Source: CDC Immigrant and Refugee Health
Epidemiology and Geographic Distribution
Following the phase-out of leaded gasoline and the ban on lead-based paint, the prevalence of lead poisoning, as defined by a blood lead level (BLL) ≥10 µg/dL, among children in the United States has dramatically declined since the 1970s, decreasing from 78% during 1976-1980 to 1.6% during 1996-2002.  In contrast, refugee children arriving in recent years have much higher rates of elevated BLL on average when they enter the United States, because of exposures prior to relocation. In addition, refugee children are at above-average risk for lead poisoning from exposures in the United States, because they typically settle into high-risk areas and substandard housing.
In areas of the world where many refugees originate, potential lead exposures include lead-containing gasoline combustion, industrial emissions, ammunition manufacturing and use, burning of fossil fuels and waste, and lead-containing traditional remedies, foods, ceramics, and utensils. [2,3]
Refugee Populations at Risk
- Refugee children originating in all regions of the world, especially those from resource-poor countries, are at risk of having lead poisoning upon arrival to the United States.
- Malnourished children may be at increased risk for lead poisoning, likely through increased intestinal lead absorption mediated by micronutrient deficiencies. The best-studied micronutrient deficiency related to lead levels is iron deficiency. Iron-deficient children are at increased risk for developing lead poisoning. Deficiencies in calcium and zinc may also increase a child’s risk. 
CDC Refugee Health Guidelines: Lead Screening
- CDC. Blood lead levels–United States, 1999-2002. MMWR Morb Mortal Wkly Rep. 2005;54:513-6.
- Minnesota Department of Health. Lead Poisoning in Minnesota Refugee Children, 2000-2002.
- Geltman PL, Brown MJ, Cochran J. Lead poisoning among refugee children resettled in Massachusetts, 1995 to 1999. Pediatrics. 2001;108:158-62.
- Laraque D, Trasande L. Lead poisoning: Successes and 21st century challenges. Pediatr Rev. 2005;26:435-43.