ABSTRACT
Although contaminated flour was first described as an important source of endemic lead poisoning in the Middle East almost 20 years ago, the use of lead in community flour mills has not been eliminated and continues to represent a significant environmental risk. The authors describe an outbreak of lead poisoning in a West Bank Palestinian family and draw attention to this unusual but important source of lead exposure. All 13 members of the family (two children and 11 adults), were found to have lead poisoning following hospitalization for "gastroenteritis," headache, joint pain, weight loss, and vision difficulties. Seven females had low hemoglobin levels. Blood lead concentrations ranged from 42 to 84 microg/dL. Household flour samples obtained from a stone mill, previously closed because of lead contamination, contained 2,000 ppm lead. Flour from traditional stone mills reinforced with lead joints remains a potential source for lead poisoning.