Trends in Blood Lead Levels Quantified by ICP-MS: A Reference Laboratory Retrospective Study

Abstract

Abstract Background Exposure to lead may cause severe adverse effects such as anemia, neurologic damage, developmental disorders, and reproductive disorders. Consequently, in 2021, the Centers for Disease Control and Prevention (CDC) reduced its blood lead reference value from 5 µg/dL to 3.5 µg/dL in pediatric patients, 1 to 5 years old. The objective of this study was to perform a retrospective analysis of patient blood lead concentrations reported by ARUP Laboratories to evaluate the frequency of blood lead concentrations greater than 3.5 µg/dL. Methods The analysis of blood lead concentration was performed in venous whole blood specimens using inductively coupled plasma mass spectrometry (ICP-MS). In addition, retrospective data analysis was performed to evaluate zinc protoporphyrin (ZPP) concentrations in adult patients with corresponding lead results, using the lead industrial exposure panel. The analysis for ZPP was performed using quantitative hematofluorometry. Results Retrospective data analysis identified a decline in blood lead concentrations from 2012 to 2021 for pediatric and adult patients. The calculated nonparametric 95% range for ZPP blood was 15 to 43 μg/dL and the ZPP heme ratio 26 to 74 μmol ZPP/mol heme. Conclusions Lowering the blood lead reference value (BLRV) to 3.5 μg/dL presents an opportunity for healthcare providers and public health agencies to extend medical or environmental interventions for lead exposure in pediatric patients.