Volume 22, Issue 1 (Spring 2025)
Sci J Iran Blood Transfus Organ 2025, 22(1): 80-89 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Pourmokhtar M, Teimourpour A, Banazadeh S. Determination of blood concentrations of lead, mercury and cadmium in blood donors: A systematic review and meta-analysis. Sci J Iran Blood Transfus Organ 2025; 22 (1) :80-89
URL: http://bloodjournal.ir/article-1-1566-en.html
URL: http://bloodjournal.ir/article-1-1566-en.html
Abstract: (241 Views)
Abstract
Background and Objectives
Exposure to lead, mercury, and cadmium is a serious threat to individuals. On the other hand, transfusions of blood and blood products are hidden and potential sources of exposure to these metals. Therefore, this study was conducted to determine the blood concentrations of these metals in blood donors.
Materials and Methods
In a Systematic review, PubMed, Scopus, Web of Science, and ProQuest databases were searched online until the end of July 2023, using the keywords Lead, Mercury, Cadmium, Pb, Hg, Cd, and “blood donor”. After screening and selecting relevant articles based on inclusion and exclusion criteria, data were extracted. In order to integrate the results of the primary studies and calculate the final mean, a Random-Effects Model was used, and the mean and standard deviation were considered as the effect size. Statistical calculations were performed using R software and the meta package.
Results
The mean blood concentrations of lead, mercury, and cadmium in blood donors worldwide were 4.85 (μg/dL), 0.154 (μg/dL), and 0.0595 (μg/dL), respectively. The mean blood concentration of lead in blood donors worldwide decreased by an average of 2.27 (μg/dL) per year. Thus, the time of the study was identified as an important and influential factor in explaining the mean blood concentration of lead in blood donors worldwide (p= 0.0018).
Conclusions
Deciding on the necessity of screening blood donors for lead still requires further preliminary studies, especially in donors from high-risk areas or specific occupations. While this screening does not seem necessary for cadmium and mercury.
References
1. Odland JØ, Donaldson S, Dudarev A, Carlsen A. AMAP assessment 2015: human health in the Arctic. Int J Circumpolar Health 2016; 75: 33949. [DOI:10.3402/ijch.v75.33949] [PMID] []
2. EPA US. Persistent organic pollutants: a global issue. A global response; 2014. Available from: https://www.epa.gov/international-cooperation/persistent-organic-pollutants-global-issue-global-response.
3. WHO. Air pollution. 2019; Available from: ttps://www.who.int/airpollution/en/.
4. EEA. Consumption of hazardous chemicals; 2018, Available from: https://www.eea.europa.eu /airs/ 2018 / environment-and-health/production-ofhazardous-chemicals.
5. Grandjean P, Landrigan PJ. Neurobehavioural effects of developmental toxicity. Lancet Neurol 2014; 13(3): 330-8. [DOI:10.1016/S1474-4422(13)70278-3] [PMID]
6. Hassan L, Moser A, Rorman E, Groisman L, Naor Y, Shinar E, et al. Human biologic monitoring based on blood donations to the National Blood Services. BMC Public Health 2020; 20(1): 469. [DOI:10.1186/s12889-020-08588-7] [PMID] []
7. Aliomrani M, Sahraian MA, Shirkhanloo H, Sharifzadeh M, Khoshayand MR, Ghahremani MH. Blood concentrations of cadmium and lead in multiple sclerosis patients from Iran. IJPR 2016; 15(4): 825-33.
8. Iarc Monographs On The Identification Of Carcinogenic Hazards To Humans. [Online] International Agency for Reserach on Cancer, September 23, 2019. [Cited: October 2, 2019.] Available from: https:// monographs. iarc. fr/ agentsclassified-by-the-iarc/.
9. Nemsadze K, Sanikidze T, Ratiani L, Gabunia L, Sharashenidze T. Mechanisms of lead-induced poisoning. Georgian Med News 2009; (172-173): 92-6.
