International Journal of Medical Laboratory
Shahid Sadoughi University of Medical Sciences
Tue, May 19, 2026
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Volume 12, Issue 2 (May 2025)
IJML 2025, 12(2): 140-152 |
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Seyed-Javadin S R, Sardari T, Sardari N, Absalan A. Proposed Serum-Lead Reference Intervals and Clinical Decision Thresholds for an Iranian Population Based on a Seven-Year Retrospective Study. IJML 2025; 12 (2) :140-152
URL: http://ijml.ssu.ac.ir/article-1-564-en.html
URL: http://ijml.ssu.ac.ir/article-1-564-en.html
Department of Medical Laboratory Sciences, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
Abstract: (15 Views)
Introduction: Chronic Lead (Pb) exposure is associated with metabolic, behavioral, and pathological disorders in both pediatric and adult populations. Serum lead levels and toxicity were assessed in patients referred to a clinical laboratory in western Tehran, Iran, over a seven-year period. In addition, lead reference intervals were determined.
Materials & Methods: 1,651 serum Pb (SPb) levels were determined by inductively coupled plasma optical emission spectrometry (ICP-OES), from March 21, 2017, to January 15, 2024. Analysis of variance was used to compare SPb levels across sex and age groups. Reference intervals were calculated according to Clinical and Laboratory Standards Institute guidelines.
Results: Mean ± standard deviation SPb levels were significantly higher in males (9.7 ± 7.6 μg/dL) than in females (6.86 ± 4.07 μg/dL) and children (4.92 ± 4.22 μg/dL; p < 0.001). Using a SPb level of >3.5 μg/dL as a screening cutoff based on Centers for Disease Control and Prevention recommendations, 51.1% of children aged ≤5 years screened positive. Older patients had significantly higher SPb levels, with the following age group means (μg/dL): 0-10 years = 5.07 ± 4.58, 11-20 years = 4.89 ± 2.49, 21-30 years = 6.95 ± 4.45, 31-40 years = 7.77 ± 5.84, 41-50 years = 7.75 ± 4.8, and age > 50 = 8.99 ± 6.65.
Conclusion: SPb toxicity should be precisely evaluated in the Iranian population, especially in children. Current reference intervals likely leading to underdiagnosis and an increased risk of chronic sequelae. Population-specific reference intervals are required to improve early identification of Pb toxicity and mitigate its long-term health consequences.
Materials & Methods: 1,651 serum Pb (SPb) levels were determined by inductively coupled plasma optical emission spectrometry (ICP-OES), from March 21, 2017, to January 15, 2024. Analysis of variance was used to compare SPb levels across sex and age groups. Reference intervals were calculated according to Clinical and Laboratory Standards Institute guidelines.
Results: Mean ± standard deviation SPb levels were significantly higher in males (9.7 ± 7.6 μg/dL) than in females (6.86 ± 4.07 μg/dL) and children (4.92 ± 4.22 μg/dL; p < 0.001). Using a SPb level of >3.5 μg/dL as a screening cutoff based on Centers for Disease Control and Prevention recommendations, 51.1% of children aged ≤5 years screened positive. Older patients had significantly higher SPb levels, with the following age group means (μg/dL): 0-10 years = 5.07 ± 4.58, 11-20 years = 4.89 ± 2.49, 21-30 years = 6.95 ± 4.45, 31-40 years = 7.77 ± 5.84, 41-50 years = 7.75 ± 4.8, and age > 50 = 8.99 ± 6.65.
Conclusion: SPb toxicity should be precisely evaluated in the Iranian population, especially in children. Current reference intervals likely leading to underdiagnosis and an increased risk of chronic sequelae. Population-specific reference intervals are required to improve early identification of Pb toxicity and mitigate its long-term health consequences.
Keywords: Biological monitoring, Heavy metal poisoning, Lead poisoning, Nervous system, Reference interval
Type of Study: Research |
Subject:
Biochemistry
Received: 2025/10/26 | Accepted: 2026/05/17 | Published: 2025/02/28
Received: 2025/10/26 | Accepted: 2026/05/17 | Published: 2025/02/28
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