Clelia Pezzi1, Deborah Lee2, Lori Kennedy3, Jenny Aguirre4, Melissa Titus5, Rebecca Ford6, Jennifer Cochran7, Laura Smock7, Blaine Mamo8, Kailey Urban8, Jennifer Morillo9, Stephen Hughes10, Colleen Payton11, Kevin Scott11, Jessica Montour12, Jasmine Matheson13, Mary Jean Brown14, Tarissa Mitchell2. 1. Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia; kpezzi@cdc.gov. 2. Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia. 3. Colorado Department of Public Health and Environment, Denver, Colorado. 4. Illinois Department of Public Health, Chicago, Illinois. 5. Marion County Public Health Department, Indianapolis, Indiana. 6. Kentucky Office for Refugees, Louisville, Kentucky. 7. Division of Global Populations and Infectious Disease Prevention, Massachusetts Department of Public Health, Boston, Massachusetts. 8. Minnesota Department of Health, St Paul, Minnesota. 9. North Carolina Division of Public Health, Raleigh, North Carolina. 10. Bureau of Tuberculosis Control, New York State Department of Health, Albany, New York. 11. Department of Family and Community Medicine, Sidney Kimmel Medical College,Thomas Jefferson University, Philadelphia, Pennsylvania. 12. Texas Department of State Health Services, Austin, Texas. 13. Refugee Health Program, Washington State Department of Health, Shoreline, Washington; and. 14. Lead Poisoning Prevention Branch, Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
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.
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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