Further, Ratcliff[17], Monterio et al.,[18, 19] and Hermes-lima et al.[20–22] explained that ALAD inactivation may lead to the accumulation of delta- aminoleuvulinic acid that can cause overproduction of ROS, which could lead to lead-induced oxidative damage in the cell and result in anemia. This evidence concerns the gene ALAD and anemia (phenotype).