Suggested Clinical Evaluation for Lead Exposure
Medical history |
Ask about |
Symptoms |
Developmental history |
Mouthing activities |
Pica |
Previous blood lead concentration measurements |
Family history of lead poisoning |
Environmental history |
Paint and soil exposure |
What is the age and general condition of the residence or other structure in which the child spends time? |
Is there evidence of chewed or peeling paint on woodwork, furniture, or toys? |
How long has the family lived at that residence? |
Have there been recent renovations or repairs to the house? |
Are the windows new? |
Are there other sites at which the child spends significant amounts of time? |
What is the condition/make-up of indoor play areas? |
Do outdoor play areas contain bare soil that may be contaminated? |
How does the family attempt to control dust and dirt? |
Relevant behavioral characteristics of the child |
To what degree does the child exhibit hand-to-mouth activity? |
Does the child exhibit pica? |
Are the child's hands washed before meals and snacks? |
Exposures to and behaviors of household members |
What are the occupations of adult household members? |
What are the hobbies of household members? (Fishing, working with ceramics or stained glass, and hunting are examples of hobbies that involve risk for lead exposure.) |
Are painted materials or unusual materials burned in household fireplaces? |
Miscellaneous |
Does the home contain vinyl miniblinds made overseas and purchased before 1997? |
Does the child receive or have access to imported food, cosmetics, or folk remedies? |
Is food prepared or stored in imported pottery or metal vessels? |
Does the family use imported foods in soldered cans? |
Nutritional history |
Take a dietary history |
Evaluate the child's iron status by using the appropriate laboratory tests |
Ask about history of food stamps or participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) |
Physical examination |
Pay particular attention to the neurologic examination and the child's psychosocial and language development |