RESUMEN
BACKGROUND: Elevated blood lead levels lead to permanent neurocognitive sequelae in children. Resettled refugee children in the United States are considered at high risk for elevated blood lead levels, but the prevalence of and risk factors for elevated blood lead levels before resettlement have not been described. METHODS: Blood samples from children aged 6 months to 14 years from refugee camps in Thailand were tested for lead and hemoglobin. Sixty-seven children with elevated blood lead levels (venous ≥10 µg/dL) or undetectable (capillary <3.3 µg/dL) blood lead levels participated in a case-control study. RESULTS: Of 642 children, 33 (5.1%) had elevated blood lead levels. Children aged <2 years had the highest prevalence (14.5%). Among children aged <2 years included in a case-control study, elevated blood lead levels risk factors included hemoglobin <10 g/dL, exposure to car batteries, and taking traditional medicines. CONCLUSIONS: The prevalence of elevated blood lead levels among tested US-bound Burmese refugee children was higher than the current US prevalence, and was especially high among children <2 years old. Refugee children may arrive in the United States with elevated blood lead levels. A population-specific understanding of preexisting lead exposures can enhance postarrival lead-poisoning prevention efforts, based on Centers for Disease Control and Prevention recommendations for resettled refugee children, and can lead to remediation efforts overseas.
Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Intoxicación por Plomo/etnología , Intoxicación por Plomo/epidemiología , Refugiados/estadística & datos numéricos , Adolescente , Anemia Ferropénica/diagnóstico , Anemia Ferropénica/epidemiología , Anemia Ferropénica/etnología , Estudios de Casos y Controles , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Plomo/sangre , Intoxicación por Plomo/diagnóstico , Masculino , Mianmar/etnología , Estado Nutricional , Tailandia/etnología , Estados UnidosRESUMEN
Recent routine screening revealed multiple cases of unexplained lead poisoning among children of Burmese refugees living in Fort Wayne, Indiana. A cross-sectional study was conducted to determine (a) the prevalence of elevated blood lead levels (BLLs) among Burmese children and (b) potential sources of lead exposure. A case was defined as an elevated venous BLL (≥10 µg/dL); prevalence was compared with all Indiana children screened during 2008. Environmental and product samples were tested for lead. In all, 14 of 197 (7.1%) children had elevated BLLs (prevalence ratio: 10.7) that ranged from 10.2 to 29.0 µg/dL. Six cases were newly identified; 4 were among US-born children. Laboratory testing identified a traditional ethnic digestive remedy, Daw Tway, containing a median 520 ppm lead. A multilevel linear regression model identified daily use of thanakha, an ethnic cosmetic, and Daw Tway use were related to elevated BLLs (P < .05). Routine monitoring of BLLs among this population should remain a priority.
