Updated Blood Lead Reference Value (BLRV)

As of January 1, 2023, the Texas Department of State Health Services (DSHS) has implemented a blood lead reference value (BLRV) of 3.5 micrograms per deciliter (µg/dL), as recommended by the Centers for Disease Control and Prevention (CDC). DSHS uses a BLRV of 3.5 µg/dL to identify children with blood lead levels that are higher than most children's levels. The Reference for Blood Lead Retesting and Medical Case Management, Pb-109 form provides guidance for blood lead levels ≥3.5 µg/dL and has been updated to reflect CDC guidance.

Welcome to the Texas Blood Lead Surveillance Provider's Resources Page. Here you can find up-to-date paperwork for testing, reporting, and conducting follow-up visits for children who test for elevated blood lead levels. You can use the list below to find our resources by category.

• Texas Blood Lead Surveillance Reporting Videos
• Texas Health Steps
• Reporting Blood Lead Levels
• Screening & Testing for Lead in Children
• Screening & Testing for Pregnant Women
• Follow-up Forms
• Environmental Lead Investigation Forms

Texas Blood Lead Surveillance Videos

The Texas Department of State Health Services has developed training videos on testing children for lead, reporting the results, and conducting follow-up.

• Importance of Childhood Lead Testing and Reporting
• Ways to Report Blood Lead Test Results
• Follow-up for Elevated Lead Levels

Texas Health Steps 

Texas Health Steps (THSteps) provides online provider education courses. Courses related to lead screening and prevention include:

• Lead Exposure: Screening, Testing, and Treatment
• Is This Child At Risk For Lead Exposure
• Texas Health Steps Provider’s Guide to the Periodicity Schedule
• How to Conduct Texas Health Steps Medical Checkups
• Specimen Collection

Reporting Blood Lead Levels

By Electronic Submission

• Electronic Reporting Form
• Texas Blood Lead Surveillance: Ways to Report Blood Lead Test Results
  Used by healthcare providers to submit blood lead test results by electronic submission or by fax.

By Fax

• Child Blood Lead Reporting Form (F09-11709) - Revised January 2021
  Used by healthcare providers to report blood lead level(s) for children under 15 years of age.
• Adult Blood Lead Reporting Form (F09-11624)
  Used by healthcare providers to report blood lead level(s) for children/adults 15 years of age and older.
• Point-Of-Care Blood Lead Testing Report (Pb-111) - Created 04/26/12
  Used by healthcare providers to report blood lead levels when using a point-of-care blood lead analyzer.

Screening & Testing for Lead in Children

• 2019 Texas Childhood Blood Lead Screening Guidelines -  Revised June 2020
  Targeted zip codes have one or more associated census tract in which:
  • The percentage of children age 1-2 years old with a blood lead level ≥ 5 mcg/dL is ≥ 3% among those tested in 2016 (Prevalence), or 
  • The percentage of residential structures built before 1950 is ≥ 27% (Housing).
   
• Pb-110: Lead Risk Questionnaire (English Version) - Revised August 2018
  The lead risk questionnaire is also included in the "2019 Texas Childhood Blood Lead Screening Guidelines" document, on page 8.
  • Pb-110: Lead Risk Questionnaire (Spanish Version) - Revised June 2020
  • Pb-110: Lead Risk Questionnaire (French Version) - Revised June 2020
  • Pb-110: Lead Risk Questionnaire (Arabic Version) - Revised June 2020
  • Pb-110: Lead Risk Questionnaire (Burmese Version) - Revised June 2020

Screening & Testing for Pregnant Women

Lead Poisoning Prevention Guidelines for Prenatal Care Providers in Texas

Used by provider for identification and follow-up care of lead poisoning in women of childbearing age, pregnant women, and postpartum women

Follow-up Forms

• Follow-up of Initial Elevated Blood Lead Level (Pb-102) - Revised January 2023
  Used by healthcare providers for follow-up of elevated blood lead levels of a child. 
• Physician Checklist for Parent Education Topics (Pb-104) - Revised April 2023
  Used by healthcare providers to determine the appropriate lead educational material to provide parents for medical care, environmental intervention, and nutritional intervention. 
• Reference for Blood Lead Retesting and Medical Case Management (Pb-109) - Revised March 2024
  Used by healthcare providers to determine when follow-up blood lead testing is necessary.
  Specifically:
  • “Schedule for Obtaining a Diagnostic Venous sample”,
  • “Schedule for Follow-up Venous Blood Lead Testing After Diagnostic Venous Sample”,
  • and “Recommendations for Children with Diagnostic Elevated Blood Lead Levels”. 

 Environmental Lead Investigation forms

• Request for Environmental Investigation (Pb-101) - Revised August 2018
  Used by healthcare providers to request an Environmental Lead Investigation for a child with a venous blood lead level test result of 20 µg/dL and higher, or two separate venous blood lead level tests collected at least 12 weeks apart in the 10-19 µg/dL range. 
• Elevated Blood Lead Level Investigation Questionnaire (Pb-103) - Revised August 2019
  Used by Lead Risk Assessors to conduct Environmental Lead Investigations. 

Last updated June 12, 2025