National blood bank services as a platform for national human biomonitoring - A proof-of-concept study.

Lior Hassan, Eilat Shinar, Luda Groisman, Efrat Rorman, Itai Kloog, Eli Jaffe, Evgeniy Stoyanov, Asher Moser, Victor Novack, Roni Gat, Kineret Grant-Sasson, Lena Novack

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Human biomonitoring (HBM) is crucial for identifying potential risks to human health from exposure to environmental hazards. However, it is an expensive and labor-intensive endeavor. To save on samples’ collection process we suggested using a national blood banking system as a platform for a national HBM program. For the case study, we used a comparison of blood donors from heavily industrialized Haifa Bay region, northern Israel, with donors from the rest of the country. Methods: The study population comprised a random sample of blood donors donating blood all over Israel. Samples of whole blood were tested for arsenic (As), cadmium (Cd), chromium (Cr) and lead (Pb). Donors’ donations sites and residential locations were geocoded. Smoking status was verified based on Cd levels, after calibrating their concentrations vs Cotinine in a sub-sample of 45 subjects. Metal concentrations were compared between regions using a lognormal regression, while controlling for age, gender, and predicted probability of smoking. Results: During Mar 2020–Feb 2022, we collected 6230 and tested 911 samples. Concentrations of most of the metals were modified by age, gender, and smoking. Cr and Pb appeared to be 1.08–1.10 times higher among Haifa Bay residents than in the rest of the country (although with borderline significance of 0.069 for Cr). Cr and Pb were 1.13–1.15 times higher for those who donated blood in the Haifa Bay region, but not necessarily resided in the area. Donors from Haifa Bay had lower levels of As and Cd as compared to other donors in Israel. Conclusions: Using a national blood banking system for HBM proved to be feasible and efficient. Blood donors from Haifa Bay area were characterized by elevated levels of Cr and Pb and lower levels of As and Cd. An extensive investigation of industries in the area is warranted.

Original languageEnglish
Article number138569
StatePublished - Jul 2023
Externally publishedYes


  • Environmental epidemiology
  • Heavy metals
  • Human biomonitoring
  • National blood bank


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