CHEMICAL COMPOSITION OF "KOHLS" 407 For the ten samples obtained in Yemen (Table II) it was found that five had galena as the main component, with a further three having it present as a minor component. One of these five samples was a "shiny" silver-grey lump, one a matte black powder, and three were "shiny" grey-black powders. One sample (100% galena) came from the mountains of either (N.) Yemen or from those of nearby Saudi Arabia, another came from Saudi Arabia (Mecca), two were of uncertain origin (possibly Yemen), and one was stated to come from the mountains north of Saana (i.e., in Yemen). Four of the five samples have, as above, minor phases (varying between approx. 2% and 18%) of cerussite and anglesite, and again these are thought to be oxidation/weathering products of the original galena ore. A further three samples had zincite as the major phase, all being black in color. Two were greasy (made in Pakistan) and one a powder (made in India). The latter sample had amorphous carbon present as a minor phase, while the two from Pakistan had galena as minor phases (at about 3 % in each sample). The two remaining samples had quartz (SiO2 , at about 95%) and iron oxides (hematite, Fe 2 O 3 and goethite, FeO(OH), at a total of about 82%) as their major phases. The latter sample was red in color and had minor phases (at about 7% or less each) of quartz, galena, calcite, and talc/an alumino­ silicate the former was grey in color and had minor phases (at less than 5 % each) of calcite and an unknown phase. A few other minor phases (all at less than 5%) were found: wax in the (2) greasy samples and sphalerite (ZnS), probably as an impurity in the original galena, in another sample. As already stated, the major phases listed in Tables I and II usually had a presence in the sample of 2::70%. However, for two of the samples in Table I ("Nirma Surmi" and "Shamsi Surma") the major phase listed was in fact less than 70%, being 51 % (talc) and 45% (sassolite), respectively (where both percentages are estimates). The meaning/importance of the texture (i.e., "shiny" or "matte") of a galena-based (i.e., as the major phase) sample is mentioned in the Discussion section below. Also, where samples were greasy (overall, seven such samples), this was caused by the presence of wax. This wax was assumed to be, with one possible exception (the sample "Khojati Mumtaz Cold Kajal" see below for details), paraffin wax. 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 % . The toxic effects of lead form a continuum from clinical or overt effects to more subtle ones (9). 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 (10,11). Blood lead level (BLL) values in children that are greater than 10 µg/dl are now considered abnormal (12), and recently it has been shown that significant intellectual impairment occurs in young children who have blood lead levels below 10 µg/dl (13,14). However, while it was initially thought that such impairments were persistent and irreversible, it is now suggested that the latter may not be true (15). Increasingly it is being suggested that the above-mentioned limit in children (10 µg/dl)

408 JOURNAL OF COSMETIC SCIENCE is no longer a safe threshold, especially for children's neurodevelopment, and it has very recently been suggested that this threshold be reduced to 2 µg/dl (16). 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 (17). Reported cases of acute encephalopathy in infants that are directly linked to excessive use of a lead-based kohl are now fewer than were reported several decades ago, but unfortunately do still occur (18). Deliberate poisoning via lead-based kohl is extremely rare, and very recently a case of such a homicidal poisoning was reported in Egypt (5). It should also be stated that lead poisoning, from traditional remedies and cosmetics, does still occasionally occur in present-day Europe (19). Frequently, mothers apply kohl to infants and children as a traditional measure to beautify and to protect the child from the "evil eye"/"the evil one." 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 (20) have shown that transcor­ neal transport is not a significant contributory mechanism for absorption of lead from lead-based eye cosmetics. Recent dermal studies (21,22) have indicated that inorganic lead compounds can be absorbed through skin. However, the BLL values, from such studies, do not show any significant increase. Thus more work is required on dermal absorption of lead, especially with respect to the small particle-sized (see below) lead sulfide found in some kohls. 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) (12). The other pool is in the soft tissue, where lead is much more labile. Lead in trabecular bone is more labile than in cortical bone, and trabecular bone has a shorter turnover time. Lead in 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 (23). Cumulative effects of low levels of lead exposure in utero and after birth can have similar detrimental effects. An increase in maternal-blood lead level may contribute to a reduction in the 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. Also, as mentioned in the Introduction, there has recently been a suggested link made between the frequency of lead-based kohl use and the accentuation of peri­ orbital pigmentation and the development of associated anemia (4). BLL values have been investigated for children of both Yemeni and Qatari families. However, the Yemeni families studied lived as immigrants in the Detroit (Michigan, USA) metropolitan area, and there was no detailed study of any underlying risk factors­ such as lead-based kohl usage. The study (24) focused primarily on gender and health issues during the outreach program. Of the total of 112 blood samples tested it was found that only seven (i.e., 6.2%) had BLLs greater than 10 µg/dl (and with no samples greater than 16 µg/dl). Further projects are under way and may well include the study