Iron Status in Relation to Low-Level Lead Exposure in a Large Population of Children Aged 0–5 Years

There are limited data regarding low lead exposure and iron status in Chinese children. This study aimed to examine the association between low-level lead exposure and iron status in a large population of children aged 0–5 years. We reviewed the records of children aged 0–5 years who had blood lead, iron, ferritin, and hemoglobin measurements during 2014–2017 at the Guangdong Women and Children Hospital. We identified 17,486 children with a blood lead level < 100 μg/L. Multiple linear and logistic regression analyses were performed to estimate the associations between blood lead levels and blood iron, serum ferritin, and hemoglobin. The mean concentrations of blood lead, iron, ferritin, and hemoglobin were 31.50 μg/L, 7.50 mmol/L, 46.98 ng/mL, and 120.41 g/L, respectively. Adjusting for age and sex, blood lead was negatively correlated with iron ( r = − 0.073, p < 0.05), ferritin ( r = − 0.043, p < 0.05), and hemoglobin ( r = − 0.047, p < 0.05). Compared with the 1st quintile of lead exposure, the 5th quintile of lead exposure was associated with a 0.146 mmol/L decrease in blood iron, a 4.678 ng/mL decrease in serum ferritin, and a 1.245 g/L decrease in hemoglobin. Adjusted odds ratios (95% confidence interval) for the 5th quintile of blood lead were 1.39 (1.25–1.55) for iron deficiency and 1.45 (1.26–1.67) for anemia, relative to the 1st quintile. Our study findings confirmed the previously established association of blood lead levels with decreasing iron status and extended previous findings to even low-level lead exposure in Chinese children.