A Toxic Haven for Refugee Children?

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According to the Refugee Council USA, each year about 98,000 refugees enter the United States. Fleeing from war and the threat of persecution, these individuals have left their homelands to seek shelter. Leaving one threat behind, is it possible that they face a new danger in their safe haven?

Overall only about 2.6% of U.S. children aged 1-5 years have blood lead levels (BLLs) above the CDC reference level while refugee children from developing countries often have BLLs several times above the national average. According to Jean Brown, chief of the CDC’s Healthy Homes/Lead Poisoning Prevention Branch, several practices in developing countries contribute to the elevated BLLs that many refugee children have before coming to the U.S. After arriving in the U.S, high BLLs often persist due to traditional customs and because refugees often end up living in older housing with flaking lead-based paint.

Lead poisoning is extremely hazardous and is especially detrimental to the neurological development of children. According to the EPA, lead poisoning in children can result in damage to the brain and nervous system, anemia, liver and kidney damage, developmental delays, and in some cases lead poisoning can even be fatal. “Refugee kids in particular can be malnourished and anemic, and that boosts lead absorption and heightens the potential for neurological effects,” states Brown.

Many refugees may not fully understand or be aware of the danger associated with lead. Some never faced lead hazards before arriving in the U.S. The CDC found that nearly 30% of 242 refugee children in New Hampshire experienced elevated BLLs within 3-6 months of coming to the United States, although their initial screenings displayed non-elevated levels. Paul Geltman, a pediatrician with Harvard Medical School and the Cambridge Health Alliance, found that 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. Clearly the housing available for many refugees poses a serious health risk.

Language barriers present another problem in communicating the issue of lead toxicity to refugees. The U.S Department of Housing and Urban Development’s Disclosure rule requires that landlords reveal lead hazards and give their new tenants the pamphlet “Protect Your Family from Lead in Your Home,”  published by the EPA. Although this pamphlet is available in several languages, the U.S. Department of Health and Human Services’ Office of Refugee Resettlement discovered that many landlords only have the English version which is of no use to refugees that cannot read English.

In addition, a few herbal remedies and practices traditionally used by certain cultures intentionally contain lead. According to Tisha Titus, a physician at Federal Occupational Health in Atlanta, Georgia, states, “They’re based on recipes handed down for generations. So for a Western doctor to come in and say ‘what you’re doing can make your child sick’ isn’t going to sit well. You face a delicate balance of trying to maintain the integrity of the culture while at the same time providing a safer alternative.”

Clearly steps need to be taken in order to reduce the BLLs of refugee children. Brown says that the CDC’s lead screening for refugees is one way to confront the issue of lead hazards. Identifying high BLLs early and appropriately following up on the problem is the best way to see a timely reduction. Working to better inform parents of the serious threat that lead poses is a necessity.

For more information see: http://ehp.niehs.nih.gov/121-a190/


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