Childhood lead poisoning associated with traditional Chinese medicine: A case report and the subsequent lead source inquiry

Background: Traditional medicines or ethnic remedies, such as Ayurvedic drug of India, have been reported in numerous cases to be one of the main exposure risks for severe lead poisoning. Methods: We describe the poisoning of 2 young children from a Chinese family in Guangzhou as a result of the use of traditional Chinese medicine instead of baby powder. Results: A 3-y-old boy with blood lead levels (BLLs) of 303 mu g/l and his 6-month-old sister with BLLs of 385 mu g/l were hospitalized. Laboratory tests showed that the powder, which was purchased in Ganzhou during a family visit, contained a lead concentration of 214,000 mg/kg. A subsequent inspection revealed that the lead contamination was in fact achieved by the addition of Hongdan to talcum. In Ganzhou, it was a popular practice for young children to apply this leaded powder on their skins in order to treat and prevent dermatitis. We sampled 16 Hongdans and observed an average lead content of 817,000 mg/kg that was comprised mainly of lead tetraoxide (Pb3O4). Lead tetraoxide is also an accessible raw material for paint and battery industries. Conclusions: The health authority of China should reevaluate the safety of such traditional remedy and weigh its toxicity versus its potential benefits. Clinicians should be aware of this leaded powder when treating a lead poisoning case that shows no explainable cause. (C) 2012 Elsevier B.V. All rights reserved.