Indiana has one of the largest Burmese populations in the United States due to refugee resettlement, particularly in Allen County and Marion County. A previous investigation in 2009 conducted in Allen County among this population found childhood lead poisoning (≥10µg/dl) was associated with the use of two pharmaceutical products and a cultural skin cream that contained >1ppm of lead. Although this investigation was valuable in raising awareness of other sources of lead, it did not examine other products.
METHODS:
In 2014, discovery of other exposures were found through research, discussions with environmental health specialists, and cultural experts. Blood lead data reported to the state was examined among the Asian Pacific demographic for Allen and Marion Counties, and for the State of Indiana. The lead poisoning data was used to design environmental sampling efforts of the Asian ethnic food stores used by this demographic.
RESULTS:
Statewide childhood lead poisoning rates (BLL≥ 5µg/dL) excluding Marion and Allen counties, leads with black and white children with the highest rates and then the Asian demographic. However, lead poisoning rates among the Asian population in Allen County are approximately twice the rate of white children. In Marion County, childhood lead poisoning rates among the Asian population are twice the rate of black children. Although the blood lead levels have decreased since the 2009 investigation, the rates are still higher than other children.
Environmental sampling results from the Asian ethnic food stores showed multiple potential exposures of lead and other contaminants. There is no safe level of lead and even products with small traces of lead have the potential to be harmful, therefore we did not classify items into safety ranges. Among the samples tested from Asian ethnic stores in Allen County, Indiana, over 50% demonstrated some level of lead along with other contaminants.
CONCLUSIONS:
Both the 2009 and 2014 investigations demonstrate a need to examine imported products leading to lead poisoning among Burmese children and other potential ethnic groups that use similar products. Due to the complexity of this investigation, we have included multijurisdictional efforts as a result of the identified sources of lead to the Burmese and other multicultural populations. Ongoing efforts to prevent lead exposures among this population include statewide environmental sampling and new county efforts, the establishment of community partnerships and the development of advisories, collaboration among other states, and investigations at the federal level.