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Hadjesfandiari N, Serrano K, Richardson-Sanchez T, Barakauskas VE, Yi QL, Murphy M, Devine DV. Measurement of lead, mercury, and cadmium in blood donors in Canada. Transfusion 2024; 64:1243-1253. [PMID: 38752406 DOI: 10.1111/trf.17872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 04/03/2024] [Accepted: 05/01/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Fetal and neonatal exposure to lead is associated with irreversible adverse effects on neural development. There is no reliable threshold for lead effect, so limiting exposure is recommended. A significant correlation has been reported between post-transfusion blood lead level (BLL) in infants and lead levels in transfused RBC units. We measured levels of lead, mercury, and cadmium, in Canadian donor blood to investigate if concerning levels for neonatal transfusion exist. STUDY DESIGN AND METHODS Whole blood samples from blood donors (n = 2529) were shipped cold within 7 days of donation. All permanent blood donation clinics across Canada were sampled. Twelve of these permanent clinics and 8 mobile clinics with a greater potential for having higher lead or mercury levels were oversampled. Heavy metals were measured by inductively coupled plasma mass spectrometry. RESULTS Of all donations, 2.2% (lead) and 0.4% (mercury) had levels higher than the recommended thresholds for safe neonatal transfusion. BLLs were higher in males but there was no significant difference in the blood mercury levels of males versus females. Cadmium levels were higher in females. There was a positive correlation between donor age and levels of heavy metals, with lead having the strongest correlation (r = 0.47, p < .0001). Three clinics in close proximity to two lead-producing mines were among the clinics with the highest BLLs. Significantly higher blood mercury levels were observed in coastal clinics. CONCLUSION Our data on donor blood heavy metal levels supports considering blood transfusion as an exposure source to heavy metals and encourages informed selection of blood units for transfusion to vulnerable groups.
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Affiliation(s)
- Narges Hadjesfandiari
- Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine Serrano
- Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tomas Richardson-Sanchez
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vilte E Barakauskas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- BC Children's and Women's Hospital, Vancouver, British Columbia, Canada
| | - Qi-Long Yi
- Donor & Clinical Services, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Michael Murphy
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dana V Devine
- Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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2
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Aly SM, Elfiky S, Mohamed YG, Soliman RAM, Shalaby N, Beauval N, Gaulier JM, Allorge D, Omran A. Lead, Mercury, and Cadmium Concentrations in Blood Products Transfused to Neonates: Elimination Not Just Mitigation. TOXICS 2023; 11:712. [PMID: 37624217 PMCID: PMC10458708 DOI: 10.3390/toxics11080712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
Lead (Pb), mercury (Hg), and cadmium (Cd) are identified as potent developmental neurotoxicants. Neonates are the main group receiving multiple blood transfusions. The exposure of neonates to these heavy metals (HMs) can occur through blood transfusions. This study aimed to determine the concentrations of lead (Pb), mercury (Hg), and cadmium (Cd) in various blood products (plasma, platelets, packed red blood cells (pRBCs), and whole blood (WB)) to explore the probability of concurrent exposure of these HMs and to identify the metal load per transfusion with risk assessment. Residual bloods from blood bank bags were collected after neonatal transfusion. Pb, Hg, and Cd concentrations were determined in 120 samples of blood products by inductively coupled plasma mass spectrometry (ICP-MS). Pb and Cd levels were over the normal levels in 19.2 and 5.9% of all blood units, respectively. In 35 and 0.8% of blood units, the Pb and Cd concentrations, respectively, were higher than that recommended for transfusions in premature neonates. The anticipated safe value was surpassed by 2.5% for Cd of all transfusions, primarily because of WB. However, Hg was detected only in 5.8% of all samples and their concentrations were within the normal range. The concurrent neonatal exposure to Pb, Hg, and Cd was statistically significant. Hazard quotients of Hg and Cr were >1 and Pb cancer risk was 2.41 × 10-4. To the best of our knowledge, this study is the first report examining Pb, Hg, and Cd in blood products other than WB and pRBCs using ICP-MS. This study demonstrated the exposure of neonates to Pb, Hg, and Cd during transfusion with a considerable amount of Pb. It confirms the significant concurrent exposure to the three HMs, which maximize their potential developmental neurotoxicity with a high probability of developing non-carcinogenic and carcinogenic health effects.
