Elevated blood lead levels, or blood lead level at or above
5 µg/dL, are common among refugee children newly arrived in the United
States. Refugee children aged 1-5 years are 10 times more likely to have
elevated blood lead levels than same-aged children in the general U.S.
population. This is one of the conclusions drawn from an analysis reported in
the May 2019 issue of Pediatrics (published online April 17), “Blood Lead Levels Among Resettled Refugee Children in Select U.S. States, 2010–2014.”
Epidemiologists examined the blood lead levels of 27,284 newly resettled
refugee children who underwent blood lead testing during routine domestic
refugee health examinations in 11 US states. They found that one out of every
five newly arrived refugee children had an elevated blood lead level. Arrival
from specific countries, younger age, male sex, and testing between July and
September were associated with elevated blood lead levels. The top three
countries with the highest proportions of children arriving with elevated blood
lead levels were India, Afghanistan and Burma. Among children who had follow-up
blood lead tests 3-6 months after the initial test, most experienced a decline
in blood lead levels. However, blood lead levels remained elevated for some
refugee children, and a small number of children even experienced increases in
blood lead levels--potentially indicating ongoing lead exposures inside the
United States. The authors conclude that early identification of newly-arrived
refugee children with elevated blood lead levels can help guide lead mitigation
efforts both domestically and internationally.
Editor’s note: A related commentary, “Commentary Preventing Harm upon Arrival: Lead Prevention in Newly Resettled Pediatric Refugees” will also be published in this issue of Pediatrics.
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds