Primary prevention of pediatric lead exposure requires new approaches to transfusion screening

Eric Gehrie, Amaris Keiser, Sheila Dawling, James Travis, Frederick G. Strathmann, Garrett S. Booth

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To facilitate further assessment of transfusion-associated lead exposure by designing a procedure to test packed red blood cells (pRBCs) prepared for transfusion. Study design: The relationship between pRBCs and whole blood lead concentration was investigated in 27 samples using a modified clinical assay. Lead concentrations were measured in 100 pRBC units. Results: Our sample preparation method demonstrated a correlation between whole blood lead and pRBC lead concentrations (R2 = 0.82). In addition, all 100 pRBC units tested had detectable lead levels. The median pRBC lead concentration was 0.8 μg/dL, with an SD of 0.8 μg/dL and a range of 0.2-4.1 μg/dL. In addition, after only a few days of storage, approximately 25% of whole blood lead was found in the supernatant plasma. Conclusion: Transfusion of pRBCs is a source of lead exposure. Here we report the quantification of lead concentration in pRBCs. We found a >20-fold range of lead concentrations in the samples tested. Pretransfusion testing of pRBC units according to our proposed approach or donor screening of whole blood lead and selection of below-average units for transfusion to children would diminish an easily overlooked source of pediatric lead exposure.

Original languageEnglish (US)
Pages (from-to)855-859
Number of pages5
JournalJournal of Pediatrics
Volume163
Issue number3
DOIs
StatePublished - Sep 1 2013
Externally publishedYes

Keywords

  • CDC
  • Centers for Disease Control and Prevention
  • ICP-MS
  • Inductively coupled plasma mass spectrometry
  • Packed red blood cell
  • VUMC
  • Vanderbilt University Medical Center
  • WHO
  • World Health Organization
  • pRBC

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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