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Affiliation(s)
- Sanaa M. Aly
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- CHU Lille, Service de Toxicologie-Génopathies, F-59000 Lille, France
| | - Samar Elfiky
- Department of Pediatrics and Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Yasmine G. Mohamed
- Department of Pediatrics and Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Radwa A. M. Soliman
- Department of Pediatrics and Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Nancy Shalaby
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Damietta University, New Damietta 34517, Egypt
| | - Nicolas Beauval
- CHU Lille, Service de Toxicologie-Génopathies, F-59000 Lille, France
- Université de Lille, ULR 4483—IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France
| | - Jean-Michel Gaulier
- CHU Lille, Service de Toxicologie-Génopathies, F-59000 Lille, France
- Université de Lille, ULR 4483—IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France
| | - Delphine Allorge
- CHU Lille, Service de Toxicologie-Génopathies, F-59000 Lille, France
- Université de Lille, ULR 4483—IMPECS—IMPact de l’Environnement Chimique sur la Santé Humaine, F-59000 Lille, France
| | - Ahmed Omran
- Department of Pediatrics and Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
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Wang J, Wang Y, Zhou W, Huang Y, Yang J. Impacts of cigarette smoking on blood circulation: do we need a new approach to blood donor selection? JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:62. [PMID: 37408051 DOI: 10.1186/s41043-023-00405-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/28/2023] [Indexed: 07/07/2023]
Abstract
Smoking is a major public health problem and is considered the leading cause of preventable death worldwide. Gas-phase smoke carries bioactive substances and toxic compounds, affecting human health and reducing life spans. The negative effects of smoking on red blood cell (RBC) quality include destroying RBCs and increasing carboxy hemoglobin (COHb). Smoking increases the concentrations of heavy metals such as cadmium (Cd) and lead (Pb) in the blood. Moreover, tobacco smoking has been found to be associated with heightened platelet (PLT)-dependent thrombin level which will induce a prothrombotic state. Smoking may affect the blood circulation of donors, and subsequently the blood components, and ultimately the recipients of transfusion. Nevertheless, there are no restrictions on smoking for volunteer blood donor screenings currently. We reviewed the articles about the influence of smoking on smokers' blood circulation as well as the impact of donated blood products on transfusion when these smokers act as blood donors. We aim to attract blood collection centers' attention to strengthen the management of blood donors who smoke, avoiding their use in massive transfusion protocol and susceptible recipients, especially pediatric ones.
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Affiliation(s)
- Jie Wang
- Department of Transfusion, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, People's Republic of China
| | - Yuhan Wang
- Department of Laboratory Medicine, Luzhou Longmatan District People's Hospital, Luzhou, 625000, Sichuan Province, People's Republic of China
| | - Weixin Zhou
- Department of Transfusion, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, People's Republic of China
| | - Yuanshuai Huang
- Department of Transfusion, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, People's Republic of China
| | - Jianbo Yang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, People's Republic of China.
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O'Callaghan-Gordo C, Rosales J, Lizárraga P, Barclay F, Okamoto T, Papoulias DM, Espinosa A, Orta-Martinez M, Kogevinas M, Astete J. Blood lead levels in indigenous peoples living close to oil extraction areas in the Peruvian Amazon. ENVIRONMENT INTERNATIONAL 2021; 154:106639. [PMID: 34103202 DOI: 10.1016/j.envint.2021.106639] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 04/21/2021] [Accepted: 05/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND High blood lead levels (BLLs) have been previously reported in indigenous people living in communities in the northern Peruvian Amazon. Oil extraction activities have been conducted in the area since the 1970s and have been identified as a source of lead exposure. OBJECTIVE Measure BLL and assess risk factors associated with BLL among indigenous populations from four river basins of the northern Peruvian Amazon. METHODS Participants from 39 communities were selected using a two-stage stratified random selection strategy and were visited between May and June 2016. Information on risk factors was collected using structured questionnaires and blood samples were taken. Overall, complete information was available from 1047 individuals (309 < 12 years old, 738 ≥ 12 years). BLL was determined using atomic absorption spectrophotometry in a graphite chamber. Weighted linear logistic regression models were used to study the association between socio-demographic variables, self-reported life-style factors, environmental, geographical and occupational exposures and BLLs. RESULTS Geometric mean (95% CI) BLL was 4.9 (4.5, 5.4) µg/dL in participants <12 years and 5.7 (5.4, 6.0) µg/dL in older participants. There were marked differences in BLL between river basins with the highest levels observed in the Corrientes river basin [8.1 (7.2, 9.1) µg/dL <12 years and 8.8 (8.0, 9.6) µg/dL older participants]. High BLL was associated with older age, being male, living in the Pastaza, Tigre or Corrientes river basins and consumption of fish offal in children and adults. Increased Euclidean distance between residence and oil production facilities was associated with a small reduction in BLL. CONCLUSION BLLs that pose a health risk were detected in the study population of a non-industrialized and remote area of the Amazon. The highest BLLs were observed in those river basins where relative oil extraction activity and environmental levels of contaminants have been reported to be greatest.
