Lead Exposure Questionnaire
This is a series of questions your child's doctor should ask you at the yearly visit to determine if your child is at-risk for having lead exposure.
If you answer yes or I don’t know to any question, your child may be exposed to lead.
Does your child:
- Live in or regularly visit a house built before 1978 with peeling or chipping paint? This could include the home of a baby-sitter or relative, a daycare center or preschool.
- Live in or regularly visit a house built before 1978 with planned, recent (within the past year) or ongoing renovation/remodeling activity?
- Have a brother or sister, a playmate or other household member with a confirmed elevated blood level?
- Live with an adult whose job or hobby involves exposure to lead?
- Live near an active lead smelter, battery recycling plant, or other industry likely to release lead?
- Have a history of possible prenatal exposure to lead (child’s mother had elevated blood lead during pregnancy)?
- Have iron deficiency anemia, sickle cell disease, developmental delay or behavioral problems?
- Have a habit of eating dirt, paint chips, or other non-food items?
- Have excessive mouthing habits that are not age appropriate?
- Have an elevated blood lead test of 10 micrograms per deciliter or higher when last tested?