Plasma Lead Levels Among Paediatric Thalassaemic Patients In Hospital Universiti Sains Malaysia, Kelantan, Malaysia

Mohd I Iyen, Mohd S Ab Wahab, Norsarwany Mohamad, Mariani Mohamad, Omotayo O Erejuwa


Objective: Lead toxicity constitutes a major environmental risk to health in both animals and humans of all ages. It is more severe in young children than adults. Blood transfusion is an important source of lead exposure and may predispose premature infants to lead toxicity. Thalassaemia is common in Malaysia and majority of patients require frequent blood transfusion. The objective of this study was to determine whether regular blood transfusion contributed to high blood lead levels in paediatric thalassaemic patients. 

Method: This was a cross sectional study conducted at the Paediatric Thalassaemia Day Care Unit, General Paediatric Ward and Paediatric Clinic in Hospital Universiti Sains Malaysia (HUSM). A total of 90 patients were included, 45 were thalassaemic transfusion dependant patients and the other 45 were control, who were of the same age and sex with patients group and had never been transfused. The blood samples were taken pre- and post-transfusion for thalassaemic and control groups. Blood lead levels were analyzed using standard Atomic Absorption Spectrometer (AAS) analysis. 

Results: The overall mean plasma lead levels (2.13 + 1.72μg/dL) were lower than those of standard CDC recommendations. The independent t-test showed that plasma lead levels in thalassaemic group were significantly (p < 0.05) lower than the levels in controls. However, the ANCOVA analysis revealed the plasma lead levels were not significantly (p > 0.05) different between the two groups. Thus, suggesting that the reduced plasma lead level in thalassaemic group was due to the administration of iron chelators. Increased frequency of blood transfusion also did not significantly (p > 0.05) increase plasma ferritin or lead levels in thalassaemic patients. 

Conclusion: This study shows that transfusion dependent thalassaemicinfants have comparable plasma lead levels to those of age- and sex-matched controls, after taking into consideration the administration of iron chelators.

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Thalassaemia; transfusion; lead; infants; paediatrics

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