Brote familiar de saturnismo asociado al consumo de kombucha fabricada y comercializada en envases cerámicos

BACKGROUND: According to the Institute for Health Metrics and Evaluation of the University of Washington (IHME), exposure to lead caused 900,000 deaths worldwide in 2019. The objective of this work was to expose the case of a lead poisoning outbreak, as well as to describe the investigation carried out to determine its origin. METHODS: After the clinical analysis of the affected people, in which high levels of lead were detected in blood samples, the pertinent epidemiological surveys were carried out. These surveys pointed out, as the possible source of intoxication, to the kombucha that they made for commercial purposes and for their own consumption. Samples of the raw materials, the final product and the containers were taken and sent to the reference laboratory where the determination of lead was carried out by means of inductively coupled plasma mass spectrometry. A risk assessment was carried out taking as parameters the lead’s Benchmark Doses established by the European Food Safety Authority (EFSA). RESULTS: The kombucha samples analysed yielded a lead content of 0.95 mg/kg for the unpackaged kombucha with 14 days of fermentation, 7.1 mg/kg for the unpackaged kombucha with 19 days of fermentation and 47 mg/kg for the packaged and ready for consumption kombucha. Lead migration studies on commercial containers found results ranging from 5.8 mg/l to 73 mg/l. CONCLUSIONS: Ceramic commercialization containers are identified as the source of the poisoning. The evaluation of the results of lead migration from the fermentation containers and the lead content of the kombucha brewed in them raises the need for the migration limits established in the regulations to be revised.