Age $2 Years
In bivariate analyses, exposures signifi-
cantly associated with EBLLs in children
$2 years were birth outside the camps,
male gender, taking “Wonotsay,” mouthing
metal objects in the past week, and
.daily exposure to motor vehicles (eg,
in/around cars and motorcycles). Having
a household member who did agricultural
work had a P value of ,.2. In
multivariate analyses for age $2 years,
only male gender remained signifi-
cantly associated.
DISCUSSION
Although EBLLs may not cause obvious
symptoms, they have measurable, longterm
effects on child development,17and endanger the health and welfare of
many children worldwide. Although the
United States has established leadpoisoning
prevention programs,18 many
children arrive from settings lackingsuch programs.19 Our data support
the previously untested hypothesis that
US-bound refugee children may be exposed
to lead before, as well as after
arrival in the United States.4 Althoughthis investigation was not designed
to determine population EBLL rates, it
suggests that children living in camps
on the Thailand-Burma border had an
∼sevenfold higher prevalence of EBLLs
(7.2%, Table 1) than US children of the
same age group (,6 years; ∼1%), with
the highest prevalence among children
,2 years of age (14.5%), when lead’s
toxic effects are most harmful to the
developing brain.20 Approximately 90%
of tested children had detectable capillary
BLLs, indicating that a large proportion
of camp children is exposed to
lead. Even at BLLs ,10 mg/dL, lead can
adversely affect development.17
Age $2 YearsIn bivariate analyses, exposures signifi-cantly associated with EBLLs in children$2 years were birth outside the camps,male gender, taking “Wonotsay,” mouthingmetal objects in the past week, and.daily exposure to motor vehicles (eg,in/around cars and motorcycles). Havinga household member who did agriculturalwork had a P value of ,.2. Inmultivariate analyses for age $2 years,only male gender remained signifi-cantly associated.DISCUSSIONAlthough EBLLs may not cause obvioussymptoms, they have measurable, longtermeffects on child development,17and endanger the health and welfare ofmany children worldwide. Although theUnited States has established leadpoisoningprevention programs,18 manychildren arrive from settings lackingsuch programs.19 Our data supportthe previously untested hypothesis thatUS-bound refugee children may be exposedto lead before, as well as afterarrival in the United States.4 Althoughthis investigation was not designedto determine population EBLL rates, itsuggests that children living in campson the Thailand-Burma border had an∼sevenfold higher prevalence of EBLLs(7.2%, Table 1) than US children of thesame age group (,6 years; ∼1%), withthe highest prevalence among children,2 years of age (14.5%), when lead’stoxic effects are most harmful to thedeveloping brain.20 Approximately 90%of tested children had detectable capillaryBLLs, indicating that a large proportionof camp children is exposed tolead. Even at BLLs ,10 mg/dL, lead canadversely affect development.17
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