Abstract Acute ingestions of spherical lead ammunition foreign bodies such as bullets and lead shot can cause acute blood lead level elevations and clinical symptoms necessitating emergency department evaluations and sometimes treatment. This article presents 3 cases of children ingesting lead ammunition, all receiving gastrointestinal (GI) decontamination and chelation therapy for significantly elevated blood lead level. Case-specific exposures and treatments for the lead ammunitions are presented. Radiographs documented lead pellet ingestion in all 3 cases. Pediatric patients absorb lead from the GI tract more quickly than adults and may necessitate more urgent evaluation and treatment than adolescents/adults. More rapid GI absorption has the potential to result in possible irreversible neurotoxicity and neurocognitive deficits as well as behavioral changes. Failure of lead foreign bodies to pass from the GI tract may require more aggressive interventions for their removal to prevent ongoing absorption. Emergency health care providers should be aware of alternative lead sources besides the most common source of paint, as these lead foreign bodies also need urgent evaluation and possibly treatment.

Activated charcoal is an adsorbent material which is consumed as a dietary supplement (100 mg) and as non-specific antidote treatment in acute poisoning at 0.5-1 g kg-1 body weight in infants and 50 g in adults. The ingestion of large quantities of it has aroused our interest in the presence of metals impurities. Therefore, the present study aimed to assess trace elements in activated charcoal products. Multielement analysis were performed using Inductively Coupled Plasma-Mass Spectrometry after digestion. Estimated daily Intake was calculated and compared to references doses for each element. Varying trace elements have been found: chromium (0.3383 ± 0.089 µg g-1), cadmium (0.5991 ± 0.2967 µg g-1), aluminum (0.7033 ± 0.1215 µg g-1), nickel (0.0111 ± 0.003 µg g-1), lead (0.0052 ± 0.0021 µg g-1), zinc (0.0414 ± 0.0076 µg g-1), and manganese (0.0036 ± 0.0006 µg g-1). when 50 g of activated charcoal is consumed by a 70 kg adult, aluminum estimated daily intake is 0.0005 mg/kg bw/day which exceeds the reference dose (0.0004 mg/kg bw/day). In the infants, consumption of 15 g of contaminated activated charcoal exposes to chromium, cadmium and aluminum as their estimated daily intake (0.00034; 0.0006; 0.0007 mg/kg bw/day respectively) exceed their reference doses (0.0003; 0.0005; 0.0004 mg/kg bw/day respectively). These trace elements are not without risk to consumers health. Activated charcoal products could be contaminated with elemental impurities. Pharmaceutical industries shoul

