Journal of Local and Global Health Science - Volume 2012, Issue 1

Kohl (surma) is a traditional eye cosmetic used in the Middle East, India, Pakistan, and parts of Africa that often contains high levels of lead (Pb), a developmental neurotoxicant. Many researchers have called for stricter governmental regulations of kohl trade and quality control and improved public education regarding its hazards and some governments have adopted import controls and educational campaigns to alert users to the hazards of using Pb-­-containing kohl. However, users remain unaware of the hazards of kohl usage, and some authorities minimize its potential danger. In this review, we summarize available data from the peer-­-reviewed literature on prevalence and attitudes regarding kohl use, Pb content of kohl samples from many sources, potential routes of entry of Pb into the body from kohl, and epidemiologic evidence that kohl is a source of Pb exposure in infants and women. Chemical analyses show that kohl has a wide range of formulae, with some containing PbS as the principal ingredient and others based on carbon and often Pb-­-free. Ocular, dermal, or gastrointestinal routes of entry of Pb into the body from kohl had been insufficiently studied to rule any of them out. The preponderance of epidemiologic evidence supports the conclusion that Pb-­-based kohl is associated with increased PbB in women who use kohl and their children.

This study was conducted in order to determine if the source of contaminants at formerly used defense sites (FUDS) in Alaska were deposited as a result of military occupancy or from long-distance transport. This determination largely influences whether remediation will occur, and, if so, to what extent. For this reason, plant samples (rinsed and unrinsed) and sediment cores were collected at military and remote sites on St. Lawrence Island (SLI) and Norton Sound, Alaska during the summers of 2002, 2006, and 2007 and analyzed for persistent organic pollutants. On St. Lawrence Island sediment core samples were collected at the Northeast Cape FUDS, also a traditional fishing/hunting camp, and were sectioned and analyzed for concentrations of Polychlorinated biphenyl (PCB) congeners, Mirex, Dichlorodiphenyldichloroethylene (DDE), Hexachlorobenzene (HCB), Mercury and Cesium-137 (¹³⁷Cs). Differences in the total concentrations and distributions of PCB congeners, Mirex, DDE and Mercury in sediment cores and in plants collected from the two SLI and three Norton Sound mainland formerly used defense sites indicate the majority of the contaminants found can be temporally related to releases during military occupancy and subsequent redistribution of contaminants. Contaminants in plant samples at the SLI sites are elevated relative to the two remote sites located on St. Lawrence Island and the three mainland Norton Sound FUDS at Elim, Unalakleet, and Wales. The concentrations, lateral and vertical distribution of the total PCBs, and congener-specific differences in sediments and plants readily differentiate locally derived from globally transported contaminants. The relative contaminant concentrations in sediment cores and between rinsed and unrinsed plants collected from the NEC FUDS indicate contaminants were remobilized and redistributed during recent site remediation activities.

Levels of daily particulates (PM2.5) were monitored at two sites in Karachi, Pakistan. One site (Korangi) is an industrial and residential neighborhood, while the other (Tibet Center) is a commercial and residential area near a major highway. Monitoring was done daily for a period of six weeks during spring, summer, fall and winter. Particulate levels were extraordinarily high, with the great majority of days falling into the “unhealthy for sensitive groups” or “very unhealthy” categories. The mean PM2.5 levels in Karachi exceeded the WHO's 24 h air quality guideline almost every day and often by a factor of greater than 5-fold. Daily emergency room (ER) visits and hospital admissions for cardiovascular diseases were obtained by review of medical records at three major tertiary and specialized hospitals. ER and hospitalizations were reported relative to days in which the concentration of PM2.5 was less than 50 μg/m³, and by 50 μg/m³ increments up to 300 μg/m³. There were statistically significant elevations in rates of hospital admissions at each of the PM2.5 categories at the Korangi site, and at concentrations >150 μg/m³ at the Tibet Center site. ER visits were significantly elevated only at PM2.5 concentrations of between 151 and 200 μg/m³ at both sites. These results show that the extremely elevated concentrations of PM2.5 in Karachi, Pakistan are, as expected, associated with significantly elevated rates of hospital admission, and to a lesser extent, ER visits for cardiovascular disease.