Lead Exposure and Associated Risk Factors among New Migrant Children Arriving in Greece

Ammunition Waste Pollution and Preliminary Assessment of Risks to Child Health from Toxic Metals at the Greek Refugee Camp Mavrovouni

The Mavrovouni refugee camp near the former Moria camp on the island of Lesvos, Greece, housed approximately 3000 asylum-seekers including children as of October 2021. The camp was built on the site of a military shooting range. This study aimed to characterize the soil contaminants and assess the risk of toxic environmental exposures for children living in Mavrovouni. Methods: Samples of surface soil (0−2 cm depth; particle size < 2 mm) from eight locations inside the camp were compared with two reference samples. Soil samples were microwave digested using a mixture of nitric and hydrofluoric acids and analyzed for lead (Pb), antimony (Sb), bismuth (Bi), and other metals using inductively coupled plasma mass spectrometry. These values were compared with action limits established by the Norwegian Environment Agency for kindergartens, playgrounds, and schools. Findings: Five of eight soil samples from inside the camp exceeded Pb levels of 100 mg/kg, which is currently the maximum acceptable value of Pb in soil for playgrounds in Norway. Two sites had extreme soil Pb levels of approximately 8000 mg/kg and 6000 mg/kg. The concen-tration of Sb and Bi in the surface soil of the firing range area strongly indicated environmental contamination, most likely from previous military activity and ammunition residue that has re-mained on the surface soil. Concentrations of arsenic (As), cadmium (Cd), copper (Cu), and zinc (Zn) in surface soil were lower than action limits. Discussion: Extremely high levels of Pb, together with high levels of Sb and Bi, were identified in soil where children live and play in the Mavrovouni refugee camp. This is the first independent study of environmental contamination at this camp and adds to the limited evidence base documenting Pb exposures prior to migrant and refugee reset-tlement. On top of the multiple existing public health crises and traumas that these asylum-seeking families face, exposure to toxic ammunition residues may have profound impacts on children’s development and health for years to come.

Association between self-reported length of time in the USA and blood lead levels: National Health and Nutrition Examination Survey 2013-2016

OBJECTIVES

The aim of this study is to determine the association between length of time in the USA with blood lead (BPb).

DESIGN

Population-based cross-sectional study using data from the 2013-2016 National Health and Nutrition Examination Survey.

SETTING

USA.

PARTICIPANTS

5933 men and women (≥15 years); subgroups of men only (n=2867), women only (n=3064) and women of childbearing age (15-45 years) (n=1580).

PRIMARY AND SECONDARY OUTCOMES

The primary outcome was BPb concentration. The main exposure variable was self-reported number of years spent in the USA, categorised as: born in the USA; 0-4 years; 5-9 years; 10-19 years and ≥20 years. We used linear regression models adjusted for race/ethnicity, education, blood cotinine, age, sex (as appropriate) and accounted for complex survey design.

RESULTS

Women of childbearing age who have lived 0-4 years in the USA have, on average, a 54% (95% CI 36% to 75%) higher BPb compared with women born in the USA. Corresponding results for all women, men and the entire population were 49% (95% CI 34% to 66%), 49% (95% CI 28% to 75%) and 49% (95% CI 33% to 66%), respectively. Similar, statistically significant, results were observed for other time periods (5-9 years, 10-19 years and ≥20 years); the magnitude of the association decreased with increasing time in the USA.

CONCLUSIONS

This study provides additional evidence that newcomers to the USA may be a population at higher risk of elevated BPb.

Impact of the Refugee Crisis on the Greek Healthcare System: A Long Road to Ithaca

Greece is the country of "Xenios Zeus", the Ancient Greek god of foreigners and hospitality; however, it is also the main point of entry to Europe. Since the beginning of 2014, 1,112,332 refugees crossed the borders of Greece. Overall, 33,677 children and adolescent refugees sought asylum in Greece from 2013 to 2017, while 57,042 refugees are currently being hosted. The rapid entry of refugees into Greece raised the critical issue of health policy. The Greek National Health Service (NHS) faces many challenges. Adequate economic and human support is essential if this situation is to be managed successfully. However, Greece still bears the burden of the economic downturn since 2009. In fact, the crisis led to shortages in crucial equipment, and unmet health needs for both locals and refugees. The NHS deals with traumatic experiences, as well as cultural and linguistic differences. Overcrowded reception centers and hotspots are highly demanding and are associated with severe disease burden. This highlights the importance of guidelines for medical screening, healthcare provision, and a well-managed transition to definitive medical facilities. Furthermore, non-governmental organizations make an essential contribution by ensuring appropriate support to refugee minors, especially when they experience poor access to the NHS.