10. National Toxicology Program. NTP monograph on health effects of low-level lead. NTP Monogr 2012; (1):xiii, xv-148.
11. Bellinger DC. Prenatal exposures to environmental chemicals and children's neurodevelopment: an update. Saf Health Work 2013; 4: 1-11. [DOI:10.5491/SHAW.2013.4.1.1] [PMID] []
12. Hong YS, Kim YM, Lee KE. Methylmercury exposure and health effects. J Prev Med Public Health 2012; 45: 353. [DOI:10.3961/jpmph.2012.45.6.353] [PMID] []
13. Nigg JT, Knottnerus GM, Martel MM, Nikolas M, Cavanagh K, Karmaus W, et al. Low blood lead levels associated with clinically diagnosed attention-deficit/hyperactivity disorder and mediated by weak cognitive control. Biol Psychiatry 2008; 63(3): 325-31. [DOI:10.1016/j.biopsych.2007.07.013] [PMID] []
14. Banerjee TD, Middleton F, Faraone SV. Environmental risk factors for attention‐deficit hyperactivity disorder. Acta Paediatr 2007; 96(6): 69-74. [DOI:10.1111/j.1651-2227.2007.00430.x] [PMID]
15. Frye RE, Casanova MF, Fatemi SH, Folsom TD, Reutiman TJ, Brown GL, et al. Neuropathological mechanisms of seizures in autism spectrum disorder. Front Neurosci 2016; 10: 192. [DOI:10.3389/fnins.2016.00192]
16. Sanders T, Liu Y, Buchner V, Tchounwou PB. Neurotoxic effects and biomarkers of lead exposure: a review. Rev Environ Health 2009; 24: 15-45. [DOI:10.1515/REVEH.2009.24.1.15] [PMID] []
17. Khanna MM. Boys, not girls, are negatively affected on cognitive tasks by lead exposure: a pilot study. J Environ Health 2015; 77: 72-7.
18. Patrick L. Lead toxicity, a review of the literature. Part I:exposure, evaluation, and treatment. Altern Med Rev 2006; 11(1): 2-23.
19. Rempel D. The lead-exposed worker. JAMA 1989; 262(4): 532-4. [DOI:10.1001/jama.1989.03430040104034]
20. Bellinger D, Leviton A, Waternaux C, Needleman H, Rabinowitz M. Longitudinal analyses of prenatal and postnatal lead exposure and early cognitive development. N Engl J Med 1987; 316: 1037-43. [DOI:10.1056/NEJM198704233161701] [PMID]
21. Hu H, Téllez-Rojo MM, Bellinger D, Smith D, Ettinger AS, Lamadrid-Figueroa H, et al. Fetal lead exposure at each stage of pregnancy as a predictor of infant mental development. Environ Health Perspect 2006; 114(11): 1730-5. [DOI:10.1289/ehp.9067] [PMID] []
22. Schnur J, John RM. Childhood lead poisoning and the new Centers for Disease Control and Prevention guidelines for lead exposure. J Am Assoc Nurse 2014; 26(5): 238-47. [DOI:10.1002/2327-6924.12112] [PMID]
23. Sowers M, Jannausch M, Scholl T, Li W, Kemp FW, Bogden JD. Blood lead concentrations and pregnancy outcomes. Arch Environ Health 2002; 57(5): 489-95. [DOI:10.1080/00039890209601442] [PMID]
24. Borja-Aburto VH, Hertz-Picciotto I, Lopez MR, Farias P, Rios C, Blanco J. Blood lead levels measured prospectively and risk of spontaneous abortion. Am J Epidemiol 1999; 150(6): 590-7. [DOI:10.1093/oxfordjournals.aje.a010057] [PMID]
25. Cheng L, Zhang B, Huo W, Cao Z, Liu W, Liao J, et al. Fetal exposure to lead during pregnancy and the risk of preterm and early-term deliveries. Int J Hyg Environ Health 2017; 220(6): 984-9. [DOI:10.1016/j.ijheh.2017.05.006] [PMID]
26. Bellinger DC. Teratogen update: lead and pregnancy. Birth Defects Res A Clin Mol Teratol 2005; 73(6): 409-20. [DOI:10.1002/bdra.20127] [PMID]
27. Zhu M, Fitzgerald EF, Gelberg KH, Lin S, Druschel CM. Maternal low-level lead exposure and fetal growth. Environ Health Perspect 2010; 118(10): 12-9. [DOI:10.1289/ehp.0901561] [PMID] []
28. Averina M. Environmental pollutants in blood donors: The multicentre Norwegian donor study. Transfus Med 2020; 30: 201-9. [DOI:10.1111/tme.12662] [PMID]
