Lead poisoning by contaminated flour

Between October 1982 and June 1983, 43 patients were identified with symptomatic lead poisoning in three Arab villages of the Nablus district. Because of the clustering of clinical poisoning by household units, investigation was focussed on potential sources common to all members of the households. After excluding water, olive oil and a variety of foodstuff, lead in high concentrations was discovered in locally ground flour in all affected households. The source of poisoning was lead poured into the fissures between the metal housing and the driveshaft of the millstone. Significant lead contamination of freshly ground flour was demonstrated in 23% of the 146 community flour mills operating in West Bank villages. Since the completion of these studies, similar outbreaks of lead poisoning caused by contaminated flourmills have been identified in the Upper Galilee and in Spain. As the methods of milling in the Mediterranean area are similar, a coordinated international effort is needed in order to eliminate this health hazard from countries where similar community stone mills are still in use.