Of the nearly 8,000 U.S. Army child dependents tested for lead exposure in calendar year 2025, less than 1% showed elevated levels, a record low that public health officials credit to early clinical screenings, proactive engineering safeguards, and rapid household interventions.
According to the newly released Army Annual Pediatric Lead Report, Calendar Year 2025 7,921 child dependents received blood lead tests within the Military Health System. Only 70 children (0.9%) exceeded the Centers for Disease Control and Prevention blood lead reference value of 3.5 micrograms per deciliter, or ug/dL. The CDC established this threshold because blood lead levels as low as 3.5 µg/dL can affect development.
Crucially, 42 of those 70 children were identified solely because the military adopted the stricter 3.5 µg/dL standard, lowering it from the previous 5.0 µg/dL. Because low-level lead exposure rarely presents obvious physical symptoms, this highly sensitive clinical threshold acts as an essential early-warning system.
Catching the invisible hazard
To monitor these trends, the MHS GENESIS electronic health record includes a built-in lead risk questionnaire completed during routine well-child visits. This system prompts providers to evaluate localized risks, such as in Hawaii’s high-risk ZIP codes, or universal testing mandates in states like Maryland, New York (near Fort Drum), and North Carolina (near Fort Bragg), where state laws require blood tests for young children at ages 1 and 2 years.
Alexis Maule, an epidemiologist with the Defense Health Agency-Public Health Disease Epidemiology branch in Aberdeen, Maryland, noted that while more testing captures more cases, it does not necessarily mean higher levels of exposure.
"Since there is no safe level of lead exposure, a lower threshold means there are more opportunities for healthcare providers and public health personnel to help families identify and eliminate, avoid, or remove potential exposures," said Maule.
She explained that while most children show no immediate physical signs of lead exposure, catching it early is vital to prevent developmental harm.
"Early intervention can ease any short-term effects of lead exposure, such as gastrointestinal upset and anemia, and prevent any long-term neurodevelopmental effects," said Maule. "Further, providers can ensure that follow-up, repeat testing occurs to monitor that blood lead levels trend down and fall below the CDC blood lead reference value."
Safety on the firing line and in the shop
While clinical screenings protect children at home, occupational safety teams work to keep service members safe in tactical environments where lead exposure is a daily hazard.
"We know that lead can accumulate on the face, hands, clothing, and boots of service members firing lead-containing ammunition," said Rebecca Hughes, an industrial hygienist with the DHA-PH Industrial Hygiene Field Services Division in Aberdeen, Maryland. "Lead particulate can settle on clothing or in surface dust and be tracked out of the workplace, like tracking mud on your boots."
To protect personnel on training ranges, Hughes said indoor facilities are engineered with heavy-duty mechanical ventilation systems designed to maintain laminar airflow averaging 75 feet per minute at the firing line. This system pulls lead vapor and dust away from the shooter’s breathing zone. Additionally, the military uses reduced-lead or lead-free-primer training ammunition to minimize exposure at the source.
In industrial workspaces like motor pools, battery shops, or aircraft maintenance bays, the industrial hygiene team actively monitors lead levels in the air.
"If the industrial hygiene team identifies lead as a potential hazard, they will perform personal air monitoring to characterize that potential exposure," said Hughes.
If exposure exceeds the Occupational Safety and Health Administration, or OSHA, Action Level, the military triggers immediate protective actions, including medical surveillance. Notably, the Department of War maintains stricter blood lead management and medical removal standards than OSHA.
"The DOW’s medical removal is based on one blood test at or greater than 30 µg/dL or an initial and follow-up BLL at or greater than 20 µg/dL," said Hughes. "The employee’s return-to-work is considered when the BLL drops below 15 µg/dL."
Breaking the 'take-home' chain
When an elevated lead level is identified, recovery rates are encouragingly high. The calendar year 2025 annual report revealed that 37.1% (26 of 70) of the children who initially tested above the threshold saw their levels drop back to normal by the end of the year.
According to DHA-PH experts, bringing those numbers down requires breaking the “take-home” exposure chain. Service members can easily carry lead dust home on their uniforms, skin, and boots.
"We recommend at minimum that service members wash their hands and faces with soap and warm water after performing work that may expose them to lead," said Hughes. "Before entering their home, service members should change out of their work clothes and remove their work boots. Work clothes should be laundered separately from the rest of the household laundry."
At home, families living in historic, pre-1978 housing must also watch out for invisible structural hazards.
"Friction and impact areas like doors and windowsills and window wells are areas where paint can slowly be worn away," said Hughes. "The wearing and chipping away of paint create loose paint particles that contain lead. The lead can then end up in the air to be breathed in or can be ingested when it settles on surfaces and ends up on hands."