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Affiliation(s)
- Cristina O'Callaghan-Gordo
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Jaime Rosales
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Peru
| | - Pilar Lizárraga
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Peru
| | - Frederica Barclay
- Centro de Políticas Públicas y Derechos Humanos - Perú Equidad, Peru
| | - Tami Okamoto
- Department of Geography, University of Cambridge, Cambridge, UK
| | | | - Ana Espinosa
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Martí Orta-Martinez
- Facultat de Ciències i Tecnologia, Universitat Central de Catalunya-Universitat de Vic, Barcelona, Catalonia, Spain; Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Instituto de Geografía, Universidad San Francisco de Quito, Quito, Ecuador
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - John Astete
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Peru
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Current Understanding of the Relationship between Blood Donor Variability and Blood Component Quality. Int J Mol Sci 2021; 22:ijms22083943. [PMID: 33920459 PMCID: PMC8069744 DOI: 10.3390/ijms22083943] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/19/2022] Open
Abstract
While differences among donors has long challenged meeting quality standards for the production of blood components for transfusion, only recently has the molecular basis for many of these differences become understood. This review article will examine our current understanding of the molecular differences that impact the quality of red blood cells (RBC), platelets, and plasma components. Factors affecting RBC quality include cytoskeletal elements and membrane proteins associated with the oxidative response as well as known enzyme polymorphisms and hemoglobin variants. Donor age and health status may also be important. Platelet quality is impacted by variables that are less well understood, but that include platelet storage sensitive metabolic parameters, responsiveness to agonists accumulating in storage containers and factors affecting the maintenance of pH. An increased understanding of these variables can be used to improve the quality of blood components for transfusion by using donor management algorithms based on a donors individual molecular and genetic profile.
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Blood donation and heavy metal poisoning in developing nations: Any link? Transfus Apher Sci 2021; 60:103067. [PMID: 33541762 DOI: 10.1016/j.transci.2021.103067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 11/24/2022]
Abstract
Long term health effects of heavy metal exposure from both occupational and environmental settings involve multi-organ toxicities including but not limited to disturbances of neurological, cognitive, and metabolic processes, immune system dysregulation, carcinogenesis and sometimes permanent disabilities. Humans are exposed to toxic metals through various sources and routes of entry. The risk of heavy metal poisoning from donor blood has been the subject of many scientific investigations. In this review we highlight how the access to a safe and adequate blood transfusion with minimal risk of toxic metals to recipients is a public health challenge, especially in developing nations. For quality assurance purposes, blood donors are screened for various blood-borne pathogens, but screening for toxic metal levels is not routine. Evidence from scientific studies used in this review lends credence to the risk of heavy metal poisoning from donors with high blood concentrations of these heavy metals. The risk of toxicity is exceptionally high in vulnerable populations such as neonates and preterm infants, as well as in pregnant women and other individuals with conditions requiring multiple blood transfusions. This is worse in developing countries where some members of the population engage in illegal refining and artisanal mining activities. In order to reduce toxic metal exposure in vulnerable populations, blood meant for transfusion in vulnerable subjects, e.g. children, should be routinely screened for heavy metal concentrations. Patients receiving multiple blood transfusions should also be monitored for iron overload and its attendant toxicities.
