Population effects of turmeric consumption on pediatric blood lead levels

Introduction: A number of pediatric lead poisoning case reports have implicated spices as the source of exposure. We carried out this research to improve characterization of the health risks associated with consumption of spices. We focused on turmeric due to its widespread use as a flavor enhancing and coloring agent, emerging popularity as an anti-oxidant, and anecdotal accounts of adulteration with lead chromate to improve pigmentation and increase weight. Methods: We collected 32 turmeric samples from grocery stores in the Boston Metropolitan Area and measured lead concentration using ICP-MS. We determined bioaccessibility using a modified EPA protocol and conducted a probabilistic exposure assessment using our concentration data in combination with spice intake data. We employed EPA's Integrated Exposure Uptake Biokinetic (IEUBK) software to predict the effects of turmeric consumption on pediatric blood lead levels. Results: We found the median lead concentration to be 0.10 µg/g (range 0.02 – 111.50 µg/g). While guidelines for allowable levels of lead in spices have not been established, half of our samples exceeded the FDA's allowable level of lead in candy (0.1 ppm) and two of our samples exceeded this concentration by 2-3 orders of magnitude. Interestingly, these outliers were our only samples imported from Bangladesh. Discussion: As traditional sources of lead are controlled and mitigated, alternative pathways assume greater visibility and importance and must be evaluated to accurately characterize a child's cumulative exposure. This analysis applies the public health paradigm to an issue previously treated at the individual level and provides insight on one of these non-traditional pathways. Interpretation of the risk estimates in light of the recently lowered CDC blood lead benchmark indicates the need for intervention. We propose the development and implementation of recommendations targeted towards consumers, clinicians and regulatory agencies for reducing lead exposure from consumption of spices.