CDC Recommendations for Lead Poisoning Prevention in Newly Arrived Refugee Children Resettlement Worker Module

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 AssistanceModule 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?

• Childrens nervous systems are still developing
• Young children have more hand-to-mouth activity
  than older children
• Children absorb more lead than adults

6
Childrens 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 AssistanceModule 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 AssistanceModule 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 nations
  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 AssistanceModule 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
Environmental AssessmentThe four components are

• Pre-assessment
• Visual interior assessment

• Visual exterior assessment
• Summary assessment

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 AssuranceNutrition
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 AssistanceModule 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