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Lead Screening Among Immigrant Children Seeking Humanitarian Protection in New York and Massachusetts, 2022-2024
Jessica Hunnewell1, Christian Olivo-Freites2, Fiona Danaher3
1Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.
Insights
Elevated blood lead levels (EBLL) affect immigrant children seeking humanitarian protection. Public health efforts are needed to screen and prevent EBLL and anemia in these vulnerable newcomer populations.
Area of Science:
- Pediatric Health
- Environmental Health
- Public Health
Background:
- Elevated blood lead levels (EBLL) pose risks to children's neurological development.
- Limited data exists on EBLL in immigrant children outside the refugee program.
- This study examines lead testing and anemia in children seeking humanitarian protection.
Purpose of the Study:
- To evaluate lead testing rates and the prevalence of EBLL in infants and children seeking humanitarian protection.
- To assess the prevalence of anemia in this population.
- To identify factors associated with EBLL.
Main Methods:
- Cross-sectional analysis of clinical data from September 2022 to June 2024 in Massachusetts and New York City.
- Included infants and children seeking humanitarian protection (e.g., asylum).
- Evaluated lead testing completion, EBLL prevalence (≥3.5 µg/dL), and anemia; used statistical tests to identify associated factors.
Main Results:
- Of 882 children, 78.6% completed lead testing; 1.3% had EBLL (mean 5.31 µg/dL).
- Lead testing was more frequent in children under 5.
- 16.6% of children had anemia; no significant association found between country of origin and EBLL.
Conclusions:
- Clinicians and public health professionals must improve prevention and screening for EBLL and anemia in newcomer children.
- Early detection and intervention are crucial for mitigating long-term health consequences.
- Further research may explore specific risk factors within this population.
Objective:
Some refugee children in the United States have an elevated blood lead level (EBLL), which can result in neurologic disease and developmental delays. Little has been published on EBLLs in immigrant infants and children whose families are seeking humanitarian protections outside the refugee program. We evaluated lead testing and anemia in this population.
Methods:
We performed a cross-sectional analysis of lead testing and anemia in infants and children whose families were seeking humanitarian protection (eg, asylum) and treated in clinics in Chelsea, Massachusetts (September 30, 2022-June 30, 2024) and New York City (January 1-November 30, 2023). We extracted demographic and clinical data from the medical records of clinics serving families who received emergency assistance with sheltering. We evaluated the proportion who completed lead testing and the prevalence of EBLL (≥3.5 µg/dL). We used Pearson χ2 and Kruskal-Wallis tests to determine factors significantly associated with EBLL.
Results:
Among 882 children (most from Venezuela [29.5%], Ecuador [22.0%], Colombia [16.2%], and Peru [6.7%]), 693 (78.6%) completed testing for lead. Lead testing was more common among children aged <5 years than among older children (P < .001). Nine of 693 children (1.3%; 95% CI, 0.6%-2.5%) had EBLL; the mean blood lead level was 5.31 µg/dL. Eight of the 9 children with EBLL were boys (P = .06). Of 882 children, 146 (16.6%) had anemia; 2 children with EBLL had anemia. We did not find a statistically significant association between country of origin and EBLL (P = .23).
Conclusion:
Clinicians and public health professionals serving newcomer populations should enhance efforts to prevent and screen for EBLL and anemia.
