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Form 0920-0931 Childhood Blood Lead Surveillance (CBLS) Aggregate Recor
ICR 202103-0920-002 · OMB 0920-0931 · Object 109635300.
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QX 202X Unprocessed BLLs
Overview
QX 202XQX 202X Unprocessed BLLs
Sheet 1: QX 202X
| Attachment 5b. Childhood Blood Lead Surveillance (CBLS) Aggregate Records Form | 
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| Number of Children Tested and Confirmed in [NAME OF JUSRISDICTION] by BLL Group, Children < 72 Months Old | |||||||||||
| Year | Number of Children Tested* | Total Confirmed BLL ≥10 µg/dL | Confirmed BLLs ≥10 µg/dL as % of Children Tested* | Number of Confirmed Children By Highest Blood Lead Level (µg/dL) at or Following Confirmation | |||||||
| 5-9 µg/dL^ | 10-14 µg/dL | 15-19 µg/dL | 20-24 µg/dL | 25-44 µg/dL | 45-69 µg/dL | ≥70 µg/dL | ≥5 µg/dL^ | ||||
| Quarter X (Month - Month) 202X | |||||||||||
| All data obtained from the [NAME OF AWARDEE] Program. | |||||||||||
| * Unprocessed BLL records not included; all unprocessed records are <5 µg/dL. | |||||||||||
| ^ Blood lead levels 5-9 μg/dL are counted as a single capillary or venous sample. | |||||||||||
Sheet 2: QX 202X Unprocessed BLLs
| Period | Number of Unprocessed BLLs |
| Quarter X (Month - Month) 202X | |
| Unprocessed BLLs have not yet been matched to patient records. If processed, the number of children tested in the given period would be expected to increase. All unprocessed records are for BLLs <5 µg/dL. | |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Title | Form 0920-0931 Childhood Blood Lead Surveillance (CBLS) Aggregate Recor |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |