Lead Poisoning Among Refugee Children and Florida Children

BACKGROUND:   Lead poisoning has been reported among refugee populations that resettled in the United States in recent years. Because refugee populations are considered at high risk for lead exposure, the Centers for Disease Control and Prevention recommends Blood Lead Level (BLL) testing of all refugee children age 6 months to 16 years old at entry to the US and a repeated BLL testing of all refugee children after they are placed in permanent residences. We aim to provide a description of childhood lead poisoning risk among Florida refugee children less than six years old; compare the prevalence between Florida refugee children and Florida non-refugee children; and to assess whether refugee children are still at high risk for lead poisoning.

METHODS:   Demographic data from newly arrived refugee children less than 6 years of age were merged with Florida BLL screening data. The children had arrived in the United States between January 2010 and June 2011 and were tested between January 2010 and December 2011. Confirmed cases of lead poisoning were identified based on the CDC case definition: a child with one venous specimen greater than or equal to 10 micrograms of lead per deciliter, or two capillary specimens greater than or equal to 10 micrograms lead per deciliter drawn within 12 weeks (84 days) of each other. Prevalence was calculated and comparisons made between refugee children and Florida children.

RESULTS:   The prevalence of lead poisoning was 19.9 per 1000 children tested (25 positive of 1258, 1.99 %) among refugee children; the corresponding prevalence among Florida non-refugee children during this time was 1.4 per 1000 children tested (451 positive of 311,814, 0.14%). Refugee children were 14 times more likely to be considered lead poisoned compared with Florida non-refugee children (95% CI: 9.32, 21.02).  The majority (94.1%) of refugee children in this sample (n=1996) were from the following seven countries, Cuba (80.7%), Haiti (3.6%), Iraq (3.0%), Thailand (2.8%), Malaysia (2.4%) and Burma (1.6%).  Among the 25 lead poisoned refugee children identified in Florida during this period, 21 were from Cuba.

CONCLUSIONS:   Refugee children resettled in Florida are at higher risk for lead poisoning compared with non-refugee Florida children.  The majority of lead poisoned refugee children in Florida are from Cuba.