SYNOPSISThe number of stippled erythrocytes in the blood of lead workers counted under dark ground microscopy show a marked fall when blood is taken into an anticoagulant. The significance of this finding is studied and alternative methods of screening workers are examined.It has long been recognized that the presence of red cells in the peripheral blood showing basophilic stippling is a feature of lead intoxication, and an assessment of their numbers has been widely used as an indication of excessive absorption by lead workers.A fortuitous finding that the high stippled cell counts in capillary blood films from lead workers were not seen in films prepared from venous blood taken into an anticoagulant seemed to be an observation worth recording in order to draw attention to the dangers of false low results in such specimens, and prompted an investigation into the phenomenon in an endeavour to throw some light on the nature and formation of stippled cells.
MATERIALS AND METHODSIndividuals were selected from local industrial concerns who were exposed to lead oxide and showed a stippled cell count in excess of 6,000 per million red cells as estimated by the method suggested by Lane (1949). These could all be regarded as showing evidence of excessive lead absorption, the criterion of which, using this method, is a count greater than 5,000 per million red cells. Both capillary and venous blood was taken Received for publication 20 September 1966. from each individual and films were prepared immediately. In addition, films were made from the venous specimens after a varying period of time in a variety of anticoagulants.The dried films were, at first, stained with 0 5% alkaline methylene blue in accordance with Lane's method, but later 1 % new methylene blue was used, staining for 15 min., and subsequently washing off with tap water.The technique for reticulocyte staining was that suggested by Breecher (1949) using 1 % new methylene blue in citrate-saline as a vital stain.The serum haptoglobulin was estimated by the agar diffusion method of Rowe (1961).
RESULTS