To estimate the prevalence and incidence of blood lead levels (BLL) ≥ 5 and ≥ 3.5 µg/dl and assess their association with primary language spoken at home in Northeast Ohio, U.S. children, a retrospective cohort study was conducted among 19,753 children aged < 6 years. Primary language spoken at home was used to define children from resettled refugee families (RRFs) and non-RRFs. The overall BLL ≥ 5 and ≥ 3.5 µg/dl prevalence were 3.22 and 6.10%, and incidence rates were 2.25 and 3.64 cases per 100 person-years, respectively. Compared to children from non-RRFs children from RRFs were 3.62-times [95% confidence interval (CI): 1.84, 7.13] as likely to have BLL ≥ 5 µg/dl prevalence, and 6.72-times [95% CI 2.60, 17.40] as likely to have BLL ≥ 5 µg/dl incidence during the follow-up period. The higher prevalence and incidence of BLL acquired in the United States among children from RRFs warrant further research to identify specific environmental and sociocultural lead sources for these children.
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