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
Refugee Assistance:Module Outline
What is the problem?
Effects on the refugee population
Sources of lead exposure
What can you do?
Resources
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
Blood Lead Levels in the
U.S. Population 1976-2002 (NHANES)
0
2
4
6
8
10
12
14
16
1976-1980 1988-1991 1991-1994 1999-2002
Year
Blo
od
Le
ad L
eve
ls (µ
g/d
L)
2.7
3.6
1.9
14.9
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
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
Refugee Assistance:Module Outline
What is the problem?
Effects on the refugee population
Sources of lead exposure
What can you do?
Resources
Refugee Migration
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.
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
Refugee Assistance:Module Outline
What is the problem?
Effects on the refugee population
Sources of lead exposure
What can you do?
Resources
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.
Lead Hazard Sources
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
Environmental Sources of Childhood Lead Exposure
Refugee Assistance:Module Outline
What is the problem?
Effects on the refugee population
Sources of lead exposure
What can you do?
Resources
Environmental Assessment
Educatepopulation
Assuremedical
interventions
ResettlementWorker
Environmental AssessmentThe four components are:
Pre-assessment
Visual interior assessment
Visual exterior assessment
Summary assessment
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?
Visual Interior Assessment
Walls
Windows
Steps
Visual Exterior Assessment
Exterior windows and doors
Porch and/or steps
Roof, gutters, and downspouts
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.
Medical Assurance: Screening1) Nutritional evaluations
2) Initial blood lead test
3) Repeat blood lead test
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”
Medical Assurance: Case Management What is case management?
Who provides case management?
Consult www.cdc.gov/nceh/lead for specific case management information
Medical Assurance:Nutrition
Educate Populations
Provide education to newly arrived refugee families Routine medical care Proper nutrition House cleaning strategies
CDC Health Education Resource Database
Refugee Assistance:Module Outline
What is the problem?
Effects on the refugee population
Sources of lead exposure
What can you do?
Resources
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/
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