California condors (Gymnogyps californianus) released into the wild in Arizona ranged widely in Arizona and Utah. Previous studies have shown that the blood lead concentrations of many of the birds rise because of ingestion of spent lead ammunition. Condors were routinely recaptured and treated to reduce their lead levels as necessary but, even so, several died from lead poisoning. We used tracking data from VHF and satellite tags, together with the results of routine testing of blood lead concentrations, to estimate daily changes in blood lead level in relation to the location of each bird. T Previous studies have shown that the blood lead concentrations of many of the birds rise because of ingestion of spent lead ammunition. Condors were routinely recaptured and treated to reduce their lead levels as necessary but, even so, several died from lead poisoning. We used tracking data from VHF and satellite tags, together with the results of routine testing of blood lead concentrations, to estimate daily changes in blood lead level in relation to the location of each bird. The mean daily increment in blood lead concentration depended upon both the location of the bird and the time of year. Birds that spent time during the deer hunting season in two areas in which deer were shot with lead ammunition (Kaibab Plateau (Arizona) and Zion (Utah)) were especially likely to have high blood lead levels. The influence upon blood lead level of presence in a particular area declined with time elapsed since the bird was last there. We estimated the daily blood lead level for each bird and its influence upon daily mortality rate from lead poisoning. Condors with high blood lead over a protracted period were much more likely to die than birds with low blood lead or short-term elevation. Individual condors in these populations have suffered from lead poisoning caused by ingested ammunition, which is the most frequently diagnosed cause of death among Grand Canyon condors. This holds despite intensive efforts to monitor blood concentrations of lead and to treat birds with high levels using chelating agents [1] . The condors in the Grand Canyon population range widely in Arizona and Utah and feed on carrion, a proportion of which comes from the carcasses of game animals shot by hunters using lead ammunition. Ingestion of shotgun pellets and This is because only eight deaths from lead poisoning were observed in 2005–2007 and, of these, two deaths occurred early in 2005 with inadequate data on their prior movement history, leaving only six birds with sufficient information. A model with many parameters cannot be supported by this small sample size. Therefore, we undertook the modeling of mortality in two steps. First, we used the zone- and season-specific estimates of mean daily blood lead increments m from the analysis described above and the observed movements of each bird to reconstruct expected values E( v ) of blood lead concentration from Eq.(2) for every day on which each bird was free-ranging. We used logistic regression to fit the relationship between the daily probability of death from lead poisoning and the weighted mean of E( v ) on and prior to each focal day. We used a bisection search to determine the value of the parameter q of the weighting function that maximised the log-likelihood of the data. The data to which the model was fitted comprised all bird-days in 2005–2007 on which condors were free-ranging, including the two bird-days on which deaths from lead poisoning of free-living birds occurred and four bird-days on which birds were taken into captivity with high blood lead levels from which they subsequently died. We ran the Monte Carlo simulations for each of the bootstrap sets of parameter values described in the analysis of mortality and took the central 95% of bootstrap estimates of annual mortality caused by lead poisoning to be its 95% confidence limits. Results Relationship of blood lead level to time since ingestion We fitted the model summarized in Eq.(2) to the 322 pairs of blood lead measurements derived from 60 condors, as described above. We used both the one-parameter and two-parameter forms of the function g( t ) that relates blood lead concentration to time since ingestion. Table 2 Maximum-likelihood estimates, with 95% bootstrap confidence limits, for the parameters of a logistic regression model relating the daily probability of death of a California condor from lead poisoning to the weighted mean of its modeled blood lead concentration (µg dL −1 ) on the focal day and on previous days. Parameter Estimate Lower C.L. Upper C.L. q 125.3 48.5 323.1 Intercept −12.31 −14.80 −9.81 Slope 0.07971 0.04460 0.1148 The parameter q (in days) determines the shape of the weighting function used to calculate the weighted mean blood lead concentration. The results were consistent with ingestion of lead being followed, in the absence of further ingestion, by a progressive exponential diminution in its concentration in the blood, with a half-life of 17 days. This pattern is broadly similar to that found in a previous study of captive condors with initially high levels of lead in the blood [7] . The daily death rate from lead intoxication was highest if blood lead levels, simulated using observed movements and the model of lead acquisition and depletion, remained high over a period exceeding one hundred days. Short periods with similarly high blood lead resulted in a lower death rate per day. Only then is a self-sustaining population of free-living California condors likely to persist within the Grand Canyon area currently occupied without continued veterinary management and the regular addition of captive-bred birds. Poisoning caused by ingestion of spent lead ammunition is a widespread hazard to many species of wild birds [6] , but few previous studies have estimated the effect on mortality rates of differential exposure to lead ammunition of free-ranging individuals [9] , [10] .

Humans have used cosmetics for thousands of years. In recent years there has been growing consumer concern that cosmetics may contain harmful levels of toxic substances. For example, in 2007 the Campaign for Safe Cosmetics published a report drawing attention to the lead content in lipsticks and lip glosses,1 and in 2009 and 2011 the Food and Drug Administration (FDA) published its own findings on lead in lipsticks.2 A new study in EHP once again turns attention to metals in lip products, this time reporting on levels not just of lead but also of aluminum, cadmium, cobalt, chromium, copper, manganese, nickel, and titanium.3 The researchers purchased 32 lip products and applied optical emission spectrometry to determine their metal content. All the products contained manganese, titanium, and aluminum, with the latter two metals showing up at the highest concentrations. Three-quarters contained detectable amounts of lead, and in nearly half the samples, lead levels were higher than the FDA standard of 0.1 ppm for lead in candy. According to the authors, neither price nor type of product (lipstick versus lip gloss) affected the metal concentrations. Based on usage data4 reported by the Personal Care Products Council (PCPC), a cosmetics industry group, the authors assumed the women ingested all the lip product they applied each day—an average of 24 mg per day, reaching 87 mg per day in the 95th percentile. They estimated intake of each metal based on the concentrations measured i