Date of Defense:
April 27, 2009
Objectives: Refugee children resettling in the United States are at an increased risk for lead poisoning. This study investigates 1) who has an elevated blood lead level (EBLL) at arrival and at follow-up (three to six months after arrival); 2) what percentage of refugee children receive a follow-up lead screening; and 3) who receives a follow-up lead screening.
Methods: We performed analysis on a cohort of 1,256 refugee children under six who arrived in Minnesota from 2004-2007. Logistic regression modeled two separate outcomes: EBLL at baseline and receiving a follow-up screening. These variables were regressed on age, sex, region of origin, county of resettlement and year of arrival.
Results: Six percent of the children included in the sample had a blood lead level of greater than 10?g/dL. Sex was marginally associated with an EBLL at arrival. Less than half of the sample (47%) received a follow-up test. Age, region of origin and an EBLL at baseline were significantly associated with having a second screening. Children from Africa, those with an EBLL at arrival and younger children had greater odds of receiving a second screening.
Conclusions: Studying refugee children as a cohort can provide valuable information on trends of EBLL in refugees. Second screenings are not being done per CDC guidelines and more interventions are needed to target those that are being lost to follow-up: older children, those from Southeast Asia and children without an EBLL at baseline.