Great gifts for EMTs! The Staff of Life Leatherette Necklace is made from pewter and zinc cast. Lead and Cadmium free. Stones that shimmer are Austrian blue crystals. Traditional EMT Staff of Life Medallion charm is sterling plated and protected from tarnish. Necklace has a Lobster Claw clasp. Assembled in the USA. Necklace measures approximately 16 ½ inches long, and the EMT Medallion measuring approximately 1 inch X 1 inch. A beautiful gift for EMTs! Comes with gift box.