Blood Lead Levels May Be Higher in Refugee Children Resettled in the US

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.

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