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Unsafe harbor? Elevated blood lead levels in refugee children.

Schmidt CW - Environ. Health Perspect. (2013)

View Article: PubMed Central - PubMed

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Once here, says Brown, exposures can persist for two main reasons: because of continued exposure via traditional customs and products like tiro, and because refugees, who are often poor, wind up living in older housing with flaking lead-based paint. “The CDC recommended [BLL screening for refugee children] because it is well known that refugee families will move to less expensive housing … shortly after resettlement,” says Paul Geltman, a pediatrician with Harvard Medical School and the Cambridge Health Alliance. “The idea is to capture those who may move into housing with lead hazards. ” Geltman says BLLs are higher on average in refugee children versus U.S.-born children, an assertion backed up by published reports from Massachusetts, New Hampshire, Minnesota, Indiana, Rhode Island, Florida, California, and other states... Similarly, Geltman reported in 2011 that refugee children in Massachusetts were 12 times more likely to have a BLL over 20 µg/dL one year after an initial screening than nonrefugee children of the same age living in the same communities... Geltman says he was at first unsure as to what was causing the increases, but he had a hunch that lead-contaminated older housing was at least partly to blame... To investigate, he and coauthor Katherine Eisenberg, currently a resident in family medicine at the University of Rochester Medical Center, matched cases of rising BLL in refugees under age 7 with the median age of housing in Massachusetts... The results confirmed his hunch: Living in zip codes dominated by pre-1950s housing was associated with a 69% increase in the risk of a child’s BLL rising within 12–15 months of arrival... In 2009, for instance, CDC investigators traced a cluster of 14 cases of elevated BLL among Burmese refugee children resettled in Indiana to a digestive folk medicine sold under the name Daw Tway... Now a Ph.D. candidate in health professions education at Simmons College in Boston, Tshabangu-Soko works with Caron on refugee health issues, particularly housing-based lead hazards from flaking paint... Language barriers pose the biggest problem in communicating about lead risks, they have found... However, Cochran points back to the evidence from Geltman and Eisenberg’s 2011 report (which she coauthored) indicating refugee children were more likely to develop elevated BLLs than same-age children in the same high-risk communities... The CDC’s lead screening recommendations for refugees are part of that strategy, Brown says... She cites evidence showing that implementation of the recommendations was associated with a reduction in the time it took for individuals’ BLLs to drop below 10 µg/dL. “Early identification and appropriate followup make BLLs come down faster,” she explains... That program’s broad objective is to phase out the manufacture and sale of lead-based paint worldwide... According to Cochran, Massachusetts resettlement workers coordinate with bilingual community health workers who emphasize key talking points related to healthy homes. “We talk about bringing food preparation up off the floor and why it’s important to use a table for food, and to watch where kids play,” she says. “But lead risks can be difficult to grasp for refugees, who are often coming from very dangerous situations to the safety of the United States... The notion that here your house or a traditional medication could poison you makes little sense. ” Many refugees arrive in the United States believing that everything in this country is great, and they will be safe, she adds, “so this becomes part of the larger conversation that goes with taking care of yourself here. ”

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Somali Bantu children in shirts provided by the U.S. Refugee Program, waiting for a bus en route to new homes in the United States. Many refugees arrive in the United States overwhelmed and concerned about day-to-day survival. Lead toxicity—especially if its effects aren’t outwardly apparent—can rank low on their list of concerns.Simon Maina/AFP/Getty Images
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f5: Somali Bantu children in shirts provided by the U.S. Refugee Program, waiting for a bus en route to new homes in the United States. Many refugees arrive in the United States overwhelmed and concerned about day-to-day survival. Lead toxicity—especially if its effects aren’t outwardly apparent—can rank low on their list of concerns.Simon Maina/AFP/Getty Images


Unsafe harbor? Elevated blood lead levels in refugee children.

Schmidt CW - Environ. Health Perspect. (2013)

Somali Bantu children in shirts provided by the U.S. Refugee Program, waiting for a bus en route to new homes in the United States. Many refugees arrive in the United States overwhelmed and concerned about day-to-day survival. Lead toxicity—especially if its effects aren’t outwardly apparent—can rank low on their list of concerns.Simon Maina/AFP/Getty Images
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3672925&req=5

f5: Somali Bantu children in shirts provided by the U.S. Refugee Program, waiting for a bus en route to new homes in the United States. Many refugees arrive in the United States overwhelmed and concerned about day-to-day survival. Lead toxicity—especially if its effects aren’t outwardly apparent—can rank low on their list of concerns.Simon Maina/AFP/Getty Images

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Once here, says Brown, exposures can persist for two main reasons: because of continued exposure via traditional customs and products like tiro, and because refugees, who are often poor, wind up living in older housing with flaking lead-based paint. “The CDC recommended [BLL screening for refugee children] because it is well known that refugee families will move to less expensive housing … shortly after resettlement,” says Paul Geltman, a pediatrician with Harvard Medical School and the Cambridge Health Alliance. “The idea is to capture those who may move into housing with lead hazards. ” Geltman says BLLs are higher on average in refugee children versus U.S.-born children, an assertion backed up by published reports from Massachusetts, New Hampshire, Minnesota, Indiana, Rhode Island, Florida, California, and other states... Similarly, Geltman reported in 2011 that refugee children in Massachusetts were 12 times more likely to have a BLL over 20 µg/dL one year after an initial screening than nonrefugee children of the same age living in the same communities... Geltman says he was at first unsure as to what was causing the increases, but he had a hunch that lead-contaminated older housing was at least partly to blame... To investigate, he and coauthor Katherine Eisenberg, currently a resident in family medicine at the University of Rochester Medical Center, matched cases of rising BLL in refugees under age 7 with the median age of housing in Massachusetts... The results confirmed his hunch: Living in zip codes dominated by pre-1950s housing was associated with a 69% increase in the risk of a child’s BLL rising within 12–15 months of arrival... In 2009, for instance, CDC investigators traced a cluster of 14 cases of elevated BLL among Burmese refugee children resettled in Indiana to a digestive folk medicine sold under the name Daw Tway... Now a Ph.D. candidate in health professions education at Simmons College in Boston, Tshabangu-Soko works with Caron on refugee health issues, particularly housing-based lead hazards from flaking paint... Language barriers pose the biggest problem in communicating about lead risks, they have found... However, Cochran points back to the evidence from Geltman and Eisenberg’s 2011 report (which she coauthored) indicating refugee children were more likely to develop elevated BLLs than same-age children in the same high-risk communities... The CDC’s lead screening recommendations for refugees are part of that strategy, Brown says... She cites evidence showing that implementation of the recommendations was associated with a reduction in the time it took for individuals’ BLLs to drop below 10 µg/dL. “Early identification and appropriate followup make BLLs come down faster,” she explains... That program’s broad objective is to phase out the manufacture and sale of lead-based paint worldwide... According to Cochran, Massachusetts resettlement workers coordinate with bilingual community health workers who emphasize key talking points related to healthy homes. “We talk about bringing food preparation up off the floor and why it’s important to use a table for food, and to watch where kids play,” she says. “But lead risks can be difficult to grasp for refugees, who are often coming from very dangerous situations to the safety of the United States... The notion that here your house or a traditional medication could poison you makes little sense. ” Many refugees arrive in the United States believing that everything in this country is great, and they will be safe, she adds, “so this becomes part of the larger conversation that goes with taking care of yourself here. ”

Show MeSH