We postulate that the observed effect of pyrethroids exposure was related to a slower pace of foetal development corresponding to the small-for-gestational-age (SGA) birth.

Background Herbal formulations, traditional medicine, and complementary and alternative medicine are used by the majority of the world's population. Toxicity associated with use of Ayurvedic products due to metal content is an increasingly recognized potential public health problem. Objectives Report on toxic metals content of Ayurvedic products obtained during an investigation of lead poisoning among users of Ayurvedic medicine. Methods Samples of Ayurvedic formulations were analyzed for metals and metalloids following established US. Environmental Protection Agency methods. Results Lead was found in 65% of 252 Ayurvedic medicine samples with mercury and arsenic found in 38 and 32% of samples, respectively. Almost half of samples containing mercury, 36% of samples containing lead and 39% of samples containing arsenic had concentrations of those metals per pill that exceeded, up to several thousand times, the recommended daily intake values for pharmaceutical impurities. Conclusions Lack of regulations regarding manufacturing and content or purity of Ayurvedic and other herbal formulations poses a significant global public health problem.

Background: Use of alternative medications and herbal remedies is widespread in the United States and across the globe. These traditional medications can be contaminated with toxic metals. Despite several case reports of poisoning from such contamination, the epidemiological data are still limited. Objectives: To report on a cluster of lead and mercury toxicity cases in 2011 among a community of adherents of traditional medical practice of Ayurveda. Methods: Adherents of Ayurveda were offered heavy metals screening following the identification of the index case. Results: Forty-six of 115 participants (40%) had elevated blood lead levels (BLLs) of 10 mg/dl or above, with 9.6% of BLLs at or above 50 mg/dl. Conclusions: This is the largest cluster of lead and mercury toxicity following use of Ayurvedic supplements described in the literature in the US. Contamination of herbal products is a public health issue of global significance. There are few regulations addressing contamination of ''natural'' products or supplements.

These results confirm the need to screen workers using beryllium alloy tools in other industries and for consideration of altering work practices.

This study found age-related discordance between two algorithms possibly related to the lack of reference equations and standards for individuals older than 80 years.