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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

23-490m Filter Paper Testing for Lead in Children Discontinued by the CDC and CLPPB

Date: 06/08/23

Childhood Lead Poisoning Prevention Branch (CLPPB) issues policy requiring discontinuation

The Tips for Childhood Blood Lead Level Screenings tip sheet has been updated online to reflect new guidance regarding filter paper testing. You can access the updated tip sheet online, Tips for Childhood Blood Lead Level Screenings (PDF).

Filter paper testing

Filter paper has multiple issues of possible contamination that are well documented. Filter paper can have unequal blood distribution which can result in false positives or false negatives when the paper is punched for analysis. The contamination issue is based on the paper production itself and the possible contamination during the collection and drying of the blood spot on the filter paper. These issues become of greater significance with the lowering of the Blood Lead Reference Value (BLRV).

The policy statemen​​t below provides guidance for discontinuing the use of filter paper testing and information on retesting children who have had filter paper lead screening or testing in the past.  The test methodology that is recommended depends on the initial blood lead value, whether less than the Centers for Disease Control & Prevention (CDC) BLRV of 3.5 mcg/dL, or equal to or greater than the CDC BLRV of 3.5 mcg/dL.

CLPPB filter paper testing policy

If you are currently using filter paper testing for blood lead tests, please discontinue its use. If you have used filter paper in the past to test children under the age of 6, and the test result was less than 3.5 mcg/dL, the test should be repeated with another screening using EITHER capillary blood and an FDA-approved Point of Care testing device OR capillary or venous blood sent to a lab. If the filter paper result was equal to or greater than 3.5 mcg/dL, repeat with a venous test and send the blood sample for analysis to a reference lab that runs inductively coupled plasma mass spectrometry (ICP-MS) or graphite furnace atomic absorption spectrometry (GFAAS).

 

This Information applies to Physicians, Independent Practice Associations (IPAs), Hospitals, and Ancillary Providers.