116 JOURNAL OF COSMETIC SCIENCE The other (i.e. "cold") "Surma Noor-Ul-Ain" sample had calcium carbonate in two forms (calcite and aragonite) as its major phase at a combined percentage of only 60%. Its minor phases were zincite (25%), with the remaining 15% covering the combined minor phases of kaolinite, graphite, magnetite, and quartz. The red/red-orange samples, "Hamid Al-Misk" and "Al Athmad," had major phases of goethite and hematite, re- spectively (each at 60% ), and minor phases (totalling the remaining 40%) of quartz plus hematite and quartz plus goethite, respectively. The last of these seven samples in Table I was "Nimco No. 96. Neem Ka Tez Surma (Special)," which had a combination of talc and dolomite (at a total of 87%) listed as the major phase(s) and a minor phase of galena (13%). Many of the 53 samples in Tables I and II originated in Pakistan (22) or India (16). The remainder came from Iran (7), Saudi Arabia (4), and Dubai, France, Morocco, and Syria supplying one each. Three of the samples from Iran, which had amorphous carbon as their major phases, unexpectedly had the mineral rutile (impure TiO2, often having a reddish coloration from the presence of small amounts of hematite) as a minor phase. DISCUSSION TOXICOLOGY OF LEAD Lead compounds are toxic by ingestion, inhalation, and skin exposure. Children are more susceptible than adults to lead intoxication. Adults absorb 5-15% of ingested lead while children can absorb as much as 41 % of ingested lead. The toxic effects of lead form a continuum from clinical or overt effects to more subtle ones (6). The critical effects in infants and children involve the nervous system. Blood lead levels once thought to be safe have been shown to be associated with intelligence quotient deficits, behavioral disorders, slowed growth, and impaired hearing (7 ,8). Blood lead levels in children that are greater than 10 µg/dl are now considered abnormal (9), and recently it has been shown that significant intellectual impairment occurs in young children who have blood lead levels below 10 µg/dl (5). Severe lead poisoning, resulting in encephalopathy, can result when blood lead levels are greater than 70 µg/dl. A recent report has demonstrated that young infants exposed to lower levels of lead following the use of traditional medicines can also present with encephalopathy (10). Reported cases of acute encephalopathy in infants that are directly linked to excessive use of a lead-based kohl are now fewer than several decades ago, but unfortunately do still occur (11). Frequently, mothers apply kohl to infants and children as a traditional measure to beautify and to protect the child from the "evil eye." Lead-containing kohls can be easily ingested by these infants, who may wipe their eyes and face, and subsequently lick their fingers. Earlier (animal) studies (12) have shown that trancorneal transport is not a significant contributory mechanism for absorption of lead from lead-based eye cosmetics. More than 90% of lead in blood resides in the red blood cells. The total body burden of lead can be divided into two kinetic pools, which have different rates of turnover. The largest pool is in the skeleton, which has a very slow turnover (a half life of more than 20 years) (9). The other pool is in the soft tissue, where it is much more labile. Lead in trabecular bone is more labile than in cortical bone, and trabecular bone has a shorter

AVAILABILITY AND COMPOSITION OF "KOHLS" 117 turnover time. Lead in the bone may contribute up to 50% of blood lead. During pregnancy and lactation, mobilization of lead from maternal bone is a cause for concern. Strong correlations between maternal and umbilical cord blood lead levels demonstrate that lead is transferred from the mother to the fetus (13 ). Cumulative effects of low levels of lead exposure in utero and after birth can have similar detrimental effects. An increase in the maternal-blood lead level may contribute to a reduction in gestation period and low birthweight. The fetal brain may also be particularly sensitive to the toxic effects of lead because of the immaturity of the blood-brain barrier. In an adult population, the most critical adverse effect of lead is probably hypertension. Other toxic effects of concern are peripheral neuropathy, lead-induced anemia, and lead nephropathy. In a previous publication (3) we discussed galena's (lead sulfide, PbS) particle size with respect to the associated kohl powder being "shiny" or "matte" in texture and with respect to its rate of dissolution in gastric fluid. It was found by us that at a mean particle size for galena of about 10 µm, the kohl powder (with galena as the major phase) became totally matte in texture. It had previously been found (12) that reducing the particle size of galena leads to a significant increase in its rate of dissolution (in gastric fluid). So, in a very simplistic toxicology sense, it can be said: "shiny is good and matte is bad" (as the latter would be much more easily dissolved in gastric fluid than the former, with the former perhaps going straight through the body with minimum absorption and negligible toxicity). Thus in Tables I and II we have stated if the powder is "shiny" or "matte" in texture when galena is the listed major phase. In Table I only one such sample is matte, but in Table II six are matte in texture. While the Table I sample "Zikra Al Haramain" is available in three of the six emirates studied here, it is also very expensive (30 dirhams) and so is therefore unlikely to be bought extensively by the local populace. However, the six such samples in Table II have one available in two, four in three, and one in all six emirates, with their prices ranging from 1 to 4 dirhams. Thus these six samples are, unfortunately, much more likely to be purchased extensively by the local populace and so could give rise to significant lead toxicity if used in such a way that adsorption can readily occur (e.g., if used on the conjunctiva of the eye). In view of all the above-mentioned toxic effects and the still widespread use of kohls in at least parts of the present-day Middle East, it follows that children who have a lead-based kohl regularly applied to them are at risk of serious and fatal toxicities of the nervous system and also to more subtle, subclinical, long-term effects. WRITTEN INFORMATION ON CONTAINER PACKAGING Eleven of the samples listed in Tables I and II have detailed (i.e., quantitative "contents data" provided with the sample (usually on an enclosed leaflet). Table III lists this detailed "contents data," our best translations/interpretations, and the (most likely) associated chemical/mineral names. There are still some "formula names" that we have been unable to translate and others with a degree of uncertainty in their translation (i.e., those with a "?" added). Most of the major phases found match a "formula name" in the "contents data," usually one with a high given percentage. Additionally, there are six more samples where qualitative "contents data" are given. For three of these samples, the information given is vague: (made with) "almonds" (trans-