Several months ago, Gerald O’Malley, the director of clinical research at Thomas Jefferson University Hospital’s Emergency Department in Philadelphia, took a stroll through Philadelphia’s Chinatown district. Recently hired by the hospital in July 2010, O’Malley wanted to orient himself with his new neighborhood. On his walk, he noticed dozens of shops selling colorfully decorated ceramic kitchenware. Upon seeing this, O’Malley, who is board certified in both emergency medicine and medical toxicology, had a hunch that launched an investigation into whether those ceramic bowls, dishes, and other eating utensils being sold in Chinatown contained lead.  

According to a recent report by The Daily Dose, the Jefferson University Hospital blog, while O’Malley was completing a fellowship in medical toxicology at the University of Colorado Medical Center before joining the hospital’s emergency department staff, “[he] was involved in a study that found lead leaching into food from glazed pottery that came from Mexico and was the cause of a pervasive lead poisoning problem among Denver’s Hispanic population.” 

It is not uncommon for ceramic items used for cooking or simply for decoration to contain lead. In fact, lead has been used in the glazing process for ceramic dishes, bowls, pitchers, plates and other utensils for centuries. Typically, after being fired in a kiln, a piece of ceramic will appear smooth and shiny due to the lead in the glaze. 

However, in order to ensure that the items are safe for use, it is necessary to heat the ceramic at very high temperatures for a long enough period of time. If this step is not done properly, the ceramic could contain levels of lead that pose a threat to human health.  

Based on his knowledge from the study that both Mexico and China are often major source of imports containing lead, O’Malley was curious to find out whether the ceramic items he observed in many Chinatown stores also contained lead.

With the help of Thomas Gilmore, a colleague and resident in Emergency Medicine at Jefferson Hospital, and a group of Jefferson medical students, O’Malley and his research team formulated a plan to randomly purchase a large quantity of the Chinese ceramics and subsequently test it for lead contamination. They gathered 87 items from 18 stores in Chinatown as well as 49 items imported from China in nearby neighborhoods. 

After washing and drying each ceramic item purchased for the study, the team then systematically tested the items for lead contamination using LeadCheck® colorimetric swabs, a screening tool commonly used to test for lead in paint. 

The results of the study were shocking. O’Malley and his fellow researchers found that 22 out of the 87 items purchased from stores within the Chinatown district, approximately 25 percent, returned positive results for lead. In comparison, 5 out of the 49 items purchased in stores in neighborhoods outside of Chinatown, or 10 percent, contained lead. 

O’Malley explained that the number of positive results was exceedingly high. “We were astounded to find so many of them positive for lead,” O’Malley said. However, he reported that the type of test performed was only an indication that the items contained some level of lead. It did not reveal the levels of lead. 

After learning the results of their study, O’Malley and Gilmore immediately contacted the U.S. Food and Drug Administration (FDA) as well as the Centers for Disease Control and Prevention’s Advisory Committee on Childhood Lead Poisoning Prevention. Alarmed by the findings, FDA officials decided that it was crucial to further investigate the problem. 

O’Malley performed additional tests on 25 of the ceramic pieces that tested positive for lead contamination to establish how high the levels, in fact, were and to what extent the lead could leach into food placed in the items to later be consumed. Researchers noted that three plates and two spoons were found to be leaching lead in quantities that significantly exceeded the levels permitted by FDA. Specifically, one of the ceramic plates tested leached lead at 145 parts per million, a rate far beyond the limit of 2 parts per million imposed by FDA.

In an interview with Nicholas Bakalar of The New York Times, O’Malley said, “What we’ve demonstrated is that there’s a problem in Philadelphia’s Chinatown. We’ve conclusively shown that. If it’s happening in Philadelphia, it’s happening in other Chinatowns in other cities,” he added. 

Unfortunately, O’Malley and his team expressed that ceramic items found in and around Philadelphia’s Chinatown “may represent an unrecognized source of lead exposure in a population that is not routinely screened for lead toxicity.” 

It is important to inform the public about this health risk since, as O’Malley stated, “Lead poisoning is especially harmful to young children because it affects their developing central nervous system and can cause serious problems like learning difficulties, developmental delays, brain damage or even death.” He added, “Perhaps not as devastating for adults, lead poisoning can still lead to significant health problems like kidney damage and anemia.”

In an effort to raise awareness among people who may have been affected by lead in the ceramic cookware, O’Malley, along with his crew of Jefferson medical students are working with the Chinatown Health Clinic to conduct a mass screening of the community. In addition, they have alerted many shopkeepers of the possible health risks posed by those items. 

Theodore A. Christopher, MD, chair of Emergency Medicine at Jefferson, praised O’Malley’s work in conducting this study. “This is an important study that will heighten the awareness of lead contamination in many different sources,” he said. “It also confirms that medical professionals need to do a more in-depth job of assessing a patient’s social history and background, which may play a very important role in diagnosis of symptoms.”