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Lead and Mercury Levels in Preterm Infants Before and After Blood Transfusions

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Abstract

Very low birth weight (VLBW) infants usually receive packed red blood cell unit (pRBC) transfusions. Heavy metal transfer via pRBCs is not widely discussed before. This study aimed to determine pre-/post-transfusion erythrocyte lead and mercury levels in infants and to correlate these levels to heavy metal concentrations in pRBCs. VLBW infants (n = 80), needing pRBC transfusion for the first time, were enrolled. Erythrocyte heavy metal levels were determined in pre-/post-transfusion blood samples and also in pRBC units. Mean lead and mercury levels in the pRBCs were found to be 16.3 ± 10.8 and 3.75 ± 3.23 μg/L, respectively. Of the infants, 69.7% received lead above reference dose. Erythrocyte lead levels increased significantly after transfusions (10.6 ± 10.3 vs. 13 ± 8.5, p < 0.05) with significant correlated to amount of lead within pRBCs (r = 0.28). Mean pre-/post-transfusion erythrocyte mercury levels were 3.28 ± 3.08 and 3.5 ± 2.83 μg/L, respectively (p > 0.05). There was a significant correlation between mean difference of mercury levels after transfusion and amount of mercury delivered by pRBCs (r = 0.28). Infants can be subject to high levels of lead and mercury through pRBC transfusions.

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Abbreviations

ATSDR:

Agency for Toxic Substances and Disease Registry

CDC:

Centers for Disease Control and Prevention

CI:

Confidence interval

CL:

Confidence level

CPDA-1:

Citrate-phosphate-dextrose-adenine

ELBW:

Extremely low birth weight

EPA:

Environmental Protection Agency

IQ:

Intelligence quotient

JECFA:

the Joint Food and Agriculture Organization/World Health Organization Expert Committee

LOD:

Limit of detection

NHANES:

National Health and Nutrition Examination Survey

NICU:

Neonatal intensive care unit

OSHA:

the US Occupational Safety and Health Administration

pRBC:

packed red blood cell unit

RfD:

Reference dose

VLBW:

Very low birth weight

WHO:

World Health Organization

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Acknowledgements

We would like to thank Düzen Laboratories for their support in the measurement of erythrocyte mercury levels. This study is supported by Turkish Pediatric Association.

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Authors and Affiliations

  1. School of Medicine, Department of Pediatrics, Gaziosmanpasa University, Tokat, Turkey

    Sahin Takci

  2. Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey

    Ali Asci, Pinar Erkekoglu & Belma Kocer-Gumusel

  3. Faculty of Pharmacy, Department of Toxicology, Atatürk University, Erzurum, Turkey

    Ali Asci

  4. Faculty of Medicine, İhsan Dogramaci Children’s Hospital, Neonatology Unit, Hacettepe University, Ankara, Turkey

    Sule Yiğit & Murat Yurdakök

  5. Faculty of Pharmacy, Department of Toxicology, Lokman Hekim University, Ankara, Turkey

    Belma Kocer-Gumusel

Authors
  1. Sahin Takci
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  2. Ali Asci
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  3. Pinar Erkekoglu
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  4. Sule Yiğit
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Corresponding author

Correspondence to Belma Kocer-Gumusel.

Ethics declarations

The study was approved by Hacettepe University Human Ethics Committee (HEK 11/18-7).

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The authors declare that they have no conflicts of interest.

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Takci, S., Asci, A., Erkekoglu, P. et al. Lead and Mercury Levels in Preterm Infants Before and After Blood Transfusions. Biol Trace Elem Res 188, 344–352 (2019). https://doi.org/10.1007/s12011-018-1436-5

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  • DOI: https://doi.org/10.1007/s12011-018-1436-5

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