Blood Lead Level Testing and Retesting Among Newly Arriving Refugee Children, Pennsylvania, 2015-2019

Area of Science:

• Public Health
• Environmental Health
• Pediatrics

Background:

• Refugee children are a vulnerable population susceptible to environmental exposures.
• Lead exposure can have significant long-term health consequences for children.
• Screening for elevated blood lead levels (EBLLs) is a critical component of refugee health assessments.

Purpose of the Study:

• To determine the prevalence of EBLLs in newly arrived refugee children.
• To identify demographic factors associated with EBLLs in this population.
• To evaluate healthcare provider adherence to CDC guidelines for lead testing and retesting.

Main Methods:

• Utilized data from the CDC's Electronic Disease Notification (EDN) system and Pennsylvania's National Electronic Disease Surveillance System.
• Matched refugee demographic data with laboratory blood lead level reports using Match*Pro software.
• Analyzed data for 3142 refugee children aged 16 years or younger with available blood lead level results.

Main Results:

• A prevalence of 18.4% for EBLLs (≥5 µg/dL) was found among the studied refugee children.
• Of children with EBLLs, 59.0% were male.
• Only 13.1% of children aged 6 years or younger with an initial EBLL were retested within the recommended 3-6 month timeframe.

Conclusions:

• A significant proportion of newly arrived refugee children present with EBLLs.
• There is a substantial gap in recommended follow-up retesting for refugee children with EBLLs.
• Improved adherence to retesting protocols is essential to mitigate ongoing lead exposure and its health impacts.