Atypical sources of childhood lead poisoning in the United States: a systematic review from 1966-2006.
BACKGROUND
Lead poisoning from atypical sources, which excludes the well-established lead-based paint ingestions and exposure in occupational settings, are increasingly reported in medical literature. Our objective is to increase awareness on atypical sources of lead exposure and to formulate recommendations for their detection based on actual reported cases.


METHODS
We systematically retrieved and reviewed reports on pediatric lead poisoning in the U.S. from atypical sources by searching Medline, Embase, CINAHL, Academic Search Premier, AltHealth, websites of state lead poisoning prevention programs, and the U.S. Consumer Product Safety Commission database for reports published from January 1966 to December 2006.


RESULTS
We retrieved 28 published reports that met our inclusion criteria. Of these reports, 20 are case reports and 8 case series, documenting a total of 82 incidents of lead poisoning in children from atypical sources.


CONCLUSIONS
There are varied sources of atypical lead exposure among U.S. children. The sources were grouped in the following categories based on their utility: fashion accessories, folk remedies, imported condiments & candies, pellets & bullets, and lastly, recreational & domestic items. Based on these findings, we have formulated a questionnaire that may assist in the identification of atypical lead sources in the home.
Gorospe
Emmanuel C
EC
University ofNevada Las Vegas, School of Public Health, Department of Environmental & Occupational Health, Las Vegas, Nevada 89154-3064, USA.
Gerstenberger
Shawn L
SL
D002182:Candy / Q000009:adverse effects; D002648:Child; D003212:Condiments / Q000009:adverse effects; D003358:Cosmetics / Q000009:adverse effects; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000009:adverse effects*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006794:Household Articles; D006801:Humans; D007223:Infant; D007855:Lead Poisoning / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008519:Medicine, Traditional; D010988:Play and Playthings; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D003358:Cosmetics; D004785:Environmental Pollutants