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Lead Poisoning in a Mother and Her Four Children Using a Traditional Eye Cosmetic - New York City, 2012-2023
Paromita Hore1, Slavenka Sedlar1, Jacqueline Ehrlich1
1Bureau of Environmental Disease and Injury Prevention, New York City Department of Health and Mental Hygiene, New York, New York.
Insights
Traditional eye cosmetic surma, containing high lead levels, caused lead poisoning in a NYC family. This highlights risks of cultural practices and the need for family-wide follow-up and global product reformulation.
Area of Science:
- Environmental Health
- Toxicology
- Public Health
Background:
- Lead exposure, even at low levels, causes developmental delays and behavioral issues in children.
- Adults are also susceptible to lead's adverse health effects.
- The New York City (NYC) Department of Health and Mental Hygiene investigates lead poisoning cases.
Purpose of the Study:
- To report a case of lead poisoning linked to traditional eye cosmetic surma.
- To highlight challenges in risk communication regarding cultural practices.
- To emphasize the need for family-centered follow-up and global product reformulation.
Main Methods:
- Case investigation initiated by blood lead testing of a 4-year-old child.
- Identification of lead exposure source through family history and product analysis.
- Monitoring of family members' blood lead levels over 11 years.
Main Results:
- A 4-year-old child and four family members exhibited elevated blood lead levels.
- The sole identified source of lead exposure was surma, containing 390,000 ppm lead.
- Intergenerational transmission of lead exposure through cultural practices was observed.
Conclusions:
- Deeply ingrained cultural practices like surma use pose significant public health challenges.
- Comprehensive family follow-up is crucial once lead exposure is identified.
- Multistakeholder global efforts are needed to eliminate lead from traditional cosmetics at the source.
Abstract:
Even low levels of lead in children's blood are associated with developmental delays, difficulty learning, and behavioral issues. Adults are also vulnerable to the detrimental health effects of lead exposure. The New York City (NYC) Department of Health and Mental Hygiene receives blood lead test results for NYC residents and conducts investigations of lead poisoning cases. Blood lead testing of a child aged 4 years in 2012 led to the discovery of blood lead levels above the CDC blood lead reference value of 3.5 μg/dL in the child as well as four other family members over a period of 11 years, including the child's mother and three younger siblings born during 2012-2016. The only potential source of lead exposure identified for all cases was the use of surma, a traditional eye cosmetic, which was found to contain 390,000 ppm lead. The cases in this report highlight the challenges of risk communication when deeply ingrained cultural practices, such as the use of surma, persist despite health warnings. Moreover, they highlight the intergenerational nature of such practices and the need for comprehensive family follow-up once a member is identified as being at risk. These products continue to be available globally, even in places such as the United States where sales are prohibited. Multistakeholder efforts involving local and global engagement could promote reformulation of these products at the countries of origin to eliminate lead as an ingredient.
