Protecting children from the dangers of lead exposure is a team effort. The Maryland Department of the Environment (MDE) and the Maryland Department of Health (MDH) work together to keep children safe, especially in communities most at risk.
1. Testing and Reporting- Universal Testing for Children at 12 and 24 months
In 2016, the entire state of Maryland was determined to be "at risk" for childhood lead exposure. Pediatric healthcare providers are required to test all children for lead at ages 12 and 24 months. These test results are sent directly to MDE and are shared with MDH and
local health departments.
NOTE: All blood lead results are required to be reported in accordance with
COMAR 26.02.01. Laboratories or clinics that are unable to report to MDE electronically must complete and submit this Reporting Form.
2. Current Lead Reference Level for Children 0-72 months of Age
In October 2021, the CDC lowered the blood lead reference value (BLRV) from 5 micrograms per deciliter to 3.5 micrograms per deciliter. This lower threshold allows for earlier intervention, enabling families and health officials to identify exposure sources and mitigate harmful health effects sooner.
Following this federal guidance, the Maryland Department of Health formally advised healthcare providers on January 25, 2022, to adopt the new 3.5 micrograms per deciliter standard for follow-up care.
3. Lead Case Management for Children 0-72 months for Elevated Blood Lead Level (EBL)
An Elevated Blood Lead Level (EBL) is defined as a confirmed blood lead level at or above 3.5 micrograms per deciliter in a child aged 0-72 months.
Notification and Response Process Effective October 28, 2022,, MDE began notifying parents and if applicable rental property owners if a child living or residing in a property has been identified with a blood lead level equal to or greater than 3.5 mcg/dL. (House Bill 1110, Chapter 86, Acts of 2022).
Additionally, MDE alerts the appropriate local health department. The local health department assigns a lead case manager to provide the family with outreach, education, and support services.
The lead case manager assists the family by:
Interpreting Results: Explaining what the test results mean for the child's health.
Source Identification: Preliminarily identifying potential sources of lead exposure and advising on how to minimize them.
Resource Coordination: Connecting families with additional useful services.
Medical Guidance: Guiding the family through necessary medical and developmental follow-ups to ensure the child receives appropriate care.
2025 Maryland Guidelines for the Assessment and Management of Childhood Lead Exposure
4. Environmental Investigation and Action
Upon notification of a confirmed blood lead level of 3.5 micrograms per deciliter or higher, MDE or local health officials will contact the family to conduct an Environmental Investigation. The goal of this inspection is to identify all lead sources in the child's environment. This includes structural hazards-such as defective lead paint, dust, and soil, as well as non-structural sources like water, toys, cultural remedies, and occupational exposure. The results of this investigation will be issued to the family and, if applicable, the rental property owner.
Resources
References
For more information, contact MDE, Lead Health and Surveillance at 410-537-4199.
