homes and Lead Poisoning Prevention Program, are available to answer health care provider questions on childhood lead exposure, blood lead level testing, and clinical management of children with elevated blood lead levels. To contact a public health lead nurse: LeadRN@dhhs.nh.gov
Nurse Case Management Services
The Division of Public Health Services provides nurse case management services at no cost to the families of all children with elevated venous blood lead levels above the State’s public health action level of 5 μg/dL. Nurse case management services begin with a nurse home visit to each child’s home and continue until child’s blood lead level has dropped below 5 μg/dL or until child is over 72 months of age. For more information, contact: LeadRN@dhhs.nh.gov
NH Blood Lead 'Action Level' Triggering Public Health Intervention
The current ‘action level’ at which NH public health nurses and lead inspectors visit a child’s home and at which a child is provided nurse case management is 5µg/dL. This ‘action level’ level is set by State of NH law. NH’s blood lead level ‘action level’ is different from the blood lead reference value established by the Centers for Disease Control and Prevention (CDC), which was recently lowered in October 2021. The CDC’s current blood lead reference value is 3.5 µg/dL.
CDC’s Blood Lead Reference Value
CDC’s blood lead reference value of 3.5 µg/dL is a screening tool to identify children who have higher levels of lead in their blood compared with most children. The reference value is not health-based and is not a regulatory standard. States independently determine action thresholds based on state laws, regulations, and resource availability. Learn more about CDC’s Blood Lead Reference Value.
Childhood Lead Poisoning Medical Management ‘Quick Guides’
NH’s Division of Public Health Services has childhood lead exposure, testing, and medical management clinical reference ‘Quick Guides’ available, at no cost, for pediatric health care providers. These laminated clinical reference ‘Quick Guides’ can be used in exam rooms and point of care lab workstations and are available upon request at: LeadRN@dhhs.nh.gov
Education Sessions for Providers and Clinical Teams
Short educational sessions, either on-site or virtual, are available at no cost to Healthcare Providers. Included in these educational session is information on NH’s blood lead testing requirements, medical management guidelines, surveillance data and the services provided by the DPHS nurse case management clinical team.
Education sessions can readily be arranged before clinic hours, lunchtime, or during the evening for your practice’s convenience. For more information contact Division of Public Health Services, Healthy Homes and Lead Poisoning Prevention Program at: LeadInfo@dhhs.gov
Distribution of Lead and Children Fact Sheet to Parents
NH state law requires that any health care provider conducting capillary blood lead level testing with point-of-care in-office analyzers, provide the Lead and Children factsheet to any parent or guardian of a child whose test indicates any presence of lead. The Lead and Children fact sheet is available as a PDF and in many additional languages. To receive printed copied of the factsheet at no cost, contact: LeadInfo@dhhs.nh.gov
Adults and Lead
Most adults with lead poisoning do not look or feel sick. Symptoms of lead poisoning include headaches, stomach cramps, constipation, muscle/joint pain, trouble sleeping, fatigue, irritability, and loss of sex drive. Lead exposure can cause high blood pressure and brain, kidney and reproductive health issues in adults. The Adult Medical Management ‘Quick Guide’ is available as a resource for Healthcare Providers that outlines what occupations are at risk for lead exposure and how to manage the follow up testing of adults that test positive for lead. The Lead and Adults fact sheet is available as an educational resource for adult patients that have tested positive for lead.
For more information about any of these resources, contact: LeadInfo@dhhs.nh.gov