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Blood Lead Surveillance Branch

Health Advisory

The Texas Department of State Health Services has issued a health advisory connected to several brands of cinnamon applesauce and cinnamon apple puree sold in pouches that may have extremely high concentrations of lead. Children in multiple states have been reported with elevated levels of blood lead after consuming these products, including children from Texas.

View the DSHS Health Advisory for more information. 


Lead Alert

A woman in California purchased hemorrhoid ointment from Vietnam containing a highly dangerous amount of lead. After using the ointment, the woman developed a severe case of lead poisoning and died. The ointment is known as Cao Bôi Trĩ Cây Thầu Dầu and was bought through Facebook and mailed by a relative from Vietnam. It is unclear if the ointment is currently available in the U.S. for direct purchase. For more information, please visit the alert issued by the California Department of Public Health.

Published April 10, 2024


Updated Blood Lead Reference Value (BLRV)

As of January 1, 2023, the Texas Department of State Health Services (DSHS) has implemented a blood lead reference value (BLRV) of 3.5 micrograms per deciliter (µg/dL), as recommended by the Centers for Disease Control and Prevention (CDC). DSHS uses a BLRV of 3.5 µg/dL to identify children with blood lead levels that are higher than most children's levels. The Reference for Blood Lead Retesting and Medical Case Management, Pb-109 form provides guidance for blood lead levels ≥3.5 µg/dL and has been updated to reflect CDC guidance.

View the HEALTH ADVISORY: DSHS adopts new blood lead reference value of 3.5 ug/dL | Texas DSHS for further information.


The Blood Lead Surveillance Branch is made up of two programs:

  1. The Texas Childhood Lead Poisoning Prevention Program
  2. The Adult Blood Lead Epidemiology and Surveillance Program

The Texas Childhood Lead Poisoning Prevention Program (TXCLPPP) maintains a surveillance system of blood lead results on children younger than 15 years of age. Texas law requires reporting of blood lead tests, elevated and non-elevated, for children younger than 15 years of age. Physicians, laboratories, hospitals, clinics, and other healthcare facilities must report all blood lead tests to the Texas Child Lead Registry.

The Adult Blood Lead Epidemiology and Surveillance Program (ABLES) maintains a surveillance system of blood lead test results on individuals 15 years of age and older. Laboratories and physicians are required by the Texas Reportable Occupational Conditions Act to report all blood lead levels.

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Last updated April 10, 2024