Childhood Lead Exposure in Primary Health Care Settings in Indonesia: A Cross-Sectional Study in Bogor City and Bogor Regency

(1) Background: Lead exposure is an important preventable environmental health concern among children, especially in low- and middle-income countries. In Indonesia, evidence from routine health service settings remains limited. (2) Methods: This cross-sectional study assessed blood lead levels (BLLs) and associated factors among children aged 1–5 years attending 12 primary health care facilities in Bogor City and Bogor Regency between December 2025 and January 2026. A total of 420 children were recruited consecutively during routine services. Environmental and household risk factors were collected using structured questionnaires, and venous blood samples were analyzed using inductively coupled plasma mass spectrometry. Elevated BLL was defined as ≥5 µg/dL. (3) Results: The mean BLL was 2.24 µg/dL, and 21.9% of children had elevated BLLs. Prevalence was higher in Bogor Regency than in Bogor City (41.2% vs. 2.4%; p < 0.001) and among children residing near lead-processing activities (44.2% vs. 16.2%; p < 0.001). One child had a BLL of 66.82 µg/dL. Results were returned to caregivers and facilities; children with BLL ≥ 5 µg/dL received counselling, exposure-reduction advice, nutritional support, and follow-up planning, while the child with BLL > 45 µg/dL was urgently referred for confirmatory assessment and specialist management. (4) Conclusions: Primary healthcare–based screening can identify vulnerable children and trigger clinical, nutritional, environmental, and referral responses, although longitudinal follow-up and environmental source testing are needed.