% Rev Saúde Pública 2006;40(1):71-6 www.fsp.usp.br/rsp Lead, hemoglobin, zinc protoporphyrin and ferritin concentrations in children Concentrações de chumbo, hemoglobina, zinco protoporfirina e ferritina em crianças Patrícia H C Rondó a , Maria de Fátima H Carvalho b , Miriam C Souza c and Flávio M oraes a a Departamento de Nutri ção. Faculdade de Saúde P ública. Universidade de S ão Paulo. S ão Paulo, SP, Brasil. b Instituto Adolfo Lutz. S ão Paulo, SP, Brasil. c Faculdade de Nutri ção. Universidade Metodista de Piracicaba. Piracicaba, SP, Brasil Correspondence: Patrícia Helen de Carvalho Rondó Departamento de Nutrição - FSP-USP Av. Dr. Arnaldo, 715 01246-904 São Paulo, SP, Brasil E-mail: phcrondo@usp.br Supported by Fundação de Amparo à Pesquisa do Estado de S ão Paulo (FAPESP - Grant n. 99/09455-1). Received on 18/4/2005. Reviewed on 28/6/2005. Approved on 6/9/2005. Keywords Lead Poisoning. Anemia. Hemoglobin. Zinc. Protoporphyrin. Ferritin. Cross-sectional studies. D escritores Intoxicação por chumbo. Anemia. Hemoglobina. Zinco. Protoporfirina. Ferritina. Estudos transversais Abstract Objective To assess the relationship of blood lead and hemoglobin, zinc protoporphyrin, and ferritin concentrations in children. Methods A cross-sectional study was carried out in 136 anemic and non-anemic children from two rural villages near a lead smelter in Adrianópolis, Southern Brazil, from July to September 2001. Hemoglobin electrophoresis was performed to exclude children with hemoglobin variants and thalassemia syndromes associated with anemia. Lead was determined by atomic absorption spectrophotometry; hemoglobin by automated cell counting; zinc protoporphyrin by hematofluorometry; ferritin by chemiluminescence. Student’s t-test, Mann-Whitney test, and the c 2 test were used to assess the significance of the differences between the variables investigated in anemic and non-anemic children. Stepwise multivariate linear regression analysis was performed using two models for anemic and non-anemic children respectively. Results Lead was negatively associated to hemoglobin (p<0.017) in the first model, and in the second model lead was positively associated to zinc protoporphyrin (p<0.004) after controlling for ferritin, age, sex, and per capita income. There was an inverse association between hemoglobin and blood lead in anemic children. It was not possible to confirm if anemic children had iron deficiency anemia or subclinical infection, considering that the majority (90.4%) had normal ferritin. Conclusions The study detected a relationship between anemia and elevated blood lead concentrations. Further epidemiological studies are necessary to investigate the impact of iron nutritional interventions as an attempt to decrease blood lead in children. Resumo Objetivo Avaliar a relação entre as concentrações sangüíneas de chumbo, hemoglobina, zinco protoporfirina e ferritina em crianças. Métodos Estudo transversal realizado com 136 crianças anêmicas e não anêmicas residentes em duas vilas da região rural de Adrianópolis, Estado do Paraná, próximas a uma