Blood Lead Levels, Hemoglobin, and Liver Enzymes in Opium‑Dependent Addicts

Farzaneh Montazerifar, Mansour Karajibani, Maryam Lashkaripour, Manijeh Sayyad Mollashahi, Abbas Ali Niaz, Moghgan Soltan Mohammadi, Samaneh Rahimi Helari

Abstract


Background: Opium addiction, as a major health problem, has been reported in Middle East countries. Recently, contaminated opium has been reported as a probable source of lead poisoning. Thus, the aim of this study is to evaluate blood lead levels (BLL), liver enzymes, and hemoglobin (Hb) concentrations in opium‑dependent addicts with healthy controls.

Methods: In a cross‑sectional study, 75 opium‑addicted men (case group) referred to Zahedan Baharan Hospital were evaluated. A group of 75 nonaddicted men were selected as a control group. BLL, Hb, and liver enzymes levels were measured. Body mass index (BMI) was also calculated.

Results: The case group had elevated BLL compared to the controls (19.1 ± 1.6 vs. 9.1 ± 0.4; P < 0.0001). Hb concentrations were significantly lower in the patients compared to the controls (13.3 ± 1.6 vs. 15.1 ± 1.3; P < 0.0001). A positive correlation was found between BLL and opium addict duration in the case group (r = 0.52, P < 0.0001).

Conclusions: Due to the contamination of opium to lead, it seems that opiate addicts are at risk of lead poisoning. Thus, it is recommended that the blood lead level is frequently monitored to control the adverse effects of poisoning and prevent lead accumulation.


Keywords


Hemoglobin; lead; liver enzymes; opium addiction

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References


Salehi H, Sayadi AR, Tashakori M, Yazdandoost R,

Soltanpoor N, Sadeghi H. Comparison of serum lead level in

oral opium addicts with healthy control group. Arch Iran Med

;12:555‑8.

Bawa U, Bukar A, Abdullahi Y. A review of lead poisoning,

sources and adverse effects. ATBU J Sci, Tech Edu (JOSTE);

:3:71-9.

Tandon SK, Chatterjee M, Bhargava A, Shukla V, Bihari V.

Lead poisoning in Indian silver refiners. Sci Total Environ

;281:177‑82.

Wolf C, Binder R, Barth A, Konnaris C, Rudiger HW. Chronic

anemia and abdominal pain as a sequela of lead poisoning

[in German]. Dtsch Med Wochenschr 2001;126:556‑8.

Wani AL, Ara A, Usmani JA. Lead toxicity: A review. Interdiscip

Toxicol 2015;8:55‑64.

Shiri R, Ansari M, Ranta M, Fallah‑Hassani K. Lead poisoning

and recurrent abdominal pain. Ind Health 2007;45:494‑6.

Flora G, Gupta D, Tiwari A. Toxicity of lead: A review with

recent updates. Interdiscip Toxicol 2012;5:47‑58.

Masoodi M, Zali MR, Ehsani‑Ardakani MJ,

Mohammad‑Alizadeh AH, Aiassofi K, Aghazadeh R, et al.

Abdominal pain due to lead‑ contaminated opium: A new source

of inorganic lead poisoning in Iran. Arch Iran Med 2006;9:72‑5.

Soltaninejad K, Shadnia SH. Lead poisoning in opium abuser in

Iran: A systematic review. Int J Prevent Med 2018;9:3.

Antonini G, Palmieri G, Millefiorini E, Spagnoli LG,

Millefiorini M. Lead poisoning during heroin addiction. Ital J

Neurol Sci 1989;10:105‑8.

Afshari R, Emadzadeh A. Short communication: Case report on

adulterated opium‑induced severe lead toxicity. J Drug Chem

Toxic 2010;33:48‑9.

Algora M, MartIn‑cAstIllo A, Zabaia P, Fernandez MN. Lead

poisoning due to drug addiction: A new source of poisoning with

clinical interest and important epidemiological consequences

[in Spanish]. Am Med Internal 1989;6:483‑5.

Bergeson LL. The proposed lead NAAQS: Is consideration

of cost in the clean air act‘s future? Environ. Qual. Manag

;18:79‑84.

Aghaee‑Afshar M, Khazaeli P, Behnam B, Razadehkermani M,

Ashraf‑Ganjooei N. Presence of lead in opium. Arch Iran Med

;11:553‑4.

It is a report of the Centers for Disease Control and Prevention

(CDC). Report of the Advisory Committee on Childhood Lead

Poisoning Prevention of the Centers for Disease Control and

Prevention.

Charles A, McKay JR. Role of chelation in the treatment of lead

poisoning: Discussion of the treatment of lead‑exposed children

trial (TLC). J Med Toxicol 2013;9:339‑43.

Amiri M, Amini R. A Comparison of Blood‑lead level (BLL)

in opium‑dependant addicts with healthy control group using

the Graphite furnace/atomic absorption spectroscopy (GF‑AAS)

followed by chemometric analysis. Iran Red Cresc Med J

;14:488‑91.

Khatibi‑Moghadam H, Khadem‑Rezaiyan M, Afshari R.

Comparison of serum and urine lead levels in opium addicts

with healthy control group. Hum Exp Toxicol 2016;35:861‑5.

Beigmohammadi MH, Aghdashi M, Mojtahedzadeh M,

Karvandian K. Quadriplegia due to lead ‑contaminated opium.

Middle East Journal of Anesthesiology 2008;19:1411‑6.

Dunbabin DW, Tallis GA, Popplewell PY, Lee RA.

Lead‑poisonin from Indian herbal medicine (Ayurveda). Med J

Australia 1992;157:835‑6.

Patrick L. Lead toxicity, a review of the literature. Part I:

Exposure, evaluation, and treatment. Altern Med Rev

;11:1‑22.

Ibrahim AS, Latif AH. Adult lead poisoning from a herbal

medicine. Saudi Med J 2002;23:591‑3.

Meybodi FA, Eslick GD, Sasani S, Abdolhoseyni M, Sazegar S,

Ebrahimi F. Oral opium: An unusual cause of lead poisoning.

Singapore Med J 2012;53:395‑7.