29. Agyemang V, Acquaye JK, Harrison SBE, Oppong FB, Gyaase S, Asante KP, et al. Blood Lead Levels among Blood Donors and High-Risk Occupational Groups in a Mining Area in Ghana: Implications for Blood Transfusion among Vulnerable Populations. J Trop Med 2020; 2020: 6718985. [DOI:10.1155/2020/6718985] [PMID] []
30. Delage G, Gingras S, Rhainds M. A population-based study on blood lead levels in blood donors. Transfusion 2015; 55: 2633-40. [DOI:10.1111/trf.13199] [PMID]
31. Zubairi H, Visintainer P, Fleming J, Richardson M, Singh R. Lead exposure in preterm infants receiving red blood cell transfusions. Pediatr Res 2015; 77(6): 814-8. [DOI:10.1038/pr.2015.53] [PMID]
32. Elabiad MT, Christensen M. Changes in premature infant mercury and lead blood levels after blood transfusions. Am J Perinatol 2014; 31(10): 863-8. [DOI:10.1055/s-0033-1361936] [PMID]
33. Bearer CF, O'Riordan MA, Powers R. Lead exposure from blood transfusion to premature infants. J Pediatr 2000; 137(4): 549-54. [DOI:10.1067/mpd.2000.108273] [PMID]
34. Bearer CF, Linsalata N, Yomtovian R, Walsh M, Singer L. Blood transfusions: a hidden source of lead exposure. Lancet 2003; 362: 332. [DOI:10.1016/S0140-6736(03)13989-X] [PMID]
35. Dignam T, Kaufmann RB, LeStourgeon L, Brown MJ. Control of lead sources in the United States, 1970-2017: public health progress and current challenges to eliminating lead exposure. JPHMP 2019; 25(Suppl): 13-22. [DOI:10.1097/PHH.0000000000000889] [PMID] []
36. Ghorani-Azam A, Riahi-Zanjani B, Balali-Mood M. Effects of air pollution on human health and practical measures for prevention in Iran. J Res Med Sci 2016; 21(5): 1-12. [DOI:10.4103/1735-1995.189646] [PMID] []
37. Han Z, Guo X, Zhang B, Liao J, Nie L. Blood lead levels of children in urban and suburban areas in China (1997-2015): Temporal and spatial variations and influencing factors. Sci Total Environ 2018; 625(12): 1659-66. [DOI:10.1016/j.scitotenv.2017.12.315] [PMID]
38. Oulhote Y, Le Bot B, Poupon J, Lucas J-P, Mandin C, Etchevers A, et al. Identification of sources of lead exposure in French children by lead isotope analysis: a cross-sectional study. J Environ Health 2011; 10(1): 1-12. [DOI:10.1186/1476-069X-10-75] [PMID] []
39. Obeng-Gyasi E. Sources of lead exposure in various countries. Rev Environ Health 2019; 34(1): 25-34. [DOI:10.1515/reveh-2018-0037] [PMID]
40. Pelc W, Pawlas N, Dobrakowski M, Kasperczyk S. Environmental and socioeconomic factors contributing to elevated blood lead levels in children from an industrial area of Upper Silesia. Environ Toxicol Chem 2016; 35(10): 2597-603. [DOI:10.1002/etc.3429] [PMID]
41. Azami M, Tardeh Z, Mansouri A, Soleymani A, Sayehmiri K. Mean blood lead level in Iranian workers: A systematic and meta-analysis. Iran Red Crescent Med J 2018; 20(1): 1-8. [DOI:10.5812/ircmj.64172]
42. Rashid A, Bhat RA, Qadri H, Mehmood MA. Environmental and socioeconomic factors induced blood lead in children: an investigation from Kashmir, India. Environ Monit Assess 2019; 191(2): 76. [DOI:10.1007/s10661-019-7220-y] [PMID]
43. Ericson B, Hu H, Nash E, Ferraro G, Sinitsky J, Taylor MP. Blood lead levels in low-income and middle-income countries: a systematic review. Lancet Planet Health 2021; 5(3): e145-e53. [DOI:10.1016/S2542-5196(20)30278-3] [PMID]
44. Andrews J. The time has come to mitigate the risk of lead exposure from blood transfusions. Pediatr Res 2019; 85(1): 7-8. [DOI:10.1038/s41390-018-0218-2] [PMID]
45. World Health Organization, Childhood Lead Poisoning: World Health Organization, 2010; Available from: http:// www. who. int/ceh/ publications/ leadguidance.pdf.
