Today we will be discussing lead levels in blood donors. Babies and young children are particularly susceptible to the neurotoxic effects of lead exposure. Chronic developmental exposure to high lead levels can lead to lower IQ, behavioral problems, and developmental delays. While deteriorating lead paint is the primary exposure for children, another concerning route is blood transfusion.
Dr. Delage explains:
“There are certain studies that have suggested that newborns, particularly premature newborns, can be exposed to high levels of lead through transfusion.”
Little is known, however, about the prevalence of lead in blood donors or the effects after transfusion. To this end, Dr. Delage and his research team screened lead levels in almost 3,500 blood donors in Quebec and found that over 15% of donors have high lead levels. Increased blood lead levels were significantly more common in older individuals and men.
Dr. Carey , who wrote an editorial in TRANSFUSION on the subject, comments:
“The study demonstrates that community blood donors are capable of harboring elevated levels of lead in their blood that might be harmful when transfused to a vulnerable patient population. The question arises if measuring blood levels becomes a new safety challenge in transfusion medicine.”
Measuring lead levels in blood, however, costs up to $80 per assay and requires specialized equipment. Dr. Delage suggests that the transfusion community may want to consider using donor characteristics to inform screening criteria. By using blood donors less than 33 years old, they could prevent 78% of the risk and still have almost 20% of donations available for premature infants.
Dr. Delage adds:
“The advantage of using donor characteristics is that you have got the information at your fingertip, and you can immediately select the units that you are going to reserve for those vulnerable populations. It does create a little bit of complexity in terms of the logistics of your blood inventory, but it can be simpler than screening.”
However, large epidemiologic studies are needed to determine community-based lead exposure levels. Additional studies are also needed to inform regulations for safe lead levels in blood transfusions.
We’ll be back with another edition of Transfusion News on November 30th. Thanks for joining us.
- Newman N, Carey PM. Donor blood lead levels and transfusion safety in a vulnerable population. Transfusion 2015;55: 2544–2546.
- Delage G, Gingras S, Rhainds M. A population-based study on blood lead levels in blood donors. Transfusion 2015;55: 2633–2640.