To combat this, Hughes recommends regular wet cleaning over dry sweeping.
"Moving a broom in a sweeping motion generates small air currents that easily throw tiny dust particles back into the air," said Hughes. "When you use wet-cleaning methods, you add weight and bind dust particles together, which helps keep them on the ground and out of the air."
Families should also remain vigilant regarding nonpaint hazards. These include imported, handmade, glazed ceramic serving dishes, antique toys, and recent Food and Drug Administration food recalls involving lead-contaminated cinnamon spices in products like apple sauce pouches.
Additionally, simple dietary choices can play a key protective role.
"Foods high in iron, calcium, and vitamin C can help prevent lead poisoning," said Maule. "Iron protects from the harmful effects of lead, calcium makes it harder for lead to be absorbed, and vitamin C helps the body absorb both better."
Clean water by design
Water is another critical vector for lead exposure, but environmental engineers maintain multiple layers of oversight to safeguard garrison systems.
"Consumer Confidence Reports provide information on drinking water quality, including lead-monitoring results, which are reviewed by environmental health personnel," said Ellyce Cook, an environmental engineer with the Water Quality Engineering Branch at DHA-PH. "In addition, the services have conducted additional lead monitoring at facilities serving high-risk populations over the past decade."
Cook added that by 2028, the updated Environment Protection Agency Lead and Copper Rule will mandate lead sampling at high-risk facilities on a strict five-year cycle.
Cook says that applying simple physical chemistry rules at the household tap can keep families safe:
- Always use cold water. "Hot or warm water can increase the release of metals from pipes, solder, and brass fixtures," said Cook. “Always use cold tap water for drinking, cooking, and preparing infant formula.”
- Never boil contaminated water. "Boiling lead-contaminated water does not remove lead," said Cook. "In fact, boiling could make the water more concentrated because as the water evaporates, the lead remains in the reduced volume of water."
- Flush the tap. If a faucet has sat unused for several hours, flush it for two minutes before use. This replaces stagnant water with fresh, treated water from the main distribution line.
- Select the right filter. Standard refrigerator or pitcher filters do not automatically filter out heavy metals. Families must check the packaging to ensure the filter is certified under International and the American National Standards Institute standard 53 for lead reduction. This standard sets minimum requirements for water filters designed to reduce specific health-related and toxic contaminates.
Taking action
If a military family suspects a lead hazard in their home or workplace, clear pathways exist to resolve the issue:
- For water testing: Residents in barracks or privatized housing should notify their installation's Department of Public Works, or DPW. DPW will coordinate testing and sampling with environmental health personnel at no cost to the resident.
- For paint and dust concerns: Contact the responsible housing office or property manager immediately. In August 2024, the DOW launched the DoW Housing Feedback System, allowing residents to submit maintenance work orders, find the Tenant Bill of Rights, and track resolution progress.
- For clinical testing: Schedule a well-child visit with your pediatrician to review the MHS GENESIS screening questionnaire and request a blood lead test.
"Children with lead exposure may not have any visible signs or symptoms," said Hughes. "It is important for parents to speak to their child's doctor about getting a blood test if their child may have been exposed."
Maule agreed, urging parents to participate in routine pediatric milestone visits.
"Most children do not show any signs or symptoms of lead exposure, so attending well-child visits where a provider can ask screening questions intended to assess both your child’s risk of lead exposure and progress on developmental milestones, is very important," said Maule. "If your child’s provider orders any blood draws for them, it is important to follow through."
Recommended resources
For more information on housing safety, healthcare, and lead exposure prevention, military families can access the following official resources:
- DHA Public Health: For lead information and resources, visit Lead Information for Military Families.
- Military OneSource: For resources on privatized housing rights, Permanent Change of Station relocation support, and family health services, visit militaryonesource.mil.
- DOW Housing Feedback System: To submit work orders and track maintenance disputes, visit dhfs.mil/rfs.
- EPA Lead Information: For federal guidelines on identifying lead in cultural goods, toys, and older homes, visit epa.gov/lead.
- CDC Childhood Lead Poisoning Prevention: For details on blood lead reference values and clinical recommendations, visit cdc.gov/nceh/lead.
- Consumer Product Safety Commission: For product recalls and product safety warnings, visit cpsc.gov.
The Defense Health Agency is a Combat Support Agency, serving as a force multiplier for the joint services by optimizing lethality through warfighter medical readiness.
NOTE: The mention of any non-federal entity and/or its products is for informational purposes only, and is not to be construed or interpreted, in any manner, as federal endorsement of that non-federal entity or its products.
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