title: Blood lead level analysis among refugee children resettled in New Hampshire and Rhode Island.
abstract: OBJECTIVE
  To examine the association between refugee status and elevated blood lead levels (EBLLs) among children living in two U.S. cities and to assess the effect of the Centers for Disease Control and Prevention recommendations for BLL testing of newly emigrated refugee children for EBLLs.
  
  
  METHODS
  A longitudinal study was conducted of 1,007 refugee children and 953 nonrefugee children living, when blood testing occurred, in the same buildings in Manchester, New Hampshire and Providence, Rhode Island.
  
  
  METHODS
  Surveillance and blood lead data were collected from both sites, including demographic information, BLLs, sample type, refugee status, and age of housing.
  
  
  RESULTS
  Refugee children living in Manchester were statistically significantly more likely to have an EBLL compared with nonrefugee children even after controlling for potential confounders. We did not find this association in Providence. Compared with before enactment, the mean time of refugee children to fall below 10 μg/dL was significantly shorter after the recommendations to test newly emigrated children were enacted.
  
  
  CONCLUSIONS
  Refugee children living in Manchester were significantly more likely to have an EBLL compared with nonrefugee children. And among refugee children, we found a statistically significant difference in the mean days to BLL decline <10 μg/dL before and after recommendations to test newly emigrated children.
authors.affiliation: Division of Emergency and Environmental Health Services, Centers for Disease Control and Prevention, National Center for Environmental Health, Healthy Homes and Lead Poisoning Prevention Branch, Atlanta, Georgia 30341, USA. jraymond@cdc.gov
authors.forename: Jaime S
authors.initials: JS
authors.lastname: Raymond
authors.forename: Chinaro
authors.initials: C
authors.lastname: Kennedy
authors.forename: Mary Jean
authors.initials: MJ
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants; D004781:Environmental Exposure; D004784:Environmental Monitoring / Q000706:statistics & numerical data; D004785:Environmental Pollutants / Q000097:blood; D005260:Female; D006798:Housing; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000097:blood* / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D008137:Longitudinal Studies; D008297:Male; D009513:New Hampshire; D012036:Refugees / Q000706:statistics & numerical data*; D012237:Rhode Island
chemical_list: D004785:Environmental Pollutants; D007854:Lead