title: Leaded eye cosmetics: a cultural cause of elevated lead levels in children.
abstract: BACKGROUND
  Preventing lead exposure is of paramount importance because lead is significantly toxic at subclinical levels, and treating patients with elevated blood lead levels is difficult. Children were evaluated for lead exposure in California through a state-mandated lead screening program that was begun in November 1991. Imported eye cosmetics were identified as a suspected source of lead exposure for Pakistani and Indian children who used these products.
  
  
  METHODS
  A retrospective chart review of children at a county hospital clinic was undertaken for the period beginning October 1991 and ending February 1994. Lead exposure questionnaires were filled out at clinic visits, and telephone interviews were conducted with parents or guardians of children from ethnic groups who use eye cosmetics.
  
  
  RESULTS
  Lead level results were available for 175 children. The average lead level was 4.3 micrograms/dL (0.21 mumol/L) for Pakistani/Indian children not using eye cosmetics and 12.9 micrograms/dL (0.62 mumol/L) (P = .03) for those using the products. Chemical evaluation of some of the eye cosmetics used by these children revealed high lead content.
  
  
  CONCLUSIONS
  Use of eye cosmetics imported from Pakistan was found to be strongly correlated with elevated blood lead levels. Although importation of leaded eye cosmetics is prohibited by law, legislation has not been effective in protecting children from this source of lead exposure. Education regarding low-level lead toxicity and avoidance of substances containing lead is needed, particularly for targeted subpopulations.
authors.affiliation: Department of Family Practice, University of California-Davis School of Medicine 95616, USA.
authors.forename: R V
authors.initials: RV
authors.lastname: Sprinkle
mesh_terms: D002675:Child, Preschool; D003358:Cosmetics / Q000009:adverse effects*; D005123:Eye; D006630:Hispanic or Latino; D006801:Humans; D007194:India / Q000208:ethnology; D007223:Infant; D007854:Lead / Q000097:blood* / Q000633:toxicity; D007855:Lead Poisoning / Q000208:ethnology / Q000209:etiology*; D010154:Pakistan / Q000208:ethnology; D012189:Retrospective Studies; D014481:United States
chemical_list: D003358:Cosmetics; D007854:Lead