Belinda Daniels panicked in 2018 when the pediatrician said her 1-year-old son, Jovanni, had lead in his body. The toxic metal could stunt his brain, the doctor told her, but catching it early meant she could prevent more damage.

Daniels moved out of her Omaha, Nebraska, apartment that had chipping lead paint. The doctor continued testing Jovanni periodically while Daniels followed instructions on cleaning, handwashing and keeping Jovanni away from contaminated dirt.

Eventually, the lead level in Jovanni’s blood dropped. While the now-8-year-old has anger and impulse-control issues, Daniels said it could have been a lot worse.

“They told me that the side effects of it would be him being autistic” or having “very delayed behaviors,” she said.

Not every child’s high lead levels are caught as early as Jovanni’s. In Nebraska, it’s largely up to the doctor or health system to decide whether to test a child’s blood for lead. As a result, local public health officials say, not enough kids are getting tested, given Omaha’s lead problems, which include being home to the largest residential lead cleanup site in the country.

For more than a century, smoke from a lead smelter and other factories deposited 400 million pounds of the toxic metal across the city’s east side. That prompted the Environmental Protection Agency to begin investigating the pollution in 1999, and a few years later, the agency declared 27 square miles of east Omaha to be a Superfund site. Over more than two decades, the EPA and the city have dug up and replaced nearly 14,000 yards, from about a third of the site’s residential properties.

Faced with similar public health concerns about lead, 13 states, including New Jersey, Louisiana and neighboring Iowa, have passed laws requiring universal lead screening, meaning all kids would get a blood test before entering kindergarten.

But not Nebraska.

Most places passed these laws after recognizing that they were reaching too few kids by simply targeting high-risk groups like children who live in old housing. Every state with available data saw increases in the number of kids tested after passing these laws, the Flatwater Free Press and ProPublica found. Some identified more kids with elevated blood lead levels.

A lack of consistent testing nationally leads health officials to miss about half the kids with high levels, according to research by the American Academy of Pediatrics. The academy and the Centers for Disease Control and Prevention recommend testing in areas that have a high prevalence of lead or older housing.

Over the years, Omaha public health officials have raised awareness about blood testing with billboards and community events about the risks of lead. But a bill to require that every child be tested failed in the Nebraska Legislature in 2011. Since then, there have been no efforts to revive it.

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Naudia McCracken, supervisor of the Douglas County Health Department’s Lead Poisoning Prevention Program, said she is planning to propose an ordinance to the Omaha City Council this summer. That could require health workers to test all kids up to age 7 who live in the Superfund site itself and a broader area east of 72nd Street, generally thought of as the dividing line between the city’s urban east side and suburban west side. Right now, fewer than half of kids under 7 in that area are........

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