[HISTORY: Adopted by the Board of Health of Allegheny County effective 1-1-2018; ratified by the County Council 7-5-2017 by Ord. No. 17-17. Amendments noted where applicable.]
Pursuant to the authority granted to the Allegheny County Health Department under the Pennsylvania Local Health Administration Law, 16 P.S. §§ 12010(f) and 12011(c), this regulation has been promulgated to improve the health of the children of Allegheny County. Universal blood lead level testing will facilitate early detection and referral for treatment of lead poisoning; will reduce the incidence, impact and cost of lead poisoning; will inform parents and guardians of their children's lead exposure; and will enable Countywide surveillance of childhood lead poisoning. The regulation applies to all residents and schools of Allegheny County.
As used in this chapter, the following terms shall have the meanings indicated:
- BLOOD LEAD LEVEL
- A measure of lead in the blood, measured in micrograms of lead per deciliter of whole blood (µg/dL).
- BLOOD LEAD LEVEL TESTING
- A blood sample obtained either by venipuncture or finger stick capillary blood collection from a child not known to be lead poisoned or to have an elevated blood lead level in order to identify the child's risk of lead poisoning or elevated blood lead level.
- A natural person under 72 months of age who is a resident of Allegheny County.
- Allegheny County Health Department.
- The Director of the Allegheny County Health Department.
- HEALTH CARE PRACTITIONER
- An individual who is authorized to practice some component of the healing arts by a license, permit, certificate or registration issued by a Pennsylvania licensing agency or board.
- RECORD OF BLOOD LEAD LEVEL TESTING
- Any written or electronic document acceptable to the Director showing the date of blood lead level testing, including, but not limited to, health care practitioner records, school health records, and other similar documents or history.
General rule. Blood lead level testing shall be performed in accordance with the following:
Children shall receive a blood lead level testing in accordance with the following schedule:
Each child shall be tested between approximately nine months to 12 months of age and again at approximately 24 months of age.
All children designated as high risk, as determined by a health care practitioner and based on the child's exposure to lead and any other factors indicating high risk, should receive subsequent blood lead level testing as deemed appropriate by a health care practitioner.
Blood lead level testing may be delayed if the health care practitioner is not able to collect a sufficient blood sample for testing.
If a child has not had their blood lead level tested between approximately nine months to 12 months of age and at approximately 24 months of age, then that child shall have their blood lead level tested as soon as possible after 24 months but before 72 months of age or entry into kindergarten, whichever is sooner.
Testing methods. Health care practitioners shall ensure that blood lead level testing is conducted either by venipuncture or by capillary blood sampling in accordance with current best practices. Capillary blood sample testing results of 5 µg/dL or greater shall be confirmed with a venipuncture test.
Medical exemption. Children need not have a blood lead level testing according to the schedule enumerated in § 810-3 above if a health care practitioner or his/her designee provides a written statement that blood lead level testing may be detrimental to the health of the child. When the health care practitioner determines that blood lead level testing is no longer detrimental to the health of the child, the child should have their blood lead level tested according to § 810-3 above.
Religious exemption. Children need not have a blood lead level testing according to the schedule enumerated in § 810-3 above if the parent, guardian, or emancipated child objects, in writing, to the blood lead level testing on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.
The administrator in charge of every school shall appoint a knowledgeable person to perform the following:
The parent or guardian of a child who has not had their blood lead level tested in accordance with § 810-3 (relating to blood lead level testing requirements) shall be informed of the blood lead level testing requirement and advised to go to his/her usual source of care, or to the nearest Allegheny County Health Department location offering blood lead level testing, to obtain a blood lead level test.
Each school shall maintain on file a record of blood lead level testing for every child enrolled in kindergarten at the school.
Every public, private, parochial or nonpublic school, including intermediate units and special education, cyber and charter schools, in Allegheny County shall, after a child's entry to kindergarten and using forms provided by the Department, report blood lead level testing data to the Department by October 15 of each year.
The school administrator or his/her designee shall forward the blood lead level testing data reports to the Department's Bureau of Assessment, Statistics & Epidemiology, or as otherwise designated by the Department.
The content of the annual blood lead level testing data report shall include, at a minimum, the following information:
The identification of the school including the name of the school, the school district, the intermediate unit, and the type of school.
The month, day, and year of report.
The number of children entering kindergarten at the school.
The number of children entering kindergarten at the school who have had their blood lead level tested.
The number of children entering kindergarten at the school who did not have their blood lead level tested due to medical exemptions.
The number of children entering kindergarten at the school who did not have their blood lead level tested due to medical exemptions or exemptions on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.
Other information as required by the Department.
The provisions of this chapter are severable. Should any section, paragraph, sentence, clause, or phrase of this chapter be declared unconstitutional or invalid for any reason, the remainder of said chapter shall not be affected thereby.
The provisions of this chapter shall become effective on January 1, 2018.