Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107796

Rachel N. Plotinsky, MD¹, Mary Jean Brown, RN, ScD², Joan Kellenberg, FNP, MPH³, Michelle Dembiec, MEd⁴, Rich DiPentima, RN, MPH³, Jesse Greenblatt, MD, MPH, and Elizabeth A. Talbot, MD⁶. (1) Epidemic Intelligence Service Officer, Centers for Disease Control and Prevention, New Hampshire Department of Health and Human Services, 29 Hazen Drive, Concord, NH 03301, 603-271-7397, rplotinsky@dhhs.state.nh.us, (2) Lead Poisoning Prevention Branch, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-40, Atlanta, GA 30341, (3) Manchester Health Department, 1528 Elm Street, Manchester, NH 03101, (4) Childhood Lead Poisoning Prevention Program, New Hampshire Department of Health and Human Services, New Hampshire Department of Health and Human Services, 29 Hazen Drive, Concord, NH 03301, (5) Communicable Disease Control, New Hampshire Department of Health and Human Services, 29 Hazen Drive, Concord, NH 03301

Background: Refugee children are at risk for lead poisoning, perhaps related to malnutrition, pica, and environmental exposures. After the lead poisoning death of a refugee child in Manchester, New Hampshire (NH) in 2000, the state adopted recommendations for blood lead level (BLL) screening for refugee children within 90 days of arrival and follow-up testing 3–6 months after initial screening for children aged <6 years. In follow-up testing, elevated BLLs (³10 mcg/dL) were identified in 37 of 242 refugee children resettled in NH in 2004. We investigated this cluster to target immediate prevention strategies and guide future research. Methods: To define clinical, demographic, and epidemiologic characteristics of refugee children with elevated BLLs, we reviewed records from NH's Childhood Lead Poisoning Prevention Program, immigration documents, and family interviews. Results: The 37 affected children, from 19 families (mean age: 4.9 years; range: 14 months–13 years), were from Africa. At initial screening, 26/37 (70.2%) had BLLs <10mcg/dL (mean: 8.1 mcg/d; range 2–28). All 37 children had elevated BLLs in testing 3–6 months after arrival in NH (mean: 18.6 mcg/dL; range: 10–63). Pre-existing malnutrition (height-for-age Z score <-2 or weight-for-height Z score <-2) was noted in 17/37 (45.9%). Of eight apartments in which environmental investigations were done, lead hazards were identified in seven. Conclusions: Follow-up BLL testing of refugee children is important to identify lead exposure that occurs after resettlement. Identification of specific risk factors is needed to guide state and national medical and environmental protocols for primary prevention.

Learning Objectives:

At the conclusion of the session,the participant will be able to 1.describe the risk of lead poisoning in refugee population
• understand potential risk factors that may make this population particularly vulnerable to lead poisoning
• Review demographic and clinical features of one cohort of affected refugees in New Hampshire

Keywords: Environmental Exposures, Lead

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation