The office of Maryland Gov. Larry Hogan (R) announced Monday that the state is expanding its fight against lead poisoning by implementing a universal screening problem for children under the age of 2. It’s a more aggressive strategy than what Maryland has previously pursued, testing only children deemed at relatively high risk of lead exposure, such as those currently enrolled on Medicaid. Now, every child will be tested at 12 and 24 months of age.

“We have made great progress in reducing lead exposure in Maryland over the past 20 years,” Gov. Hogan said in a statement. “However, we need to test all children, not just a handful, in order to put an end to childhood lead poisoning in Maryland once and for all.”

The state’s decision was largely spurned on by a change in the Centers for Disease Control and Prevention’s recommendations for lead levels in children, first announced in 2012. While emphasizing that there is no “safe” level of lead in the blood, the CDC recommended that children with a blood lead level of 5 micrograms per deciliter (5 Mcg/Dl) or over should be followed up with to ensure that they aren’t currently at risk of constant lead exposure.

According to the CDC, only 2.5 percent of the population under the age of 5 has that much lead in their blood, so they settled on that number as a good barometer to judge potential exposure. The previously acceptable number had been 10 mcg/dl. The new recommendation didn’t change the blood lead level considered to need active medical treatment in the form of chelation therapy — 45 mcg/dl.

After a joint analysis was conducted by the Maryland Department of Health and Mental Hygiene (DHMH) and the Department of the Environment, it was decided that only a universal screening method, though more costly, could provide the most protection to Maryland children. “The U.S. Centers for Disease Control and Prevention’s new recommendation is 5 micrograms of lead per deciliter of blood. Every jurisdiction in the state has children with blood lead levels higher than that,” explained Deputy Secretary Dr. Howard Haft of the DHMH.

According to the DHMH report, universal screening will allow Maryland health officials to root out previously undetected trouble spots of lead exposure, and it is estimated that the lifetime savings of reducing the blood lead levels of all children under the age of 2 will amount to $131-$512 million. The strategy will also be revised if need be in three years.

“While testing does not prevent lead poisoning, it is a critical measure to ensure we invest funding for prevention where it is needed most and that we identify at-risk children who may be missed through targeted testing,” said Ruth Ann Norton, President and CEO of the Green & Healthy Homes Initiative (GHHI). “It is clear that lead poisoning is not limited to Baltimore City but is a concern throughout Maryland and the United States. Given GHHI’s mission to break the link between unhealthy housing and unhealthy families, we are committed to ending childhood lead poisoning so that all children may reach their full potential. We thank Gov. Hogan and the State of Maryland for advancing this important step to protect Maryland’s kids.”

With the new change in strategy, Deputy Secretary Haft believes that cooperation between health providers and new parents is paramount. “The most important thing is that parents and providers make sure that children receive follow-up care, if they have elevated blood lead levels,” he said. “Children need to be retested to make certain their levels are going down, and providers need to work with parents to be sure there are no sources of lead that need to be fixed.”