Lead poisoning among refugee children resettled in Massachusetts, 1995 to 1999

Abstract

Objective: Lead poisoning has been reported among immigrant and refugee populations in the United States; however, prevalences of elevated blood lead (BPb) and risk factors have not been described fully among newly arrived refugee children. This study was conducted to address this lack of data.

Methods: We performed analysis of BPb levels among a cohort of refugee children, aged <7 years, who arrived in Massachusetts between July 1, 1995, and December 31, 1999. Gender, age, birthplace, time of year of lead testing, intestinal parasitoses, anemia, and growth retardation were examined as predictors of elevated BPb.

Results: BPb levels >/=10 microgram/dL were found in 11.3% of 693 children shortly after their arrival in the United States. Children from developing countries had the highest prevalences, including 27% of Somalis and Vietnamese. Country of birth was the strongest predictor of elevated BPb. No association between elevated lead and age was found. Among 213 children with BPb tests >/=6 months after the initial test, 7% had newly elevated levels of >/=10 microgram/dL.

Conclusions: The prevalence of elevated BPb levels in recently arrived refugee children is more than twice that of US-born children. Children who are at particular risk are those from developing countries where environmental exposures are more ubiquitous. In addition, a significant percentage of refugees acquired elevated levels after arrival, thus suggesting the importance of follow-up testing of refugee children. Refugee status should be considered a risk factor for lead poisoning.