Alternative drugs go global: possible lead and/ or mercury intoxication from imported natural health products and a need for scientifically evaluated poisoning monitoring from environmental exposures

Table 1 Limit values

Heavy metal	Diagnostic analysis (biomonitoring parameter)	Reference values [μg/L]	Limit values [μg/L]	NHP^c allowable limit values [μg/g]
Lead	total blood lead	60^a 42^b	150/250^d	3
Lead	total urine lead	- 2.3^b	-	3
Mercury	total blood mercury	2^a 4.6^b	5	0.1
Mercury	urinary total mercury	1.0^a 3.3^b	7	0.1
Arsenic	total blood arsenic	-	-	n.d.
Arsenic	urinary total arsenic	15^a 66^b	n.d.	n.d.

Limit values refer to adults >20 y (German Human Biomonitoring values). Reference values refer to adults: National report on human exposure to environmental chemicals, showing 95^th percentile values: ^aGermany (https://www.umweltbundesamt.de/themen/gesundheit/kommissionen-arbeitsgruppen/kommission-human-biomonitoring/stellungnahmen-der-kommission-human-biomonitoring); ^bUS (http://www.cdc.gov/exposurereport/pdf/fourthreport.pdf); ^cEU allowable limit values for dietary supplements
n.d. not determined; ^dthe values are not valid after 2013 (are currently being re-evaluated)

ISSN: 1745-6673