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Academic Studies

18 June 2019 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. 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%  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.