Elemental Impurities in Nigerian Pediatric Syrups: Mercury in Violation of Standard Guidelines

Studies on the human exposure to elemental impurities like antimony, tin, and mercury pharmaceutical products in the African environment are scarce and limited. In this study, we determined the concentrations of these elemental impurities in 28 different brands of commonly used pediatric syrups, purchased randomly from patent medicine retail outlets in Port Harcourt, Rivers State, Nigeria. The aim of this study was to compare the antimony, tin, and mercury levels in these pediatric syrups with the recommended limits of United States Pharmacopeia. Twenty-eight different pediatric syrups were randomly sampled and purchased using the market basket protocol from pharmacy shops in Port Harcourt, Rivers State, Nigeria in December 2010. Syrups were ashed before digestion using concentrated aqua regia, HCl: HNO3 (3:1), and antimony, tin, and mercury were analyzed using Unicam Atomic Absorption Spectrophotometer (AAS) Model 929. The ranges of heavy metal content in these pediatric syrups were 0.54-1.27, 0.86-2.56, and 0.97-5.13 g/g for antimony, tin, and mercury, respectively. About 75% of the syrups exceeded the United States Pharmacopeia mercury limit of 1.5 g/g. The estimated or calculated amounts of antimony, tin, and mercury in the 3 most likely administered syrups were 17.15, 64.20, and 34.60 g of antimony, tin, and mercury, respectively. The daily intake or estimated amount from the ingestion of syrups excluding background exposure (g metalkg body weight(-1)d(-1)) for a 15-kg child were 1.17, 2.31, and 4.28 for antimony, tin, and mercury, respectively. Mercury content in pediatric syrups may constitute a significant source of heavy metal exposure to children and may be of public health importance in Nigeria.