A box checked for a lead test on a medical form next to a test tube with blood sample.
Test tube with blood sample for lead level test. Photo by jarun011 via iStock.

Overview:

-Lead is a potent neurotoxin that can cause serious and lasting harm, especially in young children.
-The primary source is dust from deteriorating lead-based paint, especially in homes built before 1978.
-The law requires all children in Michigan to receive blood lead tests at 12 months and again at 24 months of age.

Table of contents

As of April 30, all Michigan children must be tested for lead at key points in early childhood. A new state law aims to catch lead exposure early and help prevent long-term harm. Here’s what parents and caregivers need to know.

What are the consequences of lead exposure in children?

Lead is a potent neurotoxin that can cause serious and lasting harm, especially in young children. Exposure can impair brain development, leading to lower IQ, learning disabilities, attention problems, and behavioral issues. It can also cause hearing loss, slowed growth, and anemia. In severe cases, high lead levels can result in seizures or even death. 

As the effects may not be immediately apparent, even low levels of blood lead are considered dangerous. The earlier the lead exposure is detected, the sooner interventions can help reduce its impact.

How are children exposed to lead?

Children are most commonly exposed to lead in their own homes or neighborhoods. The primary source is dust from deteriorating lead-based paint, especially in homes built before 1978, when residential lead paint was banned. Kids can ingest this dust through normal hand-to-mouth behavior. 

Other exposure pathways include contaminated soil, older plumbing that may leach lead into drinking water, and imported goods such as toys, cosmetics, or ceramics. Some children are also exposed through parents’ occupations or hobbies that involve lead, such as construction or auto repair. Since lead exposure often occurs without apparent symptoms, testing is the only way to detect it.

What is a blood lead test and why is it important?

A blood lead test measures how much lead is in a child’s bloodstream. Even very small amounts of lead can affect a child’s brain development, behavior, and physical health. There is no known safe level of lead in blood. Early testing helps identify exposure and allows families to take steps to limit long-term damage.

What does the new law require?

The law requires all children in Michigan to receive blood lead tests at 12 months and again at 24 months of age. If a child has not been tested by the time they are 6, a test must be conducted before their 72nd month. Children considered to be at higher risk must be tested again around age 4 if they live in one of 82 cities or townships designated by the state as high-risk for lead exposure. 

Children also must be tested if they live in a home built before 1978, a home where other children have tested positive for elevated blood lead levels, or if a parent or physician determines they are at risk. These additional tests must occur within three months of identifying a potential risk. Parents may decline testing, but their decision must be documented in the child’s medical record.

Who is responsible for making sure lead testing happens?

Doctors are legally responsible for testing or ordering blood lead tests for children. They must also record the test results in the child’s immunization records.

What if my child doesn’t have a regular doctor?

Families without a primary care provider can contact their local health department to ask about available services. Many local health agencies provide lead testing directly or can refer families to a clinic.

Does insurance cover lead testing?

Yes. Blood lead testing is considered a preventive health service under the Affordable Care Act, which means it must be covered without additional copayment or coinsurance charges. Most private and public insurance plans, including Medicaid, should cover the cost. 

Why did Michigan pass this law?

Michigan has one of the highest rates of elevated childhood blood lead levels in the country. In 2021, the state had the third-highest percentage of tested children with elevated levels. In Detroit, that number was even higher — nearly one in 10 tested children had elevated blood lead levels, according to state data. In 2024, more than 135,000 children were found to have elevated blood levels, with 12,752 in Detroit.

Advocates argue that too many children were missed under the old targeted testing approach, which only required testing for Medicaid-enrolled children. In 2022, fewer than a quarter of children in Detroit were tested, and statewide, that number was under 16%. Universal testing is intended to identify lead exposure early, when interventions are most effective.

What happens if my child has elevated lead levels?

If a child is found to have elevated levels of lead in their blood, doctors must refer the case to the Michigan Department of Health and Human Services. The department can provide follow-up services, including home inspections, nutritional support, and case management to help reduce exposure and mitigate harm.

Can I refuse the test?

Parents can legally decline blood lead testing for their child. However, the doctor must document this refusal in the child’s health records.

What laws and rules require this testing?

Two laws passed in 2023 set the foundation for universal testing in Michigan. Public Act 146 requires physicians to order blood lead tests at the specified ages and to include the results in the child’s immunization records. Public Act 145 also mandates documentation of lead testing on those records. The Michigan Department of Health and Human Services developed administrative rules to enact these laws, which went into effect on April 30, 2025.

Where can I find more information?

You can visit Michigan.gov/MiLeadSafe for comprehensive information about lead risks, testing guidelines, and health effects. For help finding testing services, visit your local health department’s website. If you have questions, you can also contact the state’s Childhood Lead Poisoning Prevention Program at 517-335-8885 or MDHHS-CLPPP@michigan.gov.

Resources

MDHHS Lead Exposure Prevention Tips: Lead and Your Health

LEARN MORE

Getting the lead out of Detroit’s soil

Eight years after April Ross purchased her East Village home from a private California seller in 2010, she discovered her daughter was lead poisoned. Her daughter Rayna showed an elevated blood lead level (EBLL) of nine micrograms per deciliter (µg/dL). The Centers for Disease Control and Prevention calls for action for any level above five. …

Avatar photo by Rukiya Colvin

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Nina Misuraca Ignaczak is an award-winning Metro Detroit-based editor, journalist, and documentary filmmaker. She is the founder, publisher, and editor of Planet Detroit, a digital media startup focused on producing quality climate, health, and environment journalism that holds power accountable, and spotlights solutions. Planet Detroit has received awards and recognition from the Society for Professional Journalists Detroit, the Institute for Nonprofit News, and LION Publishers since its establishment in 2019. Prior to her journalism career, Nina worked in urban planning in local government and nonprofit sectors, holding a Master of Science in Natural Resource Ecology and a Bachelor of Science in Biology from the University of Michigan, Ann Arbor.