Lead exposure is dangerous for young children. Lead impacts learning and behavior and children are most at risk because their bodies absorb lead more easily and their brains are still developing. Learn more about common sources of lead and what you can do to protect children from lead exposure: lead awareness infographic.
Current Minnesota guidelines recommend universal testing for every child at around both 1 and 2 years of age and targeted blood lead testing for children under 18 years of age. Learn more: Minnesota childhood blood lead screening guidelines. Before 2022, Minnesota's screening guidelines recommended targeted blood lead testing for children that had risk factors for lead exposure.
Elevated blood lead levels (EBLLs) are defined here as 5+ mcg/dL. In 2023, the definition of an EBLL was lowered to 3.5 mcg/dL in Minnesota and will be reflected here in the future.
Childhood lead exposure can be measured by test year or birth year. Birth year measures track childhood lead exposure by the year a child was born, also known as a birth cohort, and include blood lead tests up to 3 years of age. The most recent birth cohort to have been observed for a full three years is children born in 2021 and includes blood lead test results from 2021-2024.
Elevated blood lead levels (EBLLs) are defined here as 5+ mcg/dL. In 2023, the definition of an EBLL was lowered to 3.5 mg/dL in Minnesota and will be reflected on the MDH data portal in the future. Historically, children at higher risk for lead exposure were recommended for blood lead testing. In 2022, Minnesota guidelines changed to recommend that every child is tested at both 1 and 2 years of age.
Percent elevated (State)
Percent elevated (Region)
Percent tested (Region)
EBLL categories (State)
Percent tested by age (State)
Elevated blood lead levels (EBLLs) among Minnesota children tested, by birth year
The most recent birth cohort to have been observed for a full three years is children born in 2021. In recent years in Minnesota, about 1% of children (about 7 of every 1,000 children) had an elevated blood lead level among those that were tested by 3 years of age.
Among children tested by 3 years of age. Elevated blood lead levels (EBLLs) are defined here as 5+ mcg/dL (micrograms of lead per deciliter of blood). Source: MDH Blood Lead Database.
Elevated blood lead levels (EBLLs) by region among children tested in Minnesota, by birth year
The most recent birth cohort to have been observed for a full three years is children born in 2021. Children living within the city limits of Minneapolis or St. Paul are at a higher risk for lead exposure compared to the other regions of the state.
Among children tested by 3 years of age. The "Metro excluding MSP" trend line represents children living in the 7-county Twin Cities metropolitan area except for the cities of Minneapolis or St. Paul. The "Minneapolis-St. Paul" trend line represents children living within city limits. The "Greater MN" trend line represents children living in Minnesota outside of the 7-county Twin Cities Metro. The "Minnesota" trend line is the statewide average. Source: MDH Blood Lead Database.
Children tested in Minnesota by birth year
The most recent birth cohort to have been observed for a full three years is children born in 2021. The percent of children tested for blood lead has increased over time. In Minnesota, about 82% children born in 2021 were tested for blood lead. Testing coverage rates vary slightly across regions: slightly higher in the 7-county Twin Cities Metro region and slightly lower in Greater Minnesota.
Children tested by 3 years of age. The "7-county metro" trend line represents children living in the 7-county Twin Cities metropolitan area. The Greater MN trend line represents children living in Minnesota outside of the 7-county Twin Cities Metro. The Minnesota trend line is the statewide average. Source: MDH Blood Lead Database.
Elevated blood lead levels (EBLLs) categories among Minnesota children tested, by birth year
The most recent birth cohort to have been observed for a full three years is children born in 2021. The number of children with very high blood lead levels has generally declined over time. Though very few children test in the highest ranges of blood lead levels, these levels are associated with more severe health effects. However, there is no safe level of lead.
Among children tested for blood lead by 3 years of age. Source: MDH Blood Lead Database.
Children tested at ages 1 and 2 years in Minnesota, by birth year
The most recent birth cohort to have been observed for a full three years is children born in 2021. In recent years, about 69% of children were tested around 1 year of age and about 49% were tested around 2 years of age. Only about 4 in 10 children (37%) were tested at both 1 and 2 years of age. Minnesota guidelines recommend screening all children for lead exposure at both 1 and 2 years of age. Children tested at 1 year of age should be tested again at 2 years even if the blood lead level was low at the 1-year test since risk behaviors related to lead exposure change as a child develops.
Children were tested for blood lead around 1 year of age (9-18 months), around 2 years of age (18-36 months), or both 1 and 2 years of age. Source: MDH Blood Lead Database.
Percent tested (County)
Percent elevated (County)
Children tested for blood lead in Minnesota (2021 birth year)
Minnesota average: 81.7% tested. Source: MDH Blood Lead Database.
Elevated blood lead levels (EBLLs) among children tested in Minnesota (2021 birth year)
Lead exposure in young children is linked with health effects, including learning impairment, behavioral problems, and even death if lead levels are very high. There is no safe level of exposure to lead. Each county is compared to the statewide average for percent of children with an EBLL.
Minnesota average: 0.7% EBLLs. Among children tested for blood lead before 3 years of age (2021-2024 test results). Each county is compared to the statewide average using 95% confidence intervals. Source: MDH Blood Lead Database.
