Lead-Safe Wisconsin: Universal Testing

Wisconsin recommends universal testing because:

• We want to make sure all children can grow up healthy and lead free. Lead exposure hurts children's minds and bodies. Lead exposure can make it harder for kids to grow, learn, stay healthy, and succeed at school or work, even after they grow up. Children exposed to lead might not seem sick, so the only way to be sure about exposure is to get a blood lead test. Visit our What is Lead Poisoning? page to learn about how lead affects health.
• We don't have enough data yet to know which kids are most at risk in Wisconsin. The number of children who received a lead test dropped a lot in 2020, and testing numbers remain low. If more children get tested, we will have more information about where and how children get poisoned so we can help. Most children in Wisconsin get poisoned from lead paint dust in their homes. However, we know that children can be exposed to lead from other sources, like contaminated drinking water and imported toys, food, and cosmetics. Learn more about sources of lead on our Where is Lead Commonly Found in Wisconsin? and Other Sources of Lead pages.
• We want to simplify our testing recommendations. The new recommendations match the requirements for kids enrolled in Medicaid. Recommending two tests by age 2 for all kids means less confusion for providers and families. It also means we're less likely to miss a poisoned child. Sixteen other states already require or recommend universal blood lead testing for children.

Wisconsin recommends universal testing for all children.

CMS (Centers for Medicare and Medicaid Services) requires all children enrolled in Medicaid to be tested at 12 months and 24 months. Any child between 24 and 72 months with no record of a previous blood lead test must receive one.

Read more about the Medicaid requirements on the Medicaid Lead Screening webpage.

Lead poisoning affects children statewide.

Every Wisconsin county has had at least one lead-poisoned child within the last five years. Over half (59%) of Wisconsin housing was built before 1978. Housing built before 1978 commonly has lead-based paint, which can poison children. Also, there are over 158,000 lead service lines providing drinking water in Wisconsin.

Ingestion of lead in drinking water is estimated by the Environmental Protection Agency (EPA) to be as high as 20% or more of a person’s total lead exposure, and as high as 60% for infants who are exclusively formula fed.

Lead can hurt anyone, but it’s especially dangerous for young children because their bodies are still developing and growing so fast.

Younger children who are crawling and learning to walk are at greater risk of being exposed to lead-contaminated soil and dust. Children this age often put objects or their hands into their mouths; this can cause the child to ingest lead and over time can poison a child.

For Wisconsin children not on Medicaid, universal testing is a recommendation, not a requirement, so it is not “enforced.” However, CMS has and will continue to require that children enrolled in Medicaid get tested at 1 year old, at 2 years old, or at least once between 3 and 5 years old if there is no record of a previous test.

Before January 2024, Wisconsin recommended testing a child for lead only if the child met certain criteria. Deciding if a child should get tested was confusing for providers and families.

The new recommendations are simple: All children should receive two tests by age 2,* regardless of their family's income, housing, or city.

If you want to know more about Wisconsin's previous testing recommendations, email DHSLeadPoisoningPrevention@dhs.wisconsin.gov

*or one test between age 3 and 5, if no record of previous test.

You can find more information about lead testing and reporting, lead poisoning, and lead poisoning prevention on our Lead-Safe Wisconsin webpages.

Some helpful pages include:

• Pediatric Lead Testing and Reporting
• What is Lead Poisoning?
• Prevention and Intervention for Childhood Lead Exposure

Yes. Any child between the ages of 3 to 5 years old on or after January 2024, should receive a test if they have no record of a prior test.

Primary care providers and their health care systems are primarily responsible for ensuring children receive age-appropriate lead tests. However, providers, state and local health departments, community organizations, and families will need to work together to get children tested.

Yes.

Children can get tested at a medical provider’s office, local community organizations, or federally qualified health centers.

Contact your local health department for local organizations or view the list of Wisconsin’s federally qualified health centers.

Some WIC sites may provide blood lead testing, but their primary role will be to check that the child has received the age-appropriate tests. If the child has not received the recommended tests, WIC can refer them to a provider able to provide that service.

You can contact your local WIC agency to learn if they provide lead testing.

• Medical providers or health care organizations
• Local health departments
• Local WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) agencies
• The Wisconsin Childhood Lead Poisoning Prevention Program

Currently there is no additional funding available for local health departments.

CDC recommends targeted screening efforts for children not enrolled in Medicaid to focus on high-risk areas and children.

Screening plans should be responsive to local conditions using local data. In the absence of such plans, universal blood lead testing is appropriate. Visit CDC’s Lead FAQ page for more information.

Yes. As of November 28, 2023, 14 states require universal testing, and two states recommend universal testing.

The decrease in number of children tested since the COVID-19 pandemic means we don’t have enough information to identify which neighborhoods and children are at greatest risk. We will use testing and poisoning data from after January 2024 to:

• See how testing and poisoning rates change after we recommend universal testing.
• Figure out which neighborhoods and children in Wisconsin are most at risk for lead poisoning.