Elevated Blood Lead Levels Among Resettled Refugee Children in Ohio, 2009-2016

Objectives. To assess the prevalence of and the demographic factors for elevated blood lead level (EBLL; ≥ 5 µg/dL) at resettlement among newly admitted refugee children. Methods. This cross-sectional study used data from the postresettlement refugee medical screening of 5661 children resettled in Ohio from 2009 to 2016. We computed prevalence of EBLL and adjusted prevalence ratio with modified Poisson regression modeling. Results. Overall, 22.3% of children younger than 18 years and 27.1% of those younger than 6 years had an EBLL. Children resettled from a South Asia region including Afghanistan (EBLL prevalence = 56.2%; 95% confidence interval [95% CI] = 48.1%, 64.3%), Nepal (44.0%; 95% CI = 33.7%, 54.1%), Bhutan (32.8%; 95% CI = 30.4%, 35.9%), and Burma (31.8%; 95% CI = 27.5%, 35.9%) had the highest prevalence of EBLLs. In addition, those younger than 6 years (prevalence ratio [PR] = 2.0; 95% CI = 1.6, 2.6), male (PR = 1.3; 95% CI = 1.1, 1.4), and screened within 30 days of arrival (PR = 1.7; 95% CI = 1.1, 2.5) had significantly higher EBLL prevalence than did children aged 13 years and older, female, and screened 90 days after arrival. Conclusions. The overall high proportion of EBLL and variation in EBLL by country of origin among resettled refugee children in the United States warrant comprehensive, yet tailored, guidelines for health professionals and resettlement and government agencies for better prevention and awareness programs targeting these high-risk children.