A Systematic Review and Meta-analysis on Blood Lead Level in Opium Addicts: an Emerging Health Threat
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A Systematic Review and Meta-analysis on Blood Lead Level in Opium Addicts: an Emerging Health Threat Reza Tabrizi 1 & Sorour Sarihi 2 & Fatemeh Moazzen 3 & Mahnaz Hosseini-Bensenjan 4 & Fatemeh Malekpour 5 & Gholamreza Asadikaram 6 & Mohammad Amin Momeni-Moghaddam 7 & Hamed Akbari 6 Received: 2 October 2020 / Accepted: 17 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This meta-analysis was conducted aiming to summarize the results obtained from the previous studies so that the effect of opium on blood lead levels (BLLs) can be investigated. Scopus, Embase, PubMed, and Web of Science (ISI) were systematically searched up to June 2020. Heterogeneity of the included studies was evaluated using Cochrane’s Q test and the I2 statistic. A random-effects model was used to pool the weighted mean differences (WMDs) and their 95% confidence intervals (CIs). Out of a total of 2372 citations, eleven articles with 916 participants (487 opium addicts and 429 controls) were included in the study. The meta-analysis results showed that there were higher lead levels (WMD = 14.59 μg/dL, 95% CI = 11.59 to 17.92, Z = 8.60, P < 0.001) in opium addicts than in the control group. The degree of heterogeneity observed (P < 0.001, I2 = 98.1%) might be mainly the result of the type of sampling and of consumption. Moreover, the findings of meta-regression analyses indicated that publication year (β = 1.23, P = 0.287), total sample size (β = 0.05, P = 0.728), and quality scores (β = − 2.91, P = 0.546) had no effects on lead levels in opium addicts. In the sensitivity analysis, it was found that the pooled WMDs remained stable after excluding one by one study. Oral opium consumption increased the amount of lead in the bloodstream, and the measurement of lead levels in opium addicts’ blood may be regarded as a useful test to diagnosis and prognosis of disorders that may lead poisoning causes. Keywords Opium . Lead . Meta-analysis . Systematic review
Introduction * Mohammad Amin Momeni-Moghaddam [email protected]; [email protected] 1
Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2
Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
3
Department of Hematology, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
4
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
5
Family Medicine Department, Shiraz University of Medical Sciences, Shiraz, Iran
6
Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
7
Department of Nutrition and Biochemistry, Faculty of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran
Lead (Pb) is a non-essential, and the most important toxic heavy element in the environment that has unique physical and chemical properties [1, 2]. Given the non-degradable nature of lead and the fact that it is found in many natur
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