Thesis (Ph. D.)--University of Rochester. School of Medicine and Dentistry. Dept. of Community and Preventive Medicine, 2009.
Introduction: Young children who are resettled in the United States as refugees arrive with higher blood lead levels than children in the general U.S. population. They may also experience a high rate of new lead exposure after arriving in the U.S. However, the relevant literature is limited. The objective of this study was to determine the risk of post-resettlement exposure to lead among refugee children who had recently arrived in the U.S. Methods: Study children were resettled in Massachusetts (from 2000 through 2007) or Rochester, New York (2007-2008). For both populations, data from children under age seven who received a routine Refugee Health Assessment within 90 days of U.S. arrival, including blood lead testing, were matched with data from subsequent lead tests. A structured interview was conducted with children in Rochester. We performed a t-test (Massachusetts) or a signed-rank test (Rochester) on log-transformed blood lead levels to test whether children‘s lead levels changed significantly from the first test after arrival to the next test within a year. Rates of new blood lead level elevation to ≥20 μg/dL were compared to those of publically available data for local children.
Results: Fifty-four children were enrolled from Rochester and 1,148 from Massachusetts. Follow-up blood lead levels were available for 46 Rochester children (85%) and 413 Massachusetts children (36%). Geometric mean blood lead levels declined significantly for both Rochester and Massachusetts children who arrived with higher (p = .024 for Rochester and p < .001 for Massachusetts), but not lower (p = .609 for Rochester; p = .067 for Massachusetts), blood lead levels. Refugee children from both Rochester and Massachusetts had higher rates of new blood lead elevations ≥20 μg/dL compared to local children living in high risk communities, with a rate ratio of 4.7 (95% CI: 0.7-33.2) for Rochester and 11.2 (95% CI: 5.6-22.3) for Massachusetts. Discussion: Our findings are consistent with a high risk of substantial post-resettlement lead exposure among refugee children in the first 12-15 months after U.S. arrival compared with local children of the same age living in the same communities.
