Lead Poisoning from Mexican Folk Remedies -- California
In May 1982, a 15-month-old California child and his 3-year-old
sibling were treated in Mexico with multiple doses of azarcon (lead
tetroxide) for chronic diarrhea that had been unsuccessfully
treated
with ampicillin. In June, the children were taken to a San Diego
hospital where the younger child was found to have a blood lead
level
measurement of 124 ug/dl; the 3-year-old expired with seizures. It
was not known whether an autopsy was performed, but azarcon-induced
lead encephalopathy was suspected as a cause of death.
Because of these cases, in June 1982, the Los Angeles County
Department of Health Services surveyed residents of six
predominantly
Hispanic, geographically representative census tracts in an attempt
to
estimate exposure to and knowledge of azarcon and greta (lead
oxide).
A total of 545 systematically selected households were included.
Familiarity with the substances was greatest among
Mexican-Hispanics,
and prior use was exclusive to this group. Respondents in
approximately one-quarter of Mexican-Hispanic households were
familiar
with one or both of the substances by means other than media
announcements. An estimated 7.2%-12.1% of Mexican-Hispanic
families
admitted prior use from "years ago" to within the past month. One
respondent provided interviewers with azarcon from the family
medicine
cabinet. Since investigators noted a reluctance to admit using
azarcon or greta, the incidence of ingestion might have been
greater
than results of the survey indicated.
A Colorado survey in June-September 1982 among Texas farm
workers
showed that 7.0% of 100 migrant children under 12 years of age had
been treated with substances called azarcon or greta at some time
for
gastrointestinal illness. Other states with migrant populations,
such
as Arizona, New Mexico, and Texas, are presently investigating the
problem.
Reported by T Sankury, MD, Northridge, D Cooper, MD, R Bradley, Los
Angeles County-USC Medical Center, S Fong-Huie, MPH, A Guzman, L
Habel, MPH, W Janer, L Lieb, MPH, A Martinez, MPH, L Portigal, MS,
G
Ramirez, F Sorvillo, MPH, B Weiss, MPH, Los Angeles County Dept of
Health Svcs, D Dassey, MD, Riverside County Health Dept, T Kearney,
PharmD, Regional Poison Center, M Ginsberg, MD, San Diego County
Health Dept, R Schlag, R Murray, DrPh, J Chin, MD, State
Epidemiologist, California Dept of Health Svcs; A Ackerman, PhD,
Sunrise Community Health Center, Colorado; W Meister, MD, West
Michigan Poison Control Center, J Miller, Migrant and Rural Health
Association, Michigan; V Boersma, MD, D Bol, Holland Migrant Health
Clinic, L Truskowski, K Higgins, A Scheit, L del Rio, Kenosha
Health
Dept, Wisconsin; R Trotter, PhD, Pan American University, IG
Gosset,
MD, Pan American Health Organization, El Paso, Texas; HF Newman,
MD,
US Food and Drug Administration, Texas; R Tyler, Women and Infant
Care
Program, Dept of Health and Human Svcs, Chicago, Illinois.
Editorial Note
Editorial Note: In summer 1981, the first cases of lead poisoning
associated with the Mexican folk remedy, azarcon, were identified
in
Los Angeles, California, and Colorado (1,2). Since that time, nine
additional confirmed cases associated with the ingestion of azarcon
or
the related remedy, greta, have been reported in California. In
addition, five cases have been reported from Michigan and
Wisconsin.
Greta and azarcon are fine powders with total lead contents
varying from 70% to greater than 90%. As powder, they provide a
large
surface area for potential absorption. These remedies apparently
are
most often administered to infants and children, who are the most
susceptible in terms of clinical impact and the capacity to absorb
lead.
With the identification of multiple cases of lead poisoning and
indication of significant exposure, major media efforts publicizing
the dangers of azarcon and greta have been directed at Hispanic
communities in California. Until recently, these substances were
available at herb shops and from folk healers on both sides of the
Mexican-American border. The U.S. Food and Drug Administration
(FDA)
has initiated a national recall of greta, and a reported 25 pounds
of
the substance was recently seized in southern Texas. The FDA is
currently investigating the sale of greta in the Yakima Valley of
Washington State. Mexican health authorities have reportedly
instituted recall efforts in Baja California, Mexico.
Mexican-American border. The U.S. Food and Drug Administration
(FDA)
has initiated a national recall of greta, and a reported 25 pounds
of
the substance was recently seized in southern Texas. The FDA is
currently investigating the sale of greta in the Yakima Valley of
Washington State. Mexican health authorities have reportedly
instituted recall efforts in Baja California, Mexico.
Health professionals are urged to report cases of azarcon- or
greta-associated lead poisonings and to promote educational
programs
in their Hispanic communities regarding the dangers of these folk
remedies. Health education material in Spanish and English is
available from the State of California and Los Angeles County
Departments of Health Services and from the Sunrise Community
Health
Center, P.O. Box 245, Greely, Colorado 80632.
References
CDC. Use of lead tetroxide as a folk remedy for
gastrointestinal
illness. MMWR 1981;30:546-7.
CDC. Lead poisoning from lead tetroxide used as a folk
remedy--Colorado. MMWR 1981;30:647-8.
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