title: Adverse events associated with metal contamination of traditional chinese medicines in Korea: a clinical review.
abstract: This study was performed to review studies carried out in Korea reporting toxic reactions to traditional Chinese medicines (TCMs) as a result of heavy metal contamination. PubMed (1966-August 2013) and International Pharmaceutical Abstracts (1965-August 2013) were searched using the medical subject heading terms of "Medicine, Chinese Traditional," "Medicine, Korean Traditional," "Medicine, Traditional," "Metals, Heavy," and "Drug Contamination". For Korean literature, Korea Med (http://www.koreamed.org), the Korean Medical Database (http://kmbase.medric.or.kr), National Discovery for Science Leaders (www.ndsl.kr), Research Information Sharing Service (http://www.riss.kr), and Google Scholar were searched using the terms "Chinese medicine," "Korean medicine," "herbal medicine," and "metallic contamination" in Korean. Bibliographies of case reports and case series, identified using secondary resources, were also utilized. Only literature describing cases or studies performed in Korea were included. Case reports identified clear issues with heavy metal, particularly lead, contamination of TCMs utilized in Korea. No international standardization guidelines for processing, manufacturing and marketing of herbal products exist. Unacceptably high levels of toxic metals can be present in TCM preparations. Health care providers and patients should be educated on the potential risks associated with TCMs. International advocacy for stricter standardization procedures for production of TCMs is warranted.
authors.affiliation: College of Pharmacy, Sookmyung Women's University, Seoul, Korea.
authors.forename: Hyunah
authors.initials: H
authors.lastname: Kim
authors.affiliation: McWhorter School of Pharmacy, Samford University, Birmingham, AL, USA. pjhughes@samford.edu.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hughes
authors.affiliation: Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Hawes
mesh_terms: D004340:Drug Contamination; D004365:Drugs, Chinese Herbal / Q000009:adverse effects* / Q000737:chemistry; D000075322:Heavy Metal Poisoning; D006801:Humans; D008516:Medicine, Chinese Traditional; D055670:Medicine, Korean Traditional; D011041:Poisoning; D056910:Republic of Korea; D018570:Risk Assessment
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Korean traditional; Medicine; chinese traditional; heavy; medicine; metals