Agyemang Veronica, Acquaye Joseph K, Harrison Samuel B E, Oppong Felix B, Gyaase Stephany, Asante Kwaku P, Olayemi Edeghonghon
Kintampo Health Research Centre, Kintampo, Ghana.
Department of Haematology, University of Ghana Medical School, Korle Bu, Accra, Ghana.
J Trop Med. 2020 Jul 10;2020:6718985. doi: 10.1155/2020/6718985. eCollection 2020.
Lead poisoning has been a major global health problem for decades, and blood transfusion has been suspected as a neglected potential source of lead exposure. Children and pregnant women are most vulnerable to the toxic effects of lead and over 40 percent of blood transfused in Ghana is given to children under 5 years. However, there is little data on the levels of lead in donor blood and the main sources of lead exposure in the Ghanaian population. This study compared blood lead levels (BLL) among selected occupations at risk of lead exposure with healthy blood donors in nonexposed occupations in a Ghanaian mining area. We enrolled 40 participants each from the following high-risk occupational groups: small scale miners, painters/sprayers, drivers/fuel station attendants, and auto-mechanics as well as 40 healthy blood donors (made up of teachers, traders, and office workers). One millilitre of blood was collected from each participant for determination of their BLL, haemoglobin concentration, and blood film morphology. A total of 200 participants made up of 186 (93%) males and 14 (7%) females were enrolled. The mean age of participants was 28.6 ± 8.2 years and their geometric mean (GM) BLL was 6.3 GSD 1.4 g/dL [95% CI: 6.0 - 6.6]. Participants in high risk occupations had significantly higher GM BLL of 6.7 g/dL [95% CI :6.4-7.0] compared to 5.0 g/dL [95% CI: 4.4-5.7] for healthy blood donors [ < 0.001]. The prevalence of elevated BLL (≥5 g/dL) among the entire study participants, high risk occupations and blood donors was 84.5%, 89.4% and 65% respectively. There was significant association between elevated BLLs and working in an at-risk occupational group [aOR = 3.58, = 0.014]. Haemoglobin concentration was not significantly associated with elevated BLLs. Basophilic stippling was not observed in any of the blood smears. Blood lead levels were high in blood donors and at-risk occupations in the study area and occupation was associated with elevated BLLs. It is important that measures to safeguard the integrity of donor blood go beyond screening for infectious diseases to include screening individuals in high-risk occupations for lead and other heavy metals to ensure that donor blood from such individuals is safe and does not pose potential danger to the health of vulnerable populations such as children and pregnant women.
几十年来，铅中毒一直是一个重大的全球健康问题，输血一直被怀疑是一个被忽视的潜在铅暴露源。儿童和孕妇最易受到铅的毒性影响，加纳超过40%的输血对象是5岁以下儿童。然而，关于献血者血液中的铅含量以及加纳人群中铅暴露的主要来源的数据很少。本研究比较了加纳一个矿区中选定的有铅暴露风险职业的人群与无铅暴露职业的健康献血者的血铅水平（BLL）。我们从以下高风险职业组中各招募了40名参与者：小规模矿工、油漆工/喷漆工、司机/加油站工作人员和汽车修理工，以及40名健康献血者（由教师、商人及办公室职员组成）。从每位参与者采集1毫升血液，用于测定其血铅水平、血红蛋白浓度和血涂片形态。总共招募了200名参与者，其中186名（93%）为男性，14名（7%）为女性。参与者的平均年龄为28.6±8.2岁，其几何平均血铅水平为6.3 GSD 1.4μg/dL[95%置信区间：6.0 - 6.6]。与健康献血者的5.0μg/dL[95%置信区间：4.4 - 5.7]相比，高风险职业的参与者几何平均血铅水平显著更高，为6.7μg/dL[95%置信区间：6.4 - 7.0][P<0.001]。在整个研究参与者、高风险职业者和献血者中，血铅水平升高（≥5μg/dL）的患病率分别为84.5%、89.4%和65%。血铅水平升高与在高风险职业组工作之间存在显著关联[aOR = 3.58，P = 0.014]。血红蛋白浓度与血铅水平升高无显著关联。在任何血涂片中均未观察到嗜碱性点彩。研究区域内献血者和高风险职业者的血铅水平较高，职业与血铅水平升高有关。重要的是，保障献血者血液质量的措施不应仅限于筛查传染病，还应包括对高风险职业的个体进行铅及其他重金属筛查，以确保来自此类个体的献血安全，不会对儿童和孕妇等弱势群体的健康构成潜在危险。
