Lead Exposure Questionnaire

This is a series of questions your child’s doctor should ask you at the yearly visit to determine if your child is at-risk for having lead exposure.

Does your child:

    • Live in or regularly visit a house built before 1978 with peeling or chipping paint? This could include the home of a baby-sitter or relative, a daycare center or preschool.
    • Live in or regularly visit a house built before 1978 with planned, recent (within the past year) or ongoing renovation/remodeling activity?
    • Have a brother or sister, a playmate or other household member with a confirmed elevated blood level?
    • Live with an adult whose job or hobby involves exposure to lead?
    • Live near an active lead smelter, battery recycling plant, or other industry likely to release lead?
    • Have a history of possible prenatal exposure to lead (child’s mother had elevated blood lead during pregnancy)?
    • Have iron deficiency anemia, sickle cell disease, developmental delay or behavioral problems?
    • Have a habit of eating dirt, paint chips, or other non-food items?
    • Have excessive mouthing habits that are not age appropriate?
    • Have an elevated blood lead test of 10 micrograms per deciliter or higher when last tested?

If you answered “Yes” or “I don’t know” to any of these questions, your child may be at risk for elevated lead levels.

Talk to your child’s doctor, pediatrician or clinic about blood testing your child for lead.

City of New Haven Childhood Lead Poisoning Prevention Program

City of New Haven
Health Department
Bureau of Environmental Health
54 Meadow Street, 9th Floor
New Haven, CT 06519
(203) 946-8174