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Erythrocyte protoporphyrin screening for lead poisoning in Bedouin children. A study from Kuwait
Insights
Screening infants and children for lead poisoning using erythrocyte protoporphyrin (EP) and blood lead (PbB) levels identified significant correlations. Elevated EP indicated potential lead exposure and associated health issues like anemia.
Area of Science:
- Environmental Health
- Pediatrics
- Toxicology
Background:
- Lead poisoning is a significant public health concern in children.
- Screening methods include blood lead (PbB) and erythrocyte protoporphyrin (EP) levels.
- Early detection is crucial for preventing long-term health effects.
Purpose of the Study:
- To screen infants and children for lead poisoning in Kuwait.
- To evaluate the correlation between EP and PbB levels.
- To identify potential contributing factors to elevated lead levels.
Main Methods:
- A cross-sectional study involving 902 children aged 3 months to 5 years.
- Blood samples collected via finger prick on filter paper.
- Analysis of EP and PbB levels, hemoglobin, mean cell volumes, and transferrin saturation.
Main Results:
- 20% of children had elevated EP levels.
- 41 children had blood lead levels exceeding 25 µg/dL.
- A significant positive correlation (r=0.686) was found between EP and PbB.
- Elevated EP with normal PbB was associated with anemia and iron deficiency.
Conclusions:
- EP is a viable screening tool for lead poisoning in children.
- Elevated EP may indicate lead exposure and associated health risks, including anemia.
- Further investigation into tribal practices is warranted to understand their contribution to lead exposure.
Abstract:
Screening for lead poisoning can be performed by measuring either blood lead (PbB) or a haematological indicator such as erythrocyte protoporphyrin (EP). We have screened 902 infants and children aged from 3 months to 5 years amongst those attending three primary health care centres in AI Jahra governorate of Kuwait. Blood specimens were collected by finger prick on Guthrie filter paper and the dried blood samples were mailed to the Central Laboratory of the Children's Hospital, Buffalo, USA. One hundred and eighty-four (20 per cent) had an elevated EP (greater than 50 micrograms/dl). Of those 11 had values above 159 micrograms/dl; 140 children were further tested for blood lead levels (PbB) haemoglobin, mean cell volumes, and percentage of transferrin saturation; 41 had blood lead levels greater than 25 micrograms/dl which is the current definition of elevated blood lead levels. Two children (2 per cent) were in Class IV, 17 (15 per cent) and 16 (14 per cent) were in Class II and Class III, respectively. There was a significant correlation between EP and PbB (r = 0.686; P = less than 0.001). Of 72 children with elevated EP and normal PbB, 32 were anaemic (Hb less than 11 g/dl) and 20 had iron deficiency. The role of tribal practices using lead contaminated preparations and their contribution to elevated blood lead levels is discussed.