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Updated: Aug 20, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Elevated blood lead levels in refugee children--New Hampshire, 2003-2004
Insights
Refugee children in New Hampshire showed elevated blood lead levels (BLLs) after resettlement, indicating a need for follow-up testing. Testing refugee children upon arrival and post-resettlement is crucial for preventing lead poisoning.
Area of Science:
- Environmental Health
- Pediatric Public Health
- Toxicology
Background:
- Blood lead levels (BLLs) in US children are decreasing due to reduced lead hazards and improved screening.
- Refugee populations, including children, remain at high risk for elevated BLLs.
- A Sudanese refugee child's death from lead poisoning prompted New Hampshire to develop specific screening guidelines.
Purpose of the Study:
- To analyze blood lead level data among refugee children in New Hampshire.
- To identify patterns of lead exposure in refugee children after resettlement.
- To inform the development of effective lead poisoning prevention strategies for refugee populations.
Main Methods:
- Analysis of data from the New Hampshire Childhood Lead Poisoning Prevention Program (NHCLPPP) and Manchester Health Department (MHD).
- Focus on 37 African refugee children with elevated BLLs on follow-up testing.
- Review of New Hampshire's lead testing guidelines for refugee children.
Main Results:
- Follow-up blood lead testing effectively identifies post-resettlement lead exposure in refugee children.
- Elevated BLLs were observed in New Hampshire refugee children older than initially screened.
- The study highlights the utility of recommended screening protocols.
Conclusions:
- Routine blood lead testing upon arrival and several months after resettlement is recommended for all refugee children nationwide.
- Current screening practices may need adjustment to capture lead exposure occurring after initial resettlement.
- Targeted public health interventions are necessary for vulnerable refugee populations.
Abstract:
As a result of reductions in lead hazards and improved screening practices, blood lead levels (BLLs) in children aged 1-5 years are decreasing in the United States. However, the risk for elevated BLLs (> or =10 microg/dL) remains high for certain populations, including refugees. After the death of a Sudanese refugee child from lead poisoning in New Hampshire in 2000, the New Hampshire Department of Health and Human Services (NHDHHS) developed lead testing guidelines to screen and monitor refugee children. These guidelines recommend 1) capillary blood lead testing for refugee children aged 6 months-15 years within 3 months after arrival in New Hampshire, 2) follow-up venous testing of children aged <6 years within 3-6 months after initial screening, and 3) notation of refugee status on laboratory slips for first tests. In 2004, routine laboratory telephone reports of elevated BLLs to the New Hampshire Childhood Lead Poisoning Prevention Program (NHCLPPP) called attention to a pattern of elevated BLLs among refugee children. To develop prevention strategies, NHDHHS analyzed NHCLPPP and Manchester Health Department (MHD) data, focusing on the 37 African refugee children with elevated BLLs on follow-up for whom complete data were available. This report describes the results of that analysis, which indicated that 1) follow-up blood lead testing is useful to identify lead exposure that occurs after resettlement and 2) refugee children in New Hampshire older than those routinely tested might have elevated BLLs. Refugee children in all states should be tested for lead poisoning on arrival and several months after initial screening to assess exposure after resettlement.
