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Lead Poisoning Prevention in Refugee Children: Risks and Solutions

Learn about lead exposure risks in newly arrived refugee children, effects on health, sources of exposure, and preventive measures and resources available.

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Lead Poisoning Prevention in Refugee Children: Risks and Solutions

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  1. CDC Recommendations for Lead Poisoning Prevention in Newly Arrived Refugee ChildrenResettlement Worker Module U.S. Department of Health and Human Services Centers for Disease Control and Prevention

  2. Refugee Assistance:Module Outline • What is the problem? • Effects on the refugee population • Sources of lead exposure • What can you do? • Resources

  3. Childhood Lead Poisoning • Lead poisoning is a common and preventable childhood health problem • Lead is everywhere in the environment due to industrialization • Lead exposure is measured in children by blood lead testing

  4. Blood Lead Levels in the U.S. Population 1976-2002 (NHANES) 14.9 Blood Lead Levels (µg/dL) 3.6 2.7 1.9 Year

  5. Why are Children at High Risk? • Children’s nervous systems are still developing • Young children have more hand-to-mouth activity than older children • Children absorb more lead than adults

  6. Children’s Health RisksRelated to lead exposure • Reductions in IQ and attention span • Behavioral problems (e.g., hyperactivity) • Impaired growth and hearing loss • At very high levels, seizures, coma, and even death

  7. Refugee Assistance:Module Outline • What is the problem? • Effects on the refugee population • Sources of lead exposure • What can you do? • Resources

  8. Refugee Migration

  9. Elevated Blood Lead Levels (BLLs)in Refugee Children • Newly arrived refugee children are twice as likely as U.S. children to have elevated BLLs • Some sub-populations of refugee children are 12-14.5 times more likely to have elevated BLLs • Data suggest that refugee children are also at risk for elevated BLLs after resettlement in the U.S.

  10. Risk Factors for Elevated BLLsAmong Refugees • Living in older homes • Presence of lead hazards • Cultural practices and traditional medicines • Lack of awareness about the dangers of lead • Compromised nutritional status

  11. Refugee Assistance:Module Outline • What is the problem? • Effects on the refugee population • Sources of lead exposure • What can you do? • Resources

  12. Lead Hazard Sources • Most lead hazards come from lead paint chips that have been ground into tiny bits. • These tiny bits of lead become part of the dust and soil in and around our homes.

  13. U.S. Housing • 24 million housing units (25% of the nation’s housing) have significant lead-based paint hazards • 1.2 million homes with significant lead-based paint hazards housed low income families with children under the age of 6 years

  14. Environmental Sources of Childhood Lead Exposure

  15. Refugee Assistance:Module Outline • What is the problem? • Effects on the refugee population • Sources of lead exposure • What can you do? • Resources

  16. Environmental Assessment ResettlementWorker Educatepopulation Assuremedicalinterventions

  17. Pre-assessment Visual interior assessment Visual exterior assessment Summary assessment Environmental AssessmentThe four components are:

  18. Property Pre-Assessment • Was the property built before 1978? • Can the property owner provide a current certification that the property is lead safe or lead free?

  19. Visual Interior Assessment • Walls • Windows • Steps

  20. Visual Exterior Assessment • Exterior windows and doors • Porch and/or steps • Roof, gutters, and downspouts

  21. Summary Assessment • The summary assessment is where you will use your findings from the interior and exterior assessments to make a determination of the high risk status of the property.

  22. Medical Assurance: Screening 1) Nutritional evaluations 2) Initial blood lead test 3) Repeat blood lead test

  23. Medical Assurance: Screening Initial blood lead test • Within 90 days of arrival into the United States Repeat blood lead test • 3 to 6 months after placed in permanent residence • Considered a “medical necessity”

  24. Medical Assurance: Case Management • What is case management? • Who provides case management? • Consult www.cdc.gov/nceh/lead for specific case management information

  25. Medical Assurance:Nutrition

  26. Educate Populations • Provide education to newly arrived refugee families • Routine medical care • Proper nutrition • House cleaning strategies • CDC Health Education Resource Database

  27. Refugee Assistance:Module Outline • What is the problem? • Effects on the refugee population • Sources of lead exposure • What can you do? • Resources

  28. Federal Organizations • U.S. Department of Health and Human Services • Centers for Disease Control and Prevention • http://www.cdc.gov/nceh/lead/lead.htm • http://www.cdc.gov/ncidod/dq/ • Office of Global Health Affairs • http://www.globalhealth.gov/ • Office of Refugee Resettlement • http://www.acf.dhhs.gov/programs/orr/ • U.S. Department of State • Bureau of Population, Refugees, and Migration • http://www.state.gov/g/prm/

  29. Additional Federal Resources • U.S. Department of Housing and Urban Development (HUD) • Office of Healthy Homes and Lead Hazard Control • http://www.hud.gov/offices/lead/ • U.S. Environmental Protection Agency (EPA) • Office of Pollution and Prevention and Toxics • http://www.epa.gov/opptintr/lead/index.html

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