Abraham W Wolf1, Elias Jimenez, Betsy Lozoff. 1. Department of Psychiatry, MetroHealth Medical Center, School of Medicine, Case Western Reserve University, Cleveland, Ohio 44109, USA. axw7@cwru.edu
Abstract
OBJECTIVES: To determine the effects of iron therapy on blood lead levels in infants with mildly elevated lead levels and varied iron status. METHODS:Infants from a community-derived sample in Costa Rica were categorized into five groups. Group 1 had iron-deficiency anemia with hemoglobin levels <or=105 g/L. Infants in group 2 were iron-deficient with intermediate hemoglobin levels (between 106-119 g/L). These groups were treated with intramuscular iron or 3 months of oral iron. Group 3 (nonanemic iron-deficient) and group 4 (nonanemic iron-depleted) were treated with 3 months of oral iron. Group 5 (iron-sufficient) received oral placebo. RESULTS: After 3 months of oral iron therapy, nonanemic iron-depleted infants had the greatest decrease in lead levels, followed by nonanemic iron-deficient infants and iron-deficient infants with hemoglobin levels <120 g/L. Lead levels increased among iron-deficient infants with hemoglobin levels <120 g/L who received intramuscular iron and iron-sufficient nonanemic infants who received placebo. CONCLUSIONS: Changes in lead levels corresponded closely to changes in iron status and were plausible in terms of absorption mechanisms for lead and iron. Correcting and/or preventing iron deficiency appear to be rapid and effective means of improving infant lead levels, even in nonanemic infants.
RCT Entities:
OBJECTIVES: To determine the effects of iron therapy on blood lead levels in infants with mildly elevated lead levels and varied iron status. METHODS:Infants from a community-derived sample in Costa Rica were categorized into five groups. Group 1 had iron-deficiency anemia with hemoglobin levels <or=105 g/L. Infants in group 2 were iron-deficient with intermediate hemoglobin levels (between 106-119 g/L). These groups were treated with intramuscular iron or 3 months of oral iron. Group 3 (nonanemic iron-deficient) and group 4 (nonanemic iron-depleted) were treated with 3 months of oral iron. Group 5 (iron-sufficient) received oral placebo. RESULTS: After 3 months of oral iron therapy, nonanemic iron-depleted infants had the greatest decrease in lead levels, followed by nonanemic iron-deficientinfants and iron-deficient infants with hemoglobin levels <120 g/L. Lead levels increased among iron-deficient infants with hemoglobin levels <120 g/L who received intramuscular iron and iron-sufficient nonanemic infants who received placebo. CONCLUSIONS: Changes in lead levels corresponded closely to changes in iron status and were plausible in terms of absorption mechanisms for lead and iron. Correcting and/or preventing iron deficiency appear to be rapid and effective means of improving infant lead levels, even in nonanemic infants.
Authors: David Cantonwine; Howard Hu; Martha Maria Téllez-Rojo; Brisa N Sánchez; Héctor Lamadrid-Figueroa; Adrienne S Ettinger; Adriana Mercado-García; Mauricio Hernández-Avila; Robert O Wright Journal: Environ Health Date: 2010-07-26 Impact factor: 5.984