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 |