Talbot County Department of Health
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Elevated Lead Case Management

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Protecting Children from lead exposure is essential to promoting lifelong health and wellness. Elevated blood lead levels have been shown to negatively impact a child’s intellectual development, behavior, and health. 

Lead poisoning can be difficult to detect because it is often a silent disease and most children do not display obvious symptoms right away. All children should undergo routine screening at well-child visits, in addition to having their blood tested for lead at 12 and 24 months old. 

Elevated blood lead levels are reported to the Maryland Department of the Environment, who then notifies the child’s local Health Department. When a child in Talbot County is identified as having an elevated blood lead level, the Health Department partners with the pediatrician and family to help identify and remove the source of lead exposure from the child’s environment. 

The Health Department can educate families, provide case management, coordinate resources, and in some cases collaborate with Maryland Department of the Environment to conduct home inspections. 

Health Department staff follows children with elevated lead levels until their lead level has dropped below the level of concern identified by the Centers for Disease Control and Prevention (CDC).

About Lead Poisoning

What is lead poisoning?

Lead is a naturally occurring metal that is toxic to humans and animals. It enters the body through contaminated air, food, water, dust, or soil and accumulates in the blood and soft tissue over time. Lead poisoning is an environmental disease that has detrimental and permanent effects on the body and brain.

Who gets lead poisoning?

Anyone who eats, drinks, or breathes something that has increased lead levels is at risk of developing lead poisoning. However, lead is particularly dangerous to children because their growing bodies absorb more lead than adults do, and their brains and nervous systems are more sensitive to the damaging effects of lead. 

Babies and young children can also be more highly exposed to lead because they often put their hands and other objects in their mouths which may be contaminated with lead from dust or soil. 

Sources of adult lead poisoning are generally occupationally related. Pregnant women should be aware that lead exposure can cross the placental barrier and put their unborn child at risk.

What can cause lead poisoning?

Lead was commonly used in household products such as paint, pipes and plumbing components, gasoline, batteries, cosmetics and ammunition before it was known to be toxic to humans. In 1978, lead was banned from use in paint in the United States. However, older homes and structures may still have lead-based paint, which is the most common source of lead exposure.

Other sources of lead include:

  • Lead-contaminated soil
  • Hobbies such as fishing, stained glass, and pottery glazing
  • Imported or antique glazed pottery, ceramics, or pewter dishes
  • Spices contaminated with lead (especially turmeric, cumin, or chili powder)
  • Folk remedies (greta, azarcon, ghasard, or daw tway)
  • Ceremonial and/or religious powders (kajal, kumkum, sindoor, or kohl)
  • Consumer products such as some jewelry, mini-blinds, imported candles, and old toys or furniture


If your home was built before 1978, get your home checked for lead hazards including lead-based paint. If your child frequently spends time somewhere else, such as at a grandparent’s home or daycare, it should be evaluated as well.

Do not attempt to remove lead-based paint by sanding or stripping, as these methods release more lead dust in the home. Use only approved methods or hire an federal Environmental Protection Agency or State-approved Lead-Safe Certified renovation firm.

You can also avoid lead exposure by:

  • Not allowing your child to play in bare soil.
  • Washing your child’s hands and face often, especially before meals.
  • Keeping play areas clean and washing your child’s bottles, pacifiers, toys, and stuffed animals regularly.
  • Ensuring your children eat nutritious meals high in iron and calcium (children with good diets absorb less lead).
  • Using cold tap water (not hot) for infant formula or cooking. Letting the cold tap water run for a few minutes before using helps flush out any lead that may come from pipes.

Testing & Treatment


Maryland law requires that all children have a lead test at 12 and 24 months old. If you are concerned about your child’s lead exposure risk, or if you are not sure they have ever had a lead test, talk to your child’s pediatrician right away. Most children can be tested at their pediatrician’s office during their regular well child visits. 

A simple blood test can detect lead poisoning. A small blood sample is taken from a finger prick or from a vein. There is no safe blood level of lead. However, a level of 3. 5 micrograms per deciliter (mcg/dL) is used to indicate a possibly unsafe level for children.


Eliminating Exposure

If your child has been diagnosed with an elevated blood lead level, the first thing you should do is figure out how they are being exposed. It is important to eliminate or limit exposure to lead sources as soon as possible. 

The Health Department will work with you and  your child’s doctor to review your child’s environment and identify possible sources of lead. The Health Department will provide education and advice on eliminating the sources of lead exposure.


For most children with elevated lead levels, lead levels will come down over time naturally without medical treatment, assuming the sources of exposure have been eliminated.  However, your child will also need to be retested to ensure their lead level is coming down. Be sure to follow your doctor’s guidance for testing and retesting.

In more severe cases, your child’s doctor may recommend medication designed to help the body eliminate lead.

The Health Department will provide case management during this process to help your family navigate follow up testing and treatment, if necessary. 


For questions about lead exposure or our case management and education services, please call (410) 819-5600.