Contamination by hazardous elements in low-priced children's plastic toys bought on the local markets of Karachi, Pakistan.

Children's plastic toys may contain toxic metals to which infants and young children can be orally exposed and may pose acute or chronic adverse health effects. This research aims to evaluate the total metal concentrations (TMCs) of Pb, Cd, Cr, Ni, Zn, Cu, and Mn in children's plastic toys bought in the local markets of Karachi, Pakistan, and compare TMCs to different toy safety regulatory limits. A total of 44 children's plastic toys sourced in the Karachi local markets were analyzed by an atomic absorption spectrophotometer for contamination of hazardous elements. Toy samples were divided into two groups: plastic toys (DCT) and plastic toys with paints or coatings (DPCT). For plastic toys, 83% (19) of samples had TMCs that exceeded European Union (EU) toy safety regulation limits for Pb, and 65% (15) of samples that exceeded for Cd. For plastic toys with paints or coating, 43% (9) of samples had TMCs that exceeded EU migration limits for Pb and 24% (5) for Cd. More than 20 samples exceeded the United States Consumer Product Safety Commission (US CPSC), Canadian, and Bureau of Indian Standards (BIS) toy safety regulation limits. In toy samples (n = 44), very high TMCs of Pb (64%), Cd (45%), Cr (5%), and Ni (2%) were observed. Zn, Cu, and Mn TMCs existed but were below the regulation limits. The contamination levels of Pb, Cd, Cr, and Ni and smaller extent of Zn, Cu, and Mn still pose health issues in children and may cause serious problems in their health.

Evaluation of a patient self-stratification methodology to identify those in need of shielding during COVID-19.

The logistical challenges of rapidly and accurately identifying those patients who needed to shield during the COVID-19 pandemic were unprecedented. We report our experiences of meeting this challenge for >9,000 patients with rheumatic and musculoskeletal disease at our centre, incorporating an element of guided patient self-stratification. Our results indicate that patients are able to stratify their own risk accurately using the BSR COVID-19 risk stratification guidance.