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7
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Takci S, Yigit S, Yurdakok M. Reducing the risk of environmental pollutants for preterm infants through blood transfusions. Transfus Med 2020; 30:518-519. [PMID: 33140480 DOI: 10.1111/tme.12734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/21/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Sahin Takci
- Department of Pediatrics and Neonatology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Sule Yigit
- Department of Neonatology, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Murat Yurdakok
- Department of Neonatology, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
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8
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Owsianowska J, Kamińska MS, Bosiacki M, Chlubek D, Karakiewicz B, Jurczak A, Stanisławska M, Barczak K, Grochans E. Depression, changes in peripheral blood cell count, and changes in selected biochemical parameters related to lead concentration in whole blood (Pb-B) of women in the menopausal period. J Trace Elem Med Biol 2020; 61:126501. [PMID: 32289550 DOI: 10.1016/j.jtemb.2020.126501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 01/24/2020] [Accepted: 03/18/2020] [Indexed: 11/24/2022]
Abstract
THE AIM The aim of this study was to assess the severity of depression, vasomotor symptoms, changes in peripheral blood cell count, and selected biochemical parameters in relation to the concentration of lead in whole blood of women in the perimenopausal period. METHODS The study sample consisted of 233 women from the general population of the West Pomeranian Province (Poland) in age between 44-65 years. The intensity of menopausal symptoms was examined using the Blatt-Kupperman Index, and the severity of depression using the Beck Depression Inventory. The following biochemical data were evaluated: concentrations of glucose, triglycerides, HDL, C-reactive protein, glycated haemoglobin, cortisol, insulin, blood cell count, and lead concentration in whole blood (Pb-B). RESULTS A whole blood Pb concentration below 5 μg/dl was found in 55 subjects (23.61 %), in 142 women (60.94 %) it ranged from 5 to 10 μg/dl, while in 36 women (15.45 %) was higher than 10 μg/dl. There was a strong positive correlation between Pb concentration in the blood of the examined women and the severity of depressive symptoms (Rs=+0.60, p = 0.001). The lowest mean values for total leukocytes (5.07 ± 1.22 thousand/μl) and neutrophils (2.76 ± 0.86 thousand/μl) were found in women with Pb concentration above 10 μg/dl (p < 0.05). There was a significant negative correlation between the number of total leukocytes (r=-0.45, p = 0.002) and neutrophils (r=-0.50, p = 0.001) and blood Pb concentration. Analysis showed statistically significant differences in glucose concentration (p < 0.05) between groups. Blood glucose was higher in women with Pb-B <5 and between 5-10 μg/dl than in women with Pb-B >10 μg/dl. CONCLUSION Exposure to Pb may be a factor playing a significant role in the development of depressive symptoms in menopausal women. It may also be associated with glucose metabolism disorders and immunosuppression in women during this period of life.
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Affiliation(s)
- Joanna Owsianowska
- Department of Specialized Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210, Szczecin, Poland.
| | - Magdalena Sylwia Kamińska
- Subdepartment of Long-Term Care, Department of Social Medicine, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210, Szczecin, Poland.
| | - Mateusz Bosiacki
- Department of Functional Diagnostics and Physical Medicine, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 56 Żołnierska St., 71-210, Szczecin, Poland.
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, 72 Powstańców Wielkopolskich St., 70-111, Szczecin, Poland.
| | - Beata Karakiewicz
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210, Szczecin, Poland.
| | - Anna Jurczak
- Department of Specialized Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210, Szczecin, Poland.
| | - Marzanna Stanisławska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210, Szczecin, Poland.
| | - Katarzyna Barczak
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, 72 Powstańców Wielkopolskich St., 70-111, Szczecin, Poland.
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210, Szczecin, Poland.
