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Members of the laboratory staff should make and examine a blood smear whenever the results of the complete blood count indicate that a blood smear is essential for the validation or the further elucidation of a detected abnormality.
If error is to be avoided, sophisticated modern investigations of hematologic disorders should be interpreted in the light of peripheral-blood features as well as the clinical context Based on Scripps-Kaiser data for the 5th percentiles given in Table 2. The ethnic origin of the individuals designated as white in these 2 databases is probably very similar.
The latter difference in Table 3 is clearly an artifact resulting from the consolidation of all subjects older than 60 years into one group.
As shown in Table 2, there are a higher proportion of men 80 years in the NHANES survey than in the Scripps-Kaiser data, and there is a slight but well-documented decrease in the mean hemoglobin concentration of each decile among men (Hollowell JG, Van Assendelft OW, Gunter EW, Lewis BG, Najjar M, Pfeiffer C. Some minor discrepancies could also be due to differences in ethnic origin within populations studied.
White Americans are a genetic mixture of persons from various parts of Europe and the Middle East.
The data in these compilations are valuable, but unfortunately the hemoglobin values in one report are derived from the entire population, not corrected for subjects with disease states that may be associated with anemia (Hollowell JG, Van Assendelft OW, Gunter EW, Lewis BG, Najjar M, Pfeiffer C. The other report uses exclusion criteria that are so draconian that less than 40% of the subjects remain in the data set.Hematological and iron-related analytes: reference data for persons aged 1 year and over: United States, 1988-94. This would obviously be true with the population designated "black," because it is well known that the genes of individuals classified as African American could be anywhere between 10% and 90% of European origin, with most of the remaining genome being of African origin.As pointed out earlier, differences in the degree of the European admixture could well account for the small differences in hemoglobin concentrations documented in the 2 data sets.Among black Americans there are varying degrees of admixture with non-African ancestry.The NHANES database attempts to reach a nationwide balance.
It is likely that more of the black population of San Diego originates from the Northeast and the Midwest; therefore, San Diego may have greater white admixture than the NHANES sample.