Lead poisoning among refugee children resettled in Massachusetts, 1995 to 1999

Objective. Lead poisoning has been reported among immigrant and refugee pop ulations in the United States; however, prevalences of elevated blood lead (BPb) and risk factors have not been described fully among newly arrived re fugee children. This study was conducted to address this lack of data. Methods. We performed analysis of BPb levels among a cohort of refugee chil dren, aged <7 years, who arrived in Massachusetts between July 1, 1995, and December 31, 1999. Gender, age, birthplace, time of year of lead testing, intestinal parasitoses, anemia, and growth retardation were examined as pre dictors of elevated BPb. Results. BPb levels <greater than or equal to>10 mg/dL were found in 11.3% of 693 children shortly after their arrival in the United States. Children from developing countries had the highest prevalences, including 27% of Som alis and Vietnamese. Country of birth was the strongest predictor of elevat ed BPb. No association between elevated lead and age was found. Among 213 c hildren with BPb tests greater than or equal to6 months after the initial t est, 7% had newly elevated levels of greater than or equal to 10 mug/dL. Conclusions. The prevalence of elevated BPb levels in recently arrived refu gee children is more than twice that of US-born children. Children who are at particular risk are those from developing countries where environmental exposures are more ubiquitous. In addition, a significant percentage of ref ugees acquired elevated levels after arrival, thus suggesting the importanc e of follow-up testing of refugee children. Refugee status should be consid ered a risk factor for lead poisoning.