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APHA Scientific Session and Event Listing

Robert Saper, MD, MPH¹, Nadia Khouri, MPH¹, Janet Paquin, PhD², and Stefanos Kales, MD, MPH³. (1) Department of Family Medicine, Boston University School of Medicine, 1 Boston Medical Center Place, Dowling 5 South, Boston, MA 02118-2393, (617) 414-6276, Robert.saper@bmc.org, (2) New England Regional EPA Laboratory, 11 Technology Drive, North Chelmsford, MA 01863, (3) The Cambridge Health Alliance, Macht Building, Room 427, 1493 Cambridge Street, Cambridge, MA 02139

BACKGROUND: Ayurveda is a traditional medical system originating in India. Saper et al demonstrated that 20% of Ayurvedic herbal medicine products (HMPs) manufactured in South Asia and available in Boston ethnic groceries contained high levels of heavy metals. It is unknown if these findings are generalizable to an internationally representative sample of HMPs manufactured in the U.S. and South Asia.

METHODS: We searched Google, AOL, MSN, Yahoo and Ask Jeeves using the keywords ‘Ayurvedic medicine.' We compiled a database of all Ayurvedic HMPs for sale from websites appearing on the first page of each engine's search results. We randomly selected 230 HMPs for purchase. HMPs will be analyzed for lead, mercury, and arsenic content using x-ray fluorescence spectroscopy. HMPs with no detectable lead will be further analyzed using inductively coupled plasma mass spectroscopy. The prevalence of heavy metal-containing HMPs will be determined. Mean metal concentrations for HMPs manufactured in the U.S. and India will be compared using the paired sample student t test.

RESULTS: Our search identified 673 unique Ayurvedic HMPs. Of the 230 HMPs randomly selected for purchase, we were able to obtain 193. Of these, 110 in were manufactured in North America, 79 in India, and 4 unknown. Four percent specifically recommended pediatric use. We will present the results of our metal analyses and prevalence calculations.

IMPLICATIONS: If Ayurvedic HMPs sold on the Internet are found to contain heavy metals, public health advisories and stricter regulation of HMP production, sale and importation will be justified.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe an internet search strategy to identify an internationally representative sample of Ayurvedic herbal medicine products (HMPs).
• Define the prevalence of lead, mercury, and arsenic in an internationally representative sample of Ayurvedic HMPs.
• Discuss the implications of our study for dietary supplement regulatory policy.

Keywords: Alternative Medicine/Therapies, Lead

Presenting author's disclosure statement:

Any relevant financial relationships? No