Elevated Blood Lead Levels in Refugee Children
In addition to connecting refugees with initial health assessment services, resettlement agencies holding contracts from the U.S. Department of State provide "wrap-around" reception and placement services that include housing arranged in advance. Under a provision of the federal Lead Disclosure Rule, landlords must reveal the presence of lead paint and lead hazards and supply new tenants with a pamphlet called "Protect Your Family from Lead in Your Home," which is published by the U.S. Environmental Protection Agency (EPA). The EPA publishes the pamphlet in several languages, but the U.S. Department of Health and Human Services' Office of Refugee Resettlement (ORR) notes on its website that most landlords only have the English version. Another regulation known as the Lead-Safe Housing Rule requires that landlords who take federal funds for renting pre-1978 housing follow what ORR describes as "extremely complex" federal regulations aimed at addressing and containing lead hazards. The protections under the Lead-Safe Housing Rule vary depending on the type of public assistance used to cover housing costs.
Individual states address lead threats in refugee housing with varying levels of stringency. Massachusetts has among the strictest requirements—refugee housing for children under age 6 years must be "lead-safe." According to Brown, this means flaking lead-based paint must be controlled by repainting, while total removal is required only on "bitable" surfaces and those that are prone to rubbing or friction.
But according to Geltman, the regulations aren't always followed. In some cases, refugees wind up in lead-contaminated housing either because resettlement agencies aren't aware of the risk in a given dwelling or because landlords don't reveal it. Several years ago, Massachusetts officials visited resettlement agencies throughout the state with a reminder that refugee dwellings should be lead-safe, and preferably lead-free if they house children or women of child-bearing age.
Jennifer Cochran, director of the Division of Global Populations and Infectious Disease Prevention at the Massachusetts Department of Public Health, says the State Department's financial support for refugees lasts three months at most. Faced with dwindling support, refugees will likely try to lower expenses by looking for cheaper accommodations with even greater—and comparatively unmonitored—lead risks. Because refugee movements in Massachusetts aren't actively tracked post-resettlement, the added lead risk that comes from these subsequent housing choices isn't well characterized. However, Cochran points back to the evidence from Geltman and Eisenberg's 2011 report (which she coauthored) indicating refugee children were more likely to develop elevated BLLs than same-age children in the same high-risk communities.
A Focus on Housing
In addition to connecting refugees with initial health assessment services, resettlement agencies holding contracts from the U.S. Department of State provide "wrap-around" reception and placement services that include housing arranged in advance. Under a provision of the federal Lead Disclosure Rule, landlords must reveal the presence of lead paint and lead hazards and supply new tenants with a pamphlet called "Protect Your Family from Lead in Your Home," which is published by the U.S. Environmental Protection Agency (EPA). The EPA publishes the pamphlet in several languages, but the U.S. Department of Health and Human Services' Office of Refugee Resettlement (ORR) notes on its website that most landlords only have the English version. Another regulation known as the Lead-Safe Housing Rule requires that landlords who take federal funds for renting pre-1978 housing follow what ORR describes as "extremely complex" federal regulations aimed at addressing and containing lead hazards. The protections under the Lead-Safe Housing Rule vary depending on the type of public assistance used to cover housing costs.
Individual states address lead threats in refugee housing with varying levels of stringency. Massachusetts has among the strictest requirements—refugee housing for children under age 6 years must be "lead-safe." According to Brown, this means flaking lead-based paint must be controlled by repainting, while total removal is required only on "bitable" surfaces and those that are prone to rubbing or friction.
But according to Geltman, the regulations aren't always followed. In some cases, refugees wind up in lead-contaminated housing either because resettlement agencies aren't aware of the risk in a given dwelling or because landlords don't reveal it. Several years ago, Massachusetts officials visited resettlement agencies throughout the state with a reminder that refugee dwellings should be lead-safe, and preferably lead-free if they house children or women of child-bearing age.
Jennifer Cochran, director of the Division of Global Populations and Infectious Disease Prevention at the Massachusetts Department of Public Health, says the State Department's financial support for refugees lasts three months at most. Faced with dwindling support, refugees will likely try to lower expenses by looking for cheaper accommodations with even greater—and comparatively unmonitored—lead risks. Because refugee movements in Massachusetts aren't actively tracked post-resettlement, the added lead risk that comes from these subsequent housing choices isn't well characterized. However, Cochran points back to the evidence from Geltman and Eisenberg's 2011 report (which she coauthored) indicating refugee children were more likely to develop elevated BLLs than same-age children in the same high-risk communities.
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