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. 2019 May;143(5):e20182591.
doi: 10.1542/peds.2018-2591.

Blood Lead Levels Among Resettled Refugee Children in Select US States, 2010-2014

Clelia Pezzi  1 , Deborah Lee  2 , Lori Kennedy  3 , Jenny Aguirre  4 , Melissa Titus  5 , Rebecca Ford  6 , Jennifer Cochran  7 , Laura Smock  7 , Blaine Mamo  8 , Kailey Urban  8 , Jennifer Morillo  9 , Stephen Hughes  10 , Colleen Payton  11 , Kevin Scott  11 , Jessica Montour  12 , Jasmine Matheson  13 , Mary Jean Brown  14 , Tarissa Mitchell  2
Affiliations

Blood Lead Levels Among Resettled Refugee Children in Select US States, 2010-2014

Clelia Pezzi et al. Pediatrics. 2019 May.

Abstract

Background: Elevated blood lead levels (EBLLs; ≥5 µg/dL) are more prevalent among refugee children resettled in the United States than the general US population and contribute to permanent health and neurodevelopmental problems. The Centers for Disease Control and Prevention recommends screening of refugee children aged 6 months to 16 years on arrival in the United States and retesting those aged 6 months to 6 years between 3- and 6-months postarrival.

Methods: We analyzed EBLL prevalence among refugee children aged 6 months to 16 years who received a domestic refugee medical examination between January 1, 2010 and September 30, 2014. We assessed EBLL prevalence by predeparture examination country and, among children rescreened 3 to 6 months after initial testing, we assessed EBLL changes during follow-up screening.

Results: Twelve sites provided data on 27 284 children representing nearly 25% of refugee children resettling during the time period of this analysis. The EBLL prevalence during initial testing was 19.3%. EBLL was associated with younger age, male sex, and overseas examination country. Among 1121 children from 5 sites with available follow-up test results, EBLL prevalence was 22.7%; higher follow-up BLLs were associated with younger age and predeparture examination country.

Conclusions: EBLL decreased over the time period of our analysis in this population of refugee children. Refugee children may be exposed to lead before and after resettlement to the United States. Efforts to identify incoming refugee populations at high risk for EBLL can inform prevention efforts both domestically and overseas.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Brown has received consultant fees from Meridian Bioscience, Inc; the other authors have indicated they have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Selection of test results for inclusion in an analysis of blood lead levels among refugee children resettled in the United States
Figure 2.
Figure 2.
EBLL prevalence by arrival year and country of exam for Iraq, Kenya, Malaysia, Nepal, Thailand, and all other countries combined, 2010–2014
Figure 3.
Figure 3.
Comparison of initial and follow-up blood lead levels (BLL) 3–6 months after initial testing among N= 1,121 refugee children aged 6 months to 16 years in 5 US sites—January 1, 2010–September 30, 2014
See this image and copyright information in PMC

Comment in

References

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    1. United States Citizenship and Immigration Services. Table 15. Refugee Arrivals By Relationship To Principal Applicant And Sex, Age, And Marital Status: Fiscal Year 2016. Washington, DC: Department of Homeland Security;2018.
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