title: A cluster of lead poisoning among consumers of Ayurvedic medicine.
abstract: BACKGROUND
  Use of alternative medications and herbal remedies is widespread in the United States and across the globe. These traditional medications can be contaminated with toxic metals. Despite several case reports of poisoning from such contamination, the epidemiological data are still limited.
  
  
  OBJECTIVE
  To report on a cluster of lead and mercury toxicity cases in 2011 among a community of adherents of traditional medical practice of Ayurveda.
  
  
  METHODS
  Adherents of Ayurveda were offered heavy metals screening following the identification of the index case.
  
  
  RESULTS
  Forty-six of 115 participants (40%) had elevated blood lead levels (BLLs) of 10 μg/dl or above, with 9.6% of BLLs at or above 50 μg/dl.
  
  
  CONCLUSIONS
  This is the largest cluster of lead and mercury toxicity following use of Ayurvedic supplements described in the literature in the US. Contamination of herbal products is a public health issue of global significance. There are few regulations addressing contamination of "natural" products or supplements.
authors.affiliation: Department of Occupational and Environmental Health, College of Public Health, The University of Iowa , Iowa City, IA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Breeher
authors.forename: Marek A
authors.initials: MA
authors.lastname: Mikulski
authors.forename: Thomas
authors.initials: T
authors.lastname: Czeczok
authors.forename: Kathy
authors.initials: K
authors.lastname: Leinenkugel
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Fuortes
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008515:Medicine, Ayurvedic; D008628:Mercury / Q000097:blood*; D008630:Mercury Poisoning / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D028321:Plant Preparations / Q000009:adverse effects*
chemical_list: D028321:Plant Preparations; D007854:Lead; D008628:Mercury
keywords: Ayurvedic medicine; Complementary and alternative medicine; Lead toxicity; Mercury toxicity; Public health response
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