摘要：Objectives. We investigated whether foreign birthplace and residence were associated with an increased risk of childhood lead poisoning. Methods. We conducted a matched case–control study among New York City children (mean age=3 years) tested for lead poisoning in 2002 (n=203 pairs). Children were matched on age, date of test, and residential area. Blood lead and housing data were supplemented by a telephone survey administered to parents or guardians. Conditional logistic regression analysis was used to examine the relationship of lead poisoning status to foreign birthplace and time elapsed since most recent foreign residence after adjustment for housing and behavioral risk factors. Results. Both foreign birthplace and time since most recent foreign residence had strong adjusted associations with lead poisoning status, with children who had lived in a foreign country less than 6 months before their blood test showing a particularly elevated risk of lead poisoning relative to US-born children with no foreign residential history before their blood test (odds ratio [OR]=10.9; 95% confidence interval [CI]=3.3, 36.5). Conclusions. Our findings demonstrate an increased risk of lead poisoning among immigrant children. Despite a dramatic decline in childhood lead poisoning in the United States, an estimated 1.6% of US children aged 1 to 5 years (approximately 310000 children) have elevated blood lead levels of at least 10 μg/dL. Furthermore, the growing scientific evidence on cognitive impairments associated with blood lead levels below 10 μg/dL suggest that even a greater number of children are at risk of being adversely affected by low-level exposure to lead. 2 – 4 The most common high-dose source of lead exposure among US children is interior lead-based paint, 5 – 8 but children who spend time outside the United States may be exposed to additional sources. The literature on lead poisoning among immigrant children living in the United States is scant. Surveillance and case studies have revealed a higher prevalence or incidence of elevated blood lead levels among refugee and internationally adopted children living in the United States than among the general US population of children. 9 – 12 However, these reports have lacked a comparison group and presented results not adjusted for confounding factors. To our knowledge, a recent national study involving Mexican American children is the only investigation in which individual- and family-level characteristics (e.g., age, family income, language spoken at home) and source of drinking water were controlled for in any examination of the association between foreign birthplace and lead poisoning. The results of that study revealed higher blood lead levels among foreign-born children than among US-born children of Mexican descent. 13 In this study, we examined the associations of childhood lead poisoning with birth and residence in a foreign country among a multiethnic urban sample while accounting for child and family demographic characteristics, child behaviors, and current residential building characteristics. We hypothesized that lead poisoning would be positively associated with birth and residence in a foreign country after control for known risk factors.
