A study was carried out by the Factories and Machinery Department of Malaysia to assess the problem ofoccupational exposure to inorganic lead in Malaysian battery workers. The eight factories studied were divided into two categories: large, multinational subsidiaries with good industrial hygiene measures and small, locally-owned companies with poor hygiene features. A total of 251 workers (221 males and 30 females) were included in the study. Personal air sampling showed that 47% of the samples in the small factories had lead-in-air levels exceeding 150 ug/m3, compared unth. 29% in the larger establishments. The highest air lead levels were found in the cutting, pasting/mixing and battery assembly sections. 86.7% ofthe female workers and 62.2% of the male workers in the smaller factories had blood lead concentrations above the proposed limits of 70 ug/100 ml (males) and 40 ug/100 ml (females). In contrast, only 7.6% of the male workers in the larger factories had blood lead levels exceeding the proposed limits. Three workers also had positive signs or symptoms on clinical examination. Legislation of specific regulations to protect the health of lead-exposed workers in Malaysia is currently being drafted by the government.
We report here a case of lead poisoning in a 20 month old girl who presented with acute encephalopathy and status epilepticus. The major clues leading to the diagnosis were the occupational family history and dense lead lines on X-ray of the long bones. She showed evidence of neurological dysfunction in the initial phase, but she improved steadily, regaining her motor power partially and her vision, although some cognitive and language deficits were already evident. She will need long-term neurological assessment and evaluation to ascertain the extent of permanent brain damage.
In Malaysia, the phase 3 registration for traditional medicines was implemented on 1 January 1992 under the Control of Drugs and Cosmetics Regulation 1984, emphasizing quality, efficacy and safety (including the detection of the presence of heavy metals) in all pharmaceutical dosage forms of traditional medicine preparations. Therefore, a total of 100 products in various pharmaceutical dosage forms of a herbal preparation, were analysed for lead content using atomic absorption spectrophotometer. Results showed that 8% (eight products) possessed 10.64-20.72 ppm of lead, and therefore, do not comply with the quality requirement for traditional medicines in Malaysia. One of these products, M-Tongkat Ali (exhibited 10.64 +/-0.37 ppm of lead), was in fact already registered with the DCA Malaysia. The rest, Sukarno Tongkat Ali, Eurycoma Madu, Super Pill Tongkat Ali, Force Pill Tongkat Ali, Tender Pill Tongkat Ali, Super Pill Tongkat Ali Plus and Great Pill Tongkat Ali Plus have not registered with the DCA Malaysia and exhibited 12.24-20.72 ppm of lead. Although this study showed that only 92% of the products complied with the quality requirement for traditional medicines in Malaysia, however, they cannot be assumed safe from lead contamination because of batch-to-batch inconsistency.