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Averina M, Hervig T, Huber S, Kjær M, Kristoffersen EK, Bolann B. Environmental pollutants in blood donors: The multicentre Norwegian donor study. Transfus Med 2020; 30:201-209. [DOI: 10.1111/tme.12662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Maria Averina
- Department of Laboratory MedicineUniversity Hospital of North Norway Tromsø Norway
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of Norway Tromsø Norway
| | - Tor Hervig
- Department of Clinical ScienceUniversity of Bergen, Norway
- Laboratory of Immunology and Transfusion MedicineHaugesund Hospital Haugesund Norway
| | - Sandra Huber
- Department of Laboratory MedicineUniversity Hospital of North Norway Tromsø Norway
| | | | - Einar K. Kristoffersen
- Department of Clinical ScienceUniversity of Bergen, Norway
- Department of Immunology and Transfusion MedicineHaukeland University Hospital Bergen Norway
| | - Bjørn Bolann
- Department of Clinical ScienceUniversity of Bergen, Norway
- Department of Medical Biochemistry and PharmacologyHaukeland University Hospital Bergen Norway
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Boehm R, Cohen C, Pulcinelli R, Caletti G, Balsan A, Nascimento S, Rocha R, Calderon E, Saint’Pierre T, Garcia S, Sekine L, Onsten T, Gioda A, Gomez R. Toxic elements in packed red blood cells from smoker donors: a risk for paediatric transfusion? Vox Sang 2019; 114:808-815. [DOI: 10.1111/vox.12854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 08/22/2019] [Accepted: 09/14/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Renata Boehm
- Programa de Pós‐Graduação em Farmacologia e Terapêutica Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Carolina Cohen
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Rianne Pulcinelli
- Programa de Pós‐Graduação em Farmacologia e Terapêutica Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
| | - Greice Caletti
- Programa de Pós‐Graduação em Farmacologia e Terapêutica Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
| | - Almeri Balsan
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Sabrina Nascimento
- Laboratório de Toxicologia (LATOX) Departamento de Análises Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
| | - Rafael Rocha
- Departamento de Química Pontifícia Universidade Católica do Rio de Janeiro (PUC‐ Rio) Rio de Janeiro Brazil
| | - Enrique Calderon
- Departamento de Química Pontifícia Universidade Católica do Rio de Janeiro (PUC‐ Rio) Rio de Janeiro Brazil
| | - Tatiana Saint’Pierre
- Departamento de Química Pontifícia Universidade Católica do Rio de Janeiro (PUC‐ Rio) Rio de Janeiro Brazil
| | - Solange Garcia
- Laboratório de Toxicologia (LATOX) Departamento de Análises Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
| | - Leo Sekine
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Tor Onsten
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Adriana Gioda
- Departamento de Química Pontifícia Universidade Católica do Rio de Janeiro (PUC‐ Rio) Rio de Janeiro Brazil
| | - Rosane Gomez
- Programa de Pós‐Graduação em Farmacologia e Terapêutica Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
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11
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Wiencek JR, Gehrie EA, Keiser AM, Szklarski PC, Johnson-Davis KL, Booth GS. Detection of Nicotine and Nicotine Metabolites in Units of Banked Blood. Am J Clin Pathol 2019; 151:516-521. [PMID: 30715103 DOI: 10.1093/ajcp/aqy176] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To determine the concentrations of nicotine and nicotine metabolites in RBC units as a means to estimate the point prevalence of exposure within the healthy donor pool. METHODS Segments from 105 RBC units were tested for the presence of nicotine, cotinine, or trans-3'-hydroxycotinine by liquid chromatography-tandem mass spectrometry. RESULTS Of the 20 (19%) units that contained detectable concentrations of nicotine, cotinine, or trans-3'-hydroxycotinine, 19 (18.1%) contained concentrations consistent with the use of a nicotine-containing product within 48 hours of specimen collection. One RBC unit contained nicotine concentrations consistent with passive exposure. CONCLUSIONS Chemicals from nicotine-containing products are detectable within the US RBC supply. Further investigation is needed to determine the risks of transfusion-associated exposure to nicotine and other tobacco-associated chemicals among vulnerable patient populations such as neonates.
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Affiliation(s)
- Joesph R Wiencek
- Department of Pathology, University of Virginia School of Medicine, Charlottesville
| | - Eric A Gehrie
- Department of Pathology, Division of Transfusion Medicine, Johns Hopkins University, Baltimore, MD
| | - Amaris M Keiser
- Department of Pediatrics, Division of Neonatology, Johns Hopkins University, Baltimore, MD
| | - Penny C Szklarski
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Kamisha L Johnson-Davis
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City
| | - Garrett S Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN
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12
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Aly SM, Omran A, Abdalla MO, Gaulier JM, El-Metwally D. Lead: a hidden "untested" risk in neonatal blood transfusion. Pediatr Res 2019; 85:50-54. [PMID: 30297876 DOI: 10.1038/s41390-018-0175-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/03/2018] [Accepted: 08/24/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Neonates may be exposed to lead (Pb) through blood transfusions from donors. Pb exposure has neurological, cardiovascular, renal, and other adverse effects. The study aimed to (i) determine the blood lead levels (BLLs) in different blood product units (whole blood, packed red blood cells (pRBCs), platelets, and plasma transfused to neonates) and (ii) estimate the proportion of units with high BLLs. METHODS Residual blood from blood bank bags that were used for neonatal transfusion were collected: 25 samples from each type of blood product except for whole blood (10 samples). The Pb analysis was performed using the atomic absorption method. The study was conducted at the Suez Canal University Hospital, Egypt. RESULTS The mean of BLL in pRBCs, platelets, plasma, and whole blood were 136, 199, 108, and 130 µg/L, respectively; 60% contained Pb above 50 µg/L. The highest BLLs were in platelet units. CONCLUSIONS The present study showed for the first time that platelets and plasma in addition to whole blood and pRBCs used for neonatal transfusions are sources of Pb. Re-evaluation of the guidelines is mandatory for the safety of the neonates. Long-term neurodevelopment assessment of neonates exposed to high Pb is warranted.
