A Denver Refugee Clinic Blood Lead Level Analysis in Refugee Females of Reproductive Age, 13–45 years, 2014–2019

The objective was to determine if refugee females of reproductive age (FRA) are at risk of having elevated blood lead levels (BLL). A retrospective quality improvement project conducted at a Denver community health center (9/2014-3/2019) evaluated BLLs from initial domestic medical examinations (DME) in 312 FRA refugees (13-45 years). Associations between elevated BLL and demographic factors were explored using multivariable regression analysis. Of 312 FRA refugees, BLLs ranged from < 2.0 to 26.2 mcg/dL, 5% had elevated BLLs. Of pregnant refugees (49), 4% had elevated BLLs. Afghani country of origin was positively associated with elevated BLLs, adjusting for age (FRA: Prevalence Ratio 6.90 [2.68-17.77], p < 0.0001). Afghani FRA refugees, irrespective of pregnancy and breast-feeding status, should have BLL testing at DME. Nationally representative evaluations of FRA refugees are needed to determine if BLL screening should be expanded to all FRA refugees, irrespective of pregnancy or breast-feeding status