More Guidelines than states: variations in U.S. lead screening and management guidance and impacts on shareable CDS development

Table 2 Definitions of ELL for 50 US States and District of Columbia

ELL Definition (N = 51)	States
No level specified^a (3)	Arkansas [40], North Dakota [41], Wyoming [42]
Lead Level ≥ 3 μg/dL (1)	New Hampshire [43, 44]
Lead Level ≥ 5 μg/dL^b (37)	Alabama [45], Alaska [46], Arizona [47, 48], California [49, 50], Colorado [51, 52], Connecticut [53, 54], District of Columbia [55, 56], Georgia [57,58,59], Hawaii [60, 61], Idaho [62, 63], Illinois [64, 65], Iowa [66, 67], Kentucky [68, 69], Louisiana [70,71,72], Maine [73, 74], Maryland [75], Massachusetts [76,77,78,79], Michigan [80, 81], Minnesota [82, 83], Mississippi [84, 85], Montana [86], Nebraska [87, 88], New Mexico [89], North Carolina [90], Ohio [91, 92], Oklahoma [93, 94], Oregon [95, 96], Pennsylvania [97], Rhode Island [98, 99], South Carolina [100], South Dakota [101, 102], Tennessee [103], Texas [104, 105], Vermont [106, 107], Virginia [108,109,110], Washington [111,112,113], Wisconsin [114, 115]

^aLead is included as a ‘reportable disease’ but no ELL threshold is defined and no other guidance is given
^bMontana does not provide screening guidance, but ELL is defined in the ‘reportable disease’ list when ≥5 μg/dL
^cNew York City defines ELL as ≥5 μg/dL, however the rest of New York State uses ELL as ≥10 μg/dL

ISSN: 1471-2458