Eliminating disparities in childhood lead poisoning: Focusing on immigrant children

Recent studies have shown that immigrant children have higher risk for lead poisoning than U.S.-born children. Environmental risk factors for lead poisoning among subgroups of immigrants may differ from those among U.S.-born children. We examined differences in environmental risk factors for lead poisoning among foreign-born and U.S.-born children in order to better understand environmental risk factors and guide prevention efforts. The study included 2,899 children identified with lead poisoning in New York City between 2003 and 2006; 540 children were foreign-born, most from Haiti, Mexico, Bangladesh, Pakistan, India and Dominican Republic. Guardians were interviewed and reports on environmental risk factors were compared by country of birth. Immigrant children were older than U.S.-born children at first reported elevated blood lead level (median age 65 vs. 27 months, respectively). Lead-based paint was the most common risk factor for foreign-born and U.S.-born children; however fewer foreign-born children (60%) had lead paint hazards in their homes than U.S.-born children (80%). Over 80% of foreign-born children compared to 20% of U.S.-born children traveled to countries where environmental sources of lead are prevalent. Also, foreign-born children were more likely to use imported products which may contain lead, and South Asian children were found to use imported products two to three times more frequently than all other children. This study suggests that immigrant children are exposed to lead in their home-countries. Findings underscore the importance of efforts to control and eliminate contaminated imported products, and support current CDC recommendation for increasing age limits for testing immigrant children.