How frequently is a capillary sample confirmed as an elevated blood lead level (EBLL)?*
| Year | # Elevated Initial Capillary Screenings | # Elevated Initial Capillary Screenings CONFIRMED** | Confirmation Rate |
|---|---|---|---|
| 2025 | 967 | 164 | 16.96% |
| 2024 | 1840 | 240 | 13.04% |
| 2023 | 2104 | 329 | 15.64% |
| 2022 | 847 | 159 | 18.77% |
| 2021 | 569 | 140 | 25.60% |
| 2020 | 744 | 157 | 21.10% |
| 2019 | 956 | 220 | 23.01% |
| 2018 | 810 | 188 | 23.21% |
LeadTRK Database, TN Department of Health, Updated July 10, 2026
*Data for children aged less than 72 months. TN Department of Health adopted the new CDC blood reference value (BLRV) of 3.5 µg/dL on October 1, 2022. The year 2023 was the first complete calendar year the new BLRV was in effect. This contributed to a sharp increase in initial capillary EBLL screenings and a decrease in the confirmation rate.
Starting January, 2024 a venous test must be done to confirm an initial capillary test.
Screening Steps
Capillary Sample of 3.5 µg/dL or Higher
Step One:
Venous Confirmatory Test Conducted
- Confirmatory testing can be performed same day.
| Screening Test Result (ug/dL) | Time to Confirmatory Test |
|---|---|
| 3.5 – 9 | 1 – 3 months |
| 10 – 44 | 1 week – 1 month |
| 45 – 59 | 48 hours |
| 60 – 69 | 24 hours |
| ≥ 70 | Urgently, as an emergency test |
Do you have a patient with a confirmed EBLL?
Step Three:
Follow-Up Test Conducted
- Some providers may choose to repeat blood tests on all new patients with EBLLs within a month to ensure the BLL is not rising more quickly than anticipated.
| Venous Blood Lead Level (ug/dL) | Early Follow-Up (first 2-4 tests after identification) | Late Follow-Up (after BLL begins to decline) |
|---|---|---|
| 3.5 – 9 | 3 months | 6 – 9 months |
| 10 – 19 | 1 – 3 months | 3 – 6 months |
| 20 – 24 | 1 – 3 months | 1 – 3 months |
| 25 – 44 | 2 weeks – 1 month | 1 month |
| ≥ 45 | As soon as possible | As soon as possible |
