The Prevalence of Elevated Blood Lead Levels in Foreign-Born Refugee Children Upon Arrival to the U.S. and the Adequacy of Follow-up Treatment


This study sought to evaluate the prevalence of blood lead levels (BLL) in refugee children upon arrival to the U.S. and determine whether they received BLL screening and follow-up according to CDC guidelines. 301 refugee children ages 6 months to 16 years were seen at the International Family Medicine Clinic from 2003 to 2016. Data were collected on BLL, treatment, age, gender, English proficiency, native language, anemia, malnutrition, and microcytosis. Bivariate analyses were conducted to determine the association between these variables and BLL. The prevalence of elevated blood lead levels (EBLL), defined as ≥ 10 µg/dL before June 2012 and ≥ 5 µg/dL from June 2012, was observed in 13% (n = 39). Male sex (p = 0.033), young age (p = 0.003), and microcytosis (p = 0.009) were significantly associated with EBLL. Follow-up and treatment for EBLL were lower than the recommended CDC guidelines for BLL and greater education of healthcare providers is needed.

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The authors would like to thank Marieke Jones, PhD and Data Services at the Health Sciences Library at the University of Virginia for expert advice on the statistical analyses.

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Correspondence to Sarah Seifu.

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Seifu, S., Tanabe, K. & Hauck, F.R. The Prevalence of Elevated Blood Lead Levels in Foreign-Born Refugee Children Upon Arrival to the U.S. and the Adequacy of Follow-up Treatment. J Immigrant Minority Health 22, 10–16 (2020).

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  • Lead poisoning
  • Elevated blood lead levels
  • Refugee children
  • Foreign-born
  • Follow-up