Protection: Can people with sickle cell qualify for cover?

Sickle cell is a genetic disorder that can at its worst be painful, physically damaging and affect life expectancy. Elizabeth Brothwood of Friends Provident says advisers can expect life insurance eligibility to reflect the extent of the disease.

July was Sickle Cell Awareness Month. What is this condition and what are the implications for insurance?

Sickle cell disorders are a group of genetic diseases that affect the body’s red blood cells. They can cause extreme pain and permanent damage to many of the body’s major organs.

Sickle cell anaemia

This disorder affects the red blood cells, which contain a protein called haemoglobin. The purpose of haemoglobin is to carry oxygen from the lungs to all parts of the body. People with sickle cell anaemia have sickle haemoglobin, which is different from normal haemoglobin.

When sickle haemoglobin gives oxygen to body tissues, it sticks together to make long rods inside the blood cells, which become rigid and sickle-shaped. Normal red blood cells bend easily but sickled red blood cells, because of their shape, cannot easily fit through blood vessels. They become blocked, stopping oxygen from getting through. This can lead to severe pain and damaged organs.

Genetic disposition

Everyone inherits two copies of the gene for haemoglobin, one from each of our parents. If one of these genes carries instructions to make sickle haemoglobin but the other carries instructions to make normal haemoglobin, then the person has sickle cell trait (heterozygous form) and is a healthy carrier of the sickle haemoglobin gene.

In such cases, there is enough normal haemoglobin in red blood cells to keep the cells flexible, with no symptoms of sickle cell disorders. But carriers have to be careful of activities that entail less oxygen than normal, for example scuba diving.

If both copies of the haemoglobin gene carry instructions to make sickle haemoglobin, then this is the only type they can make, so sickled cells occur. In such cases the person has sickle cell anaemia (homozygous form) and can suffer from severe pain and anaemia.

Severe attacks are called crises. Over time, sufferers experience damage to major organs, for example heart, lungs, brain, kidney, liver and spleen. Additionally, sickled red blood cells do not live as long as normal red blood cells (120 days), resulting in chronic anaemia.

Once diagnosed with a sickle cell disorder, a sufferer will require regular medical attention, particularly during pregnancy, and before and after dental work or any operation. All family members should be tested for the disorder; they may not have the condition but may be carriers of a sickle cell trait, which could potentially be passed on to children.