Association between trace element levels and iron deficiency anaemia among children in Basrah, Iraq: A cross-sectional study

Abstract

Objective: This study aimed to investigate the association between blood levels of selected trace and heavy metals, namely lead (Pb), cadmium (Cd), and zinc (Zn), and iron deficiency anaemia among children in Basrah Province, Iraq.

Methods: A hospital-based cross-sectional study was conducted from July to December 2024. A total of 150 children were enrolled, comprising 100 children with a confirmed diagnosis of IDA and 50 age-matched healthy controls. Serum concentrations of Pb, Cd, and Zn were quantified using inductively coupled plasma mass spectrometry (ICP-MS). Haematological parameters and serum ferritin were also assessed. Statistical analyses included one-way analysis of variance (ANOVA), independent t-tests, and Pearson’s correlation.

Results: Significant age-related variations in metal concentrations were observed across the study groups (p ≤ 0.05). The highest mean serum Pb level was recorded in the 3-6-month age group (0.990 µg/dL), while the highest mean Cd level was observed in the 7-12-month age group (0.167 µg/L). The 3-6-month age group also exhibited the highest mean Zn concentration (2.600 mg/dL). Correlation analyses revealed weak, non-significant associations between iron deficiency parameters and the trace elements, although ferritin demonstrated weak inverse correlations with Pb and Cd.

Conclusion: This study demonstrates a measurable association between IDA and altered serum concentrations of Pb, Cd, and Zn among children in Basrah, with distinct age-related patterns. These findings underscore the need for integrated public health strategies that combine nutritional interventions with environmental monitoring to mitigate heavy metal exposure in vulnerable paediatric populations.