"Kohl" Use for Infants
Iraqi Postgraduate Medical Journal,
2008, Volume 7, Issue 1, Pages 1-5
Kohl is still being used for the eyes of infants. The habit is of concern to paediatritians because of the
serious toxic effects.
1.To determine how frequent kohl was being used for infants eyes, the reasons for its use and the
method of application.
2. To estimate the blood and urine level of lead in infants, and in kohl samples from the local market.
3. To document kohl induced encephalopathy.
Mothers of 150 children under a year of age were interviewed and samples of 40 infants' blood and
urine were analyzed for their lead content.
Kohl was used for 47% of infants. Forty percent of town mothers and 57% of rural mothers were
applying it to their infants eyes. Fifty percent of illiterate mothers and 33% of college graduates were
The habit started in the neonatal period: 40% of which on the third day after birth. The reasons for the
use were: cosmetic 54%, improving vision 41% and prevention of eye infection 4%.
The mean blood and urine levels of lead were higher among kohl user, but it did not reach statistical
significance. The lead contents of kohl samples varied from 0.4% to 54%. In two infants encephalitis
was present, the most likely cause was kohl use.
Kohl use is common during infancy. Its lead content could be high. I t was usually applied to the
conjunctival side of the eyelid where a higher chance of absorption into the blood stream was
expected. Kohl use for infants could lead to encephalopathy. Active means should be adopted to
educate mothers about the hazards of kohl use for infants, and possibly banning the sales of lead
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