Risk factors for elevated blood lead levels among African refugee children in New Hampshire, 2004.
OBJECTIVE
Surveillance blood lead screening of refugee children resettled in Manchester, NH, in 2004 revealed that 39 (42%) of 92 children had elevated levels (>or=10 microg/dL) after resettlement. Furthermore, 27/92 children (29%) had nonelevated screening blood lead levels on arrival (BLL1) but had elevated follow-up blood lead levels 3-6 months after settlement (BLL2). The main objective was to identify risk factors for increasing lead levels among refugee children after resettlement in Manchester in 2004.


METHODS
We conducted a cohort study, with completion of household interviews and home assessments for refugee families who had resettled in 2004 in Manchester, NH. Blood lead level (BLL) data were abstracted from the New Hampshire (NH) Childhood Lead Poisoning Prevention Program. To assess acute and chronic malnutrition among refugees, we used anthropometric data from International Organization of Migration documents to calculate nutritional indices.


CONCLUSIONS
Of the 93 African refugee children in 42 families who participated, 60 (65%) had been born in a refugee camp. Median age was 5.5 years at the time of BLL2 measurement. Thirty-six (39%) of the refugee children had BLL2 >or= 10 microg/dL. Liberians and those born in refugee camps had higher geometric mean BLL2 than those not Liberian or not born in camps. Younger children and children with nutritional wasting before immigrating to the United States had a greater increase in geometric mean from BLL1 to BLL2, compared to older children and those without nutritional wasting. Follow-up blood lead testing of refugee children, particularly those resettled in areas with older housing stock, as in Manchester, is important for identifying lead exposure occurring after resettlement. Increased attention to improve nutritional status of children in refugee camps and after arrival in the United States and awareness of children who were born in refugee camps should be incorporated into lead-poisoning prevention strategies.
Plotinsky
Rachel N
RN
Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, USA. plotinsky@hotmail.com
Straetemans
Masja
M
Wong
Lee-Yang
LY
Brown
Mary Jean
MJ
Dignam
Timothy
T
Dana Flanders
W
W
Tehan
Megan
M
Azziz-Baumgartner
Eduardo
E
Dipentima
Richard
R
Talbot
Elizabeth A
EA
D002648:Child; D015331:Cohort Studies; D004781:Environmental Exposure; D004784:Environmental Monitoring / Q000706:statistics & numerical data*; D004785:Environmental Pollutants / Q000097:blood*; D006801:Humans; D007854:Lead / Q000097:blood*; D007988:Liberia / Q000208:ethnology; D008954:Models, Biological; D009513:New Hampshire; D012036:Refugees / Q000706:statistics & numerical data; D012307:Risk Factors; D011795:Surveys and Questionnaires
D004785:Environmental Pollutants; D007854:Lead