Data on blood lead testing and elevated blood lead levels are provided by the MDH Lead & Healthy Homes Program, which implements the Childhood Lead Poisoning Prevention Program (CLPPP). Data are extracted from the Blood Lead Database which is housed within the Minnesota Electronic Disease Surveillance System (MEDSS).
Data Questions
The number and percent of children tested for blood lead prior to either 3 or 6 years of age in Minnesota, either by test year - the year that the blood test was performed (annual method) - or by birth year (cohort method) among children tested before 3 years of age.
The number and percent of children with elevated blood lead levels among children tested in the state of Minnesota, by two different methods: birth year (cohort method) and test year (annual method).
The geographic distribution of testing rates and elevated blood lead levels.
To inform the public about testing coverage for blood lead levels in children, elevated blood lead levels, and the geographic distribution of associated risk factors for elevated blood levels.
For program planning and evaluation by state and local partners.
Results are not representative of all children living in Minnesota because blood lead testing was not universal until recently. Learn more about MDH Blood Lead Level Guidelines.
Data cannot tell us exactly how or where a child was exposed to lead.
In the data shown here, an elevated blood lead level (EBLL) in a child was defined as a blood test result greater than or equal to 5 micrograms of lead per deciliter of whole blood (mcg/dL) in a child. That reference level was lowered from 10 to 5 mcg/dL in 2011 and lowered again to 3.5 mcg/dL in 2023.
The National Tracking Network defines a “confirmed” elevated blood lead level as one "venous" test result greater than or equal to 5 mcg/dL, or two "capillary" test results greater than or equal to 5 mcg/dL within 12 weeks of each other.
Capillary blood specimens are drawn from a finger stick, and the blood is collected either in capillary tubes or on filter paper. These specimens are considered "screening" tests because they are prone to falsely high results because of surface contamination when children's hands are not properly washed (prior to drawing the blood). Capillary tests, however, tend to be more acceptable to parents and may be performed in a wider range of settings (i.e., outside of clinical settings).
Venous specimens are considered "diagnostic" tests because they are drawn directly from a vein, but they may be less acceptable to some parents because of a child's discomfort. These tests also require greater expertise in drawing the blood.
Reference levels for lead are based on the U.S. population of children aged 1-5 years who are in the upper 2.5% of children tested for blood lead, based on National Health and Nutrition Examination Study (NHANES) data. Reference levels are expected to decline over time as blood lead levels in U.S. children decline.
If a child has multiple confirmed tests, only the highest confirmed test result is displayed. This applies to an individual test year or a birth year. However, children can appear in multiple test years using the annual method.
The COVID-19 pandemic had a significant impact on testing rates: from 2019 to 2020, there was a 16% drop in testing for children under 6 years. Testing recovered moderately in 2021, which showed 83,562 children under age 6 receiving a blood lead test. However, this number was still 8% lower than in 2019. Similarly, there was a decline in testing at age 1 year for the 2019 birth cohort as well as a decline in testing at age 2 years for the 2018 birth cohort.
Blood lead testing was not universal or randomly sampled in Minnesota in the data shown here, so the data collected by the Blood Lead Database are not representative of all Minnesota children. The MDH Blood Lead Level Guidelines historically directed physicians to order blood lead tests for certain populations at higher risk for lead exposure: 1) children residing in specific geographic areas that have high rates of elevated blood lead levels; and 2) children matching specific demographic groups that tend to have higher rates of elevated blood lead levels. The Childhood Blood Lead Screening Guidelines for Minnesota were updated in 2022 to recommend universal screening for all children at or around 1 and 2 years of age.
The percent of children tested by birth year in a specific county can occasionally exceed 100%. This is because the percent of children tested is not calculated using the total number of children living in that county but, rather, is calculated using the total number of children born in a county in that birth year as a denominator. The number of children tested prior to 3 years of age in a specific county may be higher than the number of children that were born in that county.
American Community Survey (ACS) data on the proportion of older housing provides a population-based proxy for risk of lead exposure, especially housing built before 1950, because old properties with lead-based paint are the most common source of exposure. However, this measure may not accurately reflect exposure risk for several reasons:
ACS data are aggregated to county or census tract areas to provide population-level totals or percentages, so may not accurately reflect exposure risk for individual residents.
Residential addresses in the Blood Lead Database may not reflect the actual location of a child's exposure.
The condition of paint within the home is an important factor in exposure risk, and American Community Survey data does not contain information on housing condition.
Older properties that have undergone remediation (e.g., lead hazard removal, enclosure, or encapsulation) may pose less exposure risk.
Housing age varies within counties. The percentage of older homes in the county does not determine whether individual children reside in older homes.
Vital statistics data from the MDH Office of the Registrar provide high quality information on all Minnesota births, but errors may occur when using vital statistics data or total births as denominators for the birth cohort lead testing measure. A child's address on a birth certificate, for example, may be different from her/his address at the time of the lead test. Additionally, the number of children born in a specific geographic area does not include children who have moved in or out of that area since birth, so using total births as a denominator may lead to an inaccurate estimation of the number of children tested who are born in a specific year.
