Globalization, binational communities, and imported food risks: results of an outbreak investigation of lead poisoning in Monterey County, California.
OBJECTIVE
Although the burden of lead poisoning has decreased across developed countries, it remains the most prevalent environmental poison worldwide. Our objective was to investigate the sources of an outbreak of lead poisoning in Monterey County, California.


METHODS
An investigation in 3 county health department clinics in Monterey County, California, was conducted between 2001 and 2003 to identify risk factors for elevated blood lead levels (> or = 10 microg/dL) among children and pregnant women.


RESULTS
The prevalence of elevated blood lead levels was significantly higher in 1 of the 3 clinics (6% among screened children and 13% among prenatal patients). Risk factors included eating imported foods (relative risk [RR]=3.4; 95% confidence interval [CI]=1.2, 9.5) and having originated from the Zimatlan area of Oaxaca, Mexico, compared with other areas of Oaxaca (RR=4.0; 95% CI=1.7, 9.5). Home-prepared dried grasshoppers (chapulines) sent from Oaxaca were found to contain significant amounts of lead.


CONCLUSIONS
Consumption of foods imported from Oaxaca was identified as a risk factor for elevated blood lead levels in Monterey County, California. Lead-contaminated imported chapulines were identified as 1 source of lead poisoning, although other sources may also contribute to the observed findings. Food transport between binational communities presents a unique risk for the importation of environmental hazards [corrected]
Handley
Margaret A
MA
Department of Family Medicine and Community Medicine, University of California, San Francisco 94110, USA. handleym@fcm.ucsf.edu
Hall
Celeste
C
Sanford
Eric
E
Diaz
Evie
E
Gonzalez-Mendez
Enrique
E
Drace
Kaitie
K
Wilson
Robert
R
Villalobos
Mario
M
Croughan
Mary
M
D000328:Adult; D000818:Animals; D002140:California; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003132:Commerce; D004196:Disease Outbreaks; D005260:Female; D005506:Food Contamination; D006110:Grasshoppers / Q000737:chemistry; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007391:International Cooperation; D007855:Lead Poisoning / Q000453:epidemiology*; D008800:Mexico; D011247:Pregnancy; D012307:Risk Factors