Our Residential Services Team works with local partners to provide care to immigrant and refugee families with children who have been tested with blood lead levels at or above the reportable threshold. The Residential Services Team tracks blood lead level results in King County and schedules an in-home visit with families to identify potential sources of lead that may be contributing a child’s blood lead level. 

During an in-home environmental assessment, different items, materials, and areas of the home are screened for lead using an X-ray fluorescent analyzer (XRF). There are many potential sources of lead including: 

• Food preparation items, such as traditional pressure cookers, aluminum cookware, glazed dishes, and silverware brought from outside the U.S.
• Traditional remedies and some Ayurveda medicines
• Cosmetics like surma, kajal, and kohl
• Cosmetic jewelry
• Lead paint and paint dust from homes built before 1978
• Old toys that are painted or made of metal

In-home environmental investigations

Photo caption: Matt Wilson, Haz Waste Program (left) and Nilu Pedram, Afghan Health Initiative (right) get ready to do an in-home environmental assessment in Kent.

Let’s follow Matt Wilson, Health and Environmental Investigator with the Haz Waste Program Residential Services Team, while he conducts an in-home environmental assessment in the city of Kent with a recently resettled Afghan family. Newly arriving immigrant and refugee children are at a higher risk of lead exposure from common household materials brought from their home country, such as cookware and cosmetics.

For this visit, Matt teamed up with Nilu Pedram, a health advocate from community-based organization Afghan Health Initiative (AHI) to provide in-language and culturally appropriate services to the family. Nilu led in-language greetings and introductions. Then, Matt set up two cases in the living room that hold the equipment used to test samples from the home for lead. On this particular visit, Matt used the XRF analyzer to test two cookpots brought from the family’s country of origin that they often used to prepare meals. The XRF results revealed both cookpots were found to contain lead. Matt and Nilu then collaborated to communicate the results to the family, recommending that the family stop using the cookpots.

  

Public health recommendations to stop using lead-contaminated pots is essential to reducing lead exposure health risks. But it can also create a challenge for immigrant and refugee families who may use these cookpots almost daily. Through direct work conducting hundreds of in-home visits with families each year, the Residential Services and AHI teams discovered that for some families, stopping the use of the lead-contaminated pots isn’t a straightforward switch. Immigrant and refugee families often face access barriers that prevent them from easily purchasing a safer cooking pot. Additionally, traditional pressure cookers and cookware may also have sentimental value to families because they are passed down through generations or given to commemorate a special event. These considerations mean that sometimes families will continue to use lead-contaminated pots despite public health recommendations.

 

With these lessons in mind, a new service was created to reduce at-home lead exposure – a safer cookware exchange program.

 

Safer cookware exchange

 

Photo caption: Nilu unboxes a stainless steel cooking pot, a safer alternative that the family can start using right away to reduce their lead exposure. 

A recent study conducted by the Haz Waste Program’s Research Team found that aluminum cookpots and pressure cookers, often brought to the U.S. from Afghanistan, can be a source of lead exposure. The Residential Services and Research teams worked together to identify the best safter alternative for families to replace cookpots and pressure cookers containing lead. Once stainless steel was confirmed as the best replacement cookware, the Residential Services team secured a grant to fund the cookware exchange project to support services for immigrant and refugee families.  

Now, when Matt and his team members conduct an in-home environmental assessment and confirm a family is using lead-contaminated cookware, they are able to provide them a stainless steel cookpot alternative – an immediate and effective resource to protect the family from lead exposure.