A 2-year-old child screened for lead poisoning has a lead level of 14 mcg/dL. The intervention should include which action?

A 2-year-old child screened for lead poisoning has a lead level of 14 mcg/dL. The intervention should include which action?

• A. A long bone x-ray film for lead
• B. A low-calcium diet
• C. Referral to the health department for environmental investigation
• D. A high-calcium diet

Answer: (C)

A lead level of 14 mcg/dL in a toddler signals ongoing environmental exposure to lead and the primary goal is to identify and remove the source. The best next step is to involve the health department for an environmental investigation of the home and surrounding environment. Public health workers can locate lead hazards—such as deteriorating paint, soil, dust, or contaminated water—coordinate remediation, and assess other children in the household or community who may be at risk. Chelation therapy or urgent medical interventions are not indicated at this level; the focus is on hazard control and prevention of further exposure. Nutrition matters, such as ensuring adequate calcium and iron to modestly reduce absorption, but this does not replace addressing the environmental source. Imaging the bones or altering calcium intake alone does not address the root cause of exposure.

A lead level of 14 mcg/dL in a toddler signals ongoing environmental exposure to lead and the primary goal is to identify and remove the source. The best next step is to involve the health department for an environmental investigation of the home and surrounding environment. Public health workers can locate lead hazards—such as deteriorating paint, soil, dust, or contaminated water—coordinate remediation, and assess other children in the household or community who may be at risk. Chelation therapy or urgent medical interventions are not indicated at this level; the focus is on hazard control and prevention of further exposure. Nutrition matters, such as ensuring adequate calcium and iron to modestly reduce absorption, but this does not replace addressing the environmental source. Imaging the bones or altering calcium intake alone does not address the root cause of exposure.