Lead Screening Among Immigrant Children Seeking Humanitarian Protection in New York and Massachusetts,2022-2024

Abstract

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.

Keywords

immigrant asylum lead anemia pediatrics

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