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Affiliation(s)
- Sanaa Mohamed Aly
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Ahmed Omran
- Pediatrics and Neonatology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Mohamed Osama Abdalla
- Clinical Pathology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | - Dina El-Metwally
- Pediatrics and Neonatology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Thomas T, Spitalnik SL. Hitchhiker's guide to the red blood cell storage lesion. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 17:1-3. [PMID: 30653457 PMCID: PMC6343593 DOI: 10.2450/2019.0257-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Tiffany Thomas
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States of America
| | - Steven L Spitalnik
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States of America
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Smoking fewer than 20 cigarettes per day and remaining abstinent for more than 12 hours reduces carboxyhemoglobin levels in packed red blood cells for transfusion. PLoS One 2018; 13:e0204102. [PMID: 30256832 PMCID: PMC6157890 DOI: 10.1371/journal.pone.0204102] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 09/04/2018] [Indexed: 01/01/2023] Open
Abstract
Background The prevalence of smokers among blood donors and the effect of smoking on the quality of donated blood have not been extensively explored. In the present study, we determined the prevalence of smoker donors in a large blood bank in Southern Brazil and evaluated the quality of packed red blood cells (RBCs) from these donors through recommended quality control tests and measurement of carboxyhemoglobin (COHb) levels. We then assessed the influence of smoking habits and abstinence before donation on these parameters. Material and methods An observational study was conducted to determine the prevalence of smoking donors, while a prospective cohort study compared conventional hematological and serological parameters and COHb levels at 0, 15, and 30 days after donation in RBCs donated by smokers (N = 31) and nonsmokers (N = 31) and their association with smoking habits and abstinence before donation. Results Of 14,428 blood donations received in 1 year, 5.9% were provided by smokers. Storage over time slightly altered some quality parameters, such as hematocrit, hemoglobin, hemolysis, and COHb levels, in RBC packs. COHb levels were higher in RBC packs from smokers (8%) than from non-smokers (2%), and increased as a function of the number of cigarettes smoked daily and time elapsed since the last cigarette smoked before donation. Lower levels were found in RBC packs from donors who smoked fewer than 20 cigarettes per day or remained abstinent for more than 12h before giving blood. Conclusion Although cigarette smoke had no significant effect on blood quality parameters such as hematocrit, hemoglobin, or hemolysis, it quadrupled COHb levels in packed RBCs. Abstinence from smoking for more than 12h or smoking fewer than 20 cigarettes daily helped decrease COHb levels. Implications Given the increasing prevalence of tobacco use worldwide, we suggest blood banks recommend 12h of tobacco abstinence before donation and analyze COHb levels in donated blood as an approach to reduce risk for high-risk recipients.
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Newman N, Carey PM. Donor blood lead levels and transfusion safety in a vulnerable population. Transfusion 2015; 55:2544-6. [DOI: 10.1111/trf.13362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/02/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Nicholas Newman
- Pediatrics and Environmental Health; , University of Cincinnati College of Medicine, Pediatric Environmental Health and Lead Clinic, Cincinnati Children's Hospital Medical Center; Cincinnati OH
| | - Patricia M. Carey
- Pathology and Laboratory Medicine; University of Cincinnati College of Medicine, Clinical Services, Hoxworth Blood Center, UC Medical Center & Cincinnati Children's Hospital Medical Center; Cincinnati OH
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