WIC to Include Questions on Blood Lead Testing Starting March 1st.

Leigh Cullen, Testing Promotion Coordinator
Childhood Blood Lead Team

Office of Environmental Public Health Services
Washington State Department of Health

Starting this spring, health care providers can expect more questions from parents and caregivers about blood lead testing. Washington state’s Women, Infants, and Children (WIC) program will include questions on lead testing in their annual child nutrition assessment visits beginning March 1, 2023. The U.S. Department of Agriculture now requires WIC staff to ask parents or caregivers if their child has had a blood lead test. Any child who hasn’t had a blood lead test will be referred to their health care provider for testing.

At each annual nutrition assessment visit, WIC staff will ask the parent or caregiver:

“Has your child been tested for lead?”

  • If the answer is yes, WIC staff will ask, “Do you know the value?” and “What did the doctor say about the test?”
    • If the answer is no, WIC staff will refer all children who haven’t been tested to their health care providers. WIC staff will follow up at later visits to see if the child has received a blood lead test.

During these visits, WIC will give parents and caregivers information about key nutrients in WIC foods that help reduce lead absorption, including calcium, iron, and vitamin C. If parents or caregivers have questions about lead exposure sources or ways to reduce their child’s lead risk, WIC will refer them to the Department of Health’s (DOH) Childhood Blood Lead Program.  WIC staff may give parents and caregivers DOH’s Lead Test Card, which has a simple lead risk questionnaire and a tear-away card families can bring to their health care providers.

Washington’s WIC clinics served over 137,000 infants and children in 2022. WIC’s questions about lead testing can reach many families and increase the number of families seeking blood lead testing at their health care visits. Approximately 90% of infants and children receiving WIC services are also enrolled in Medicaid. The Centers for Medicare and Medicaid Services requires that all Medicaid-enrolled children be tested at  12 and 24 months, or at  24–72 months if they have not previously been tested. For all other children in Washington, DOH recommends children with risks factors, such as living in a home older built before 1978 or having a sibling with an elevated blood lead level, get tested at 12 and 24 months.

To help you know when to screen children for lead, DOH created a childhood blood lead testing clinical algorithm. The Northwest Pediatric Environmental Health Specialty Unit (PEHSU) has a fact sheet providing guidance on childhood blood lead medical management.

For more information on blood lead testing or on WIC’s new lead questions, please contact us.