Biomarkers · Hematology
White Blood Cell Count (WBC)
Lower values go with lower risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 20% higher risk of death. We found the same pattern in NHANES
WBC and risk of death
Published curve higher than the NHANES fitNHANES fit higher
Risk of death relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.
WBC by age and sex
Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.
The percentiles as a table
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 4.50 | 6.00 | 7.10 | 8.70 | 11.3 | 1,457 | NHANES 2017-2018 |
| All | 40-59 | 4.20 | 5.70 | 7.00 | 8.50 | 11.3 | 1,584 | NHANES 2017-2018 |
| All | 60+ | 4.40 | 5.60 | 7.00 | 8.40 | 11.2 | 1,940 | NHANES 2017-2018 |
| All | all | 4.40 | 5.80 | 7.10 | 8.50 | 11.3 | 4,981 | NHANES 2017-2018 |
| Men | 20-39 | 4.20 | 5.80 | 6.80 | 8.40 | 11.1 | 698 | NHANES 2017-2018 |
| Men | 40-59 | 4.30 | 5.70 | 6.90 | 8.40 | 10.8 | 740 | NHANES 2017-2018 |
| Men | 60+ | 4.41 | 5.60 | 7.20 | 8.64 | 11.2 | 981 | NHANES 2017-2018 |
| Men | all | 4.30 | 5.70 | 6.90 | 8.40 | 11.1 | 2,419 | NHANES 2017-2018 |
| Women | 20-39 | 4.60 | 6.20 | 7.40 | 8.90 | 11.5 | 759 | NHANES 2017-2018 |
| Women | 40-59 | 4.10 | 5.70 | 7.30 | 8.70 | 11.7 | 844 | NHANES 2017-2018 |
| Women | 60+ | 4.30 | 5.60 | 6.90 | 8.30 | 11.1 | 959 | NHANES 2017-2018 |
| Women | all | 4.40 | 5.80 | 7.20 | 8.60 | 11.5 | 2,562 | NHANES 2017-2018 |
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| behavioral | Smoking cessation | Successful quitters had significant decreases in WBC count after 1 year vs continuing smokers, independent of weight change | prospective cohort | King CC, et al. Longitudinal Impact of Smoking and Smoking Cessation on… |
| behavioral | Smoking cessation | WBC and neutrophil counts fell significantly within one year of quitting and stayed lower beyond two years (effect size not reported) | cohort | Higuchi T, et al. Current cigarette smoking is a reversible cause of elevated… |
| clinical | Treatment of chronic dental focal infection (periodontitis) | Non-surgical periodontal therapy reduced WBC and neutrophil counts at 6-8 weeks (effect size not reported) | non-randomised trial | Guan X, et al. Effects of Non-Surgical Treatment on Hematological Indices in… |
| diet | High adherence to the Mediterranean diet in healthy adults | 14% lower white blood cell counts in the highest vs lowest tertile of Mediterranean diet score (p = 0.001) | cross-sectional | Chrysohoou C, et al. Adherence to the Mediterranean diet attenuates… |
Things that worsen it
| Type | Condition or exposure | Reported effect | Evidence | Source |
|---|---|---|---|---|
| pharmacologic | Myelosuppressive chemotherapy | Myelosuppressive chemotherapy causes neutropenia (effect size not reported) | clinical guideline | Freifeld AG, et al. Clin Infect Dis. 2011;52:e56-e93. |
Sources
- Risk curve: Chan 2022 (PMID 35078679): all-cause HR 1.42 (1.33-1.53) 10th decile of total WBC vs decile of lowest risk, men (women: 1.54, 1.42-1.68). Scaled to US values (NHANES).
- Chan et al. Total and differential white blood cell count and cause-specific mortality in 436 750 Taiwanese adults. Nutrition, metabolism, and cardiovascular diseases : NMCD. 2022;32:937-947.
- NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.
Map White Blood Cell Count (WBC) against another biomarker.
Related markers: Absolute Lymphocyte Count · Absolute Neutrophil Count · Basophil Count · Eosinophil Count · Hematocrit · Hemoglobin Concentration · Immature Reticulocyte Fraction · Lymphocyte Percentage