Lead level (μg per dL [μmol per L])	Evaluation	Education	Intervention	Follow-up
< 5 (0.24)	Routine nutrition and developmental milestones	Anticipatory guidance about common sources of lead exposure	None	Continued age-appropriate screening as recommended by state programs or the CDC
5 to 9 (0.24 to 0.43)	Routine nutrition and developmental milestones and environmental assessment (through history-taking) to evaluate for potential exposure sources	Nutrition counseling to increase calcium and iron consumption	Formal environmental investigation*	Continued age-appropriate screening in addition to interval testing (Table 5)
10 to 19 (0.48 to 0.92)	Routine nutrition and developmental milestones and environmental assessment (through history-taking) to evaluate for potential exposure sources	Nutrition counseling to increase calcium and iron consumption	Consider laboratory testing to assess iron status Formal environmental investigation*	Interval testing (Table 5)
20 to 44 (0.97 to 2.13)	Neurodevelopmental assessment in addition to routine assessments	Nutrition counseling to increase calcium and iron consumption	Laboratory testing to check hemoglobin/hematocrit levels and iron status Consider abdominal radiography to evaluate for ingestion Environmental investigation and lead hazard reduction	Interval testing (Table 5)
45 to 69 (2.17 to 3.33)	Neurologic examination as well as neurodevelopmental assessment	—	Laboratory testing to check hemoglobin/hematocrit levels and iron status Consider abdominal radiography to evaluate for ingestion Oral chelation therapy, consider hospitalization if lead-safe environment cannot be assured Environmental investigation and lead hazard reduction	Interval testing (Table 5)
≥ 70 (3.38)	Hospitalize, consult with medical toxicologist or pediatric environmental health specialty unit	—	Commence chelation therapy with help as noted above, proceed with all actions as advised for blood lead levels between 45 and 69 μg per dL	Once down to less urgent level, perform interval testing (Table 5)