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Am Fam Physician. 2005;72(4):710

The Centers for Disease Control and Prevention (CDC) has released recommendations on identifying and treating lead exposure in refugee children. The full report, “Recommendations for Lead Poisoning Prevention in Newly Arrived Refugee Children,” is available online at

Although blood lead levels in children one to five years of age are decreasing in the United States, the prevalence of elevated blood lead levels among newly resettled refugee children is substantially higher than in children born in the United States.

The CDC recommends that physicians test blood lead levels for all refugee children six months to 16 years of age upon entering the United States. After children six months to six years of age are placed in permanent residences, testing should be repeated in three to six months. In older children, testing should be repeated if a child has a sibling with elevated blood lead levels, regardless of his or her initial test results.

The CDC guidelines recommend performing nutritional evaluations for all refugee children upon their arrival in the United States, and providing appropriate nutritional and vitamin supplements when needed. Physicians also should evaluate the value of iron supplementation in refugee children.

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