46. Falck AJ, Sundararajan S, Al-Mudares F, Contag SA, Bearer CF. Fetal exposure to mercury and lead from intrauterine blood transfusions. Pediatr Res 2019; 86(4): 510-4. [DOI:10.1038/s41390-019-0463-z] [PMID]
47. Gehrie E, Keiser A, Dawling S, Travis J, Strathmann FG, Booth GS. Primary prevention of pediatric lead exposure requires new approaches to transfusion screening. J Pediatr 2013; 163(3): 855-9. [DOI:10.1016/j.jpeds.2013.03.003] [PMID] []
48. Janicka M, Binkowski ŁJ, Błaszczyk M, Paluch J, Wojtaś W, Massanyi P, et al. Cadmium, lead and mercury concentrations and their influence on morphological parameters in blood donors from different age groups from southern Poland. J Trace Elem Med Biol 2015; 29: 342-6. [DOI:10.1016/j.jtemb.2014.10.002] [PMID]
49. Elabiad MT, Hook RE. Lead content of blood transfusions for extremely low-birth-weight infants. Am J Perinatol 2013; 30(9): 765-9. [DOI:10.1055/s-0032-1332803] [PMID]
50. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2015; 4(1): 1-9. [DOI:10.1136/bmj.g7647] [PMID]
51. WHO, World Health Organization. Blood donor selection: guidelines on assessing donor suitability for blood donation. Available from: http://www.who.int/bloodsafety/publications/bts_guideline1/en/index.html; 2012. [accessed 01 June 2020].
52. Chassé M, McIntyre L, English SW, Tinmouth A, Knoll G, Wolfe D, et al. Effect of Blood Donor Characteristics on Transfusion Outcomes: A Systematic Review and Meta-Analysis. Transfus Med Rev 2016; 30(2): 69-80. [DOI:10.1016/j.tmrv.2016.01.002] [PMID]
53. Maximova N, Zanon D, Pascolo L, Zennaro F, Gregori M, Grosso D, et al. Metal accumulation in the renal cortex of a pediatric patient with sickle cell disease: A case report and review of the literature. J Pediatr Hematol Oncol 2015; 37: 311-4. [DOI:10.1097/MPH.0000000000000322] [PMID]
54. Agency for Toxic Substances and Disease Registry. Toxicological Profile for Nickel (Update). Atlanta, GA: US Department of Public Health and Human Services, Public Health Service. Available from: http:/www.atsdr.cdc.gov; 2005.
55. Chervona Y, Arita A, Costa M. Carcinogenic metals and the epigenome: understanding the effect of nickel, arsenic, and chromium. Metallomics 2012; 4: 619-27. [DOI:10.1039/c2mt20033c] [PMID] []
56. WHO (2020). Global elimination of lead paint: why and how countries should take action: technical brief. Available from: https://apps.who.int/iris/handle/10665/333840.
57. Public health impact of chemicals: knowns and unknowns-2021 data addendum Available from: https://www.who.int/publications/i/item/WHO-HEP-ECH-EHD-21.01.
58. UN Environment Program. Final review of scientific information on lead [Internet]. 2010. Available from: http://www.cms.int/sites/default/files/document/UNEP_GC26_INF_11_Add_1_Final_UNEP_Lead_review_and_apppendix_Dec_2010.pdf [Accessed 2017 May 23].
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
