Paediatric Blood Lead Levels and its Correlation with Anaemia: A Study from Central India

Abstract

Introduction: Lead is a toxic element used commonly in many products like lead-acid batteries, paints, toys etc. Young children are particularly vulnerable to lead poisoning because of higher absorption capacity in comparison of adults. Safe level of lead exposure has to be established yet. Literature suggests a threshold lead level of 20-40 μg/dL for a decrease in haemoglobin in children. Aim: To assess the correlation between Blood Lead Levels (BLL) and anaemia in children. Materials and Methods: This cross-sectional study was conducted in a Paediatric Tertiary Care Hospital of Gwalior, Madhya Pradesh, India, during the period of May 2019 to September 2020. A 81 children between one to five years of age were included in study. Information was collected regarding general profile of the children and other parameters like socio- economic status (Modified Kuppuswamy scale), history of pica, application of surma, type of toys used, scholastic performance and somatic symptoms. Routine blood investigations were done including Haemoglobin (Hb) and BLL through venous blood sampling. BLL were done at Defense Research and Development Establishment (DRDE) Gwalior. Data entry was done in Microsoft Office Excel 2010 and analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0. Chi-square test with Yates correlation was applied and p-value <0.05 was considered statistically significant. Results: Among 81 study subjects, 53 were males and 28 were females. Total 48 (59.2%) children had Hb <11 gm/dL, 42 (51.8%) children had BLL <5 μg/dL and 32 (39.5%) had BLL between 5-10 μg/dL. There were 9% children (n=7) with BLL more than 10 μg/dL and none beyond 15 μg/dL. In the children it was found to have BLL ≥5 μg/dL, 20 children had Hb levels between 7-11 gm/dL whereas 19 had Hb levels above 11 gm/ dL. No statistically significant association was found between the BLL and childhood anaemia. Conclusion: This study did not show any relationship between BLL and Hb in children of age one to five years. Scarcity of diagnostic tools for detecting BLL and lack of public awareness regarding the probable sources of lead and its complications may result in missing the diagnosis.