Evaluation of blood lead levels by atomic absorption spectrometry in school going children of northern areas of Pakistan

Objectives: To evaluate blood lead levels and assess their correlation with academic performance in school children. Methods: The cross-sectional study was conducted at the Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from January to December, 2017, and comprised school children in Rawalpindi, Pakistan, and Hajira, Azad Jammu and Kashmir. About 5 ml of venous blood was collected in potassium-ethylenediaminetetraacetic acid tubes for lead levels, haemoglobin and plasma ferritin. The preceding three years' academic performance, rated as excellent, good, fair and poor, of the subjects was categorised on a specifically-designed proforma. Data was analysed using SPSS 24. Results: Of the 400 subjects, 205 (50.25%) were females. The overall mean age was 9.15 +/- 2.8 years. Mean level of lead was 4.3 +/- 2.6 mu g/dL, and difference in values was significant between children of Hajira and Rawalpindi (p<0.05). Mean haemoglobin was 12.9 +/- 0.919g/dL and mean ferritin was 49.17 +/- 16.0ng/ml. Of the total, 85(21.3%) showed excellent school performance, 162(40.5%) good, 113(28.3%) fair and 40(10%) showed poor performance. Significant negative association was found between school performance and mean blood lead level (p>0.05). No significant difference was found in terms of gender and age with school performance of both regions. Conclusion: Majority of school going children in northern Pakistan were found to have lead levels = 5 mu g/dL which is a level of concern as it is inversely related to academic performance.