What to know about lead poisoning in children

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A recent outbreak of lead poisoning from cinnamon in applesauce has drawn attention to the toxic effect the heavy metal can have on children. The cinnamon in applesauce was believed to have been intentionally contaminated, possibly to increase its value as a product sold by weight. It had unusually high levels of lead.

The Centers for Disease Control and Prevention estimates that more than 400 children were poisoned in the applesauce outbreak. Their average blood lead levels were six times higher than the average seen during the height of the Flint water crisis, the CDC said.

While these cases of poisoning are rare, lead is a widespread contaminant and has come under increasing scrutiny. Here’s what you need to know.

Paint is one of the most common and well-known sources of lead. Children can also be exposed by drinking water that flows through old lead pipes.

Lead poisoning through food is less common but does occur. Lead can enter foods at low levels when plants extract it from the soil. For example, a study on baby foods found that sweet potatoes had some of the highest levels of lead among the products tested.

A lead-based pigment is sometimes illegally added to spices to give them volume or enhance their color. The Food and Drug Administration suspects the additive caused contamination of applesauce last year.

The FDA, relying on researchers in Ecuador, said a spice grinder likely added the pigment, powdered lead chromate, to the cinnamon before mixing it with the applesauce.

An investigation by The New York Times and the nonprofit health journalism organization The Examination found that tainted cinnamon and applesauce passed all checks intended to safeguard the U.S. food supply. Ecuadorian food processor Austrofood was not required to test for toxic metals and did not do so, records show.

International inspections by the FDA have not come close to meeting a goal set in a landmark 2011 food safety law. The agency is conducting half as many spot food checks at the border as it did a decade ago. Food importers, who are required to examine foreign foods, allow applesauce into the country.

Lead exposure can go undetected until levels build up, doctors say. High levels of lead can cause stomach pain, vomiting, fatigue, learning difficulties, developmental delays, and even seizures.

Pediatricians recommend blood tests for babies and toddlers who live in homes built before 1978 or who have other risk factors. Screening is required by Medicaid programs and some states, but it is not typically recommended for children over 3 years old.

While officials have said there is no safe level of lead, parents should not automatically worry if traces of lead show up in a child’s blood test. The average blood lead level among young American children is less than 1 microgram per deciliter of blood. “I don’t think they should worry at all,” said Kim Dietrich, professor emeritus of epidemiology and environmental health at the University of Cincinnati College of Medicine.

Studies that find IQ score deficits and links to ADHD tend to focus on children with scores of 5 or higher. According to the CDC, about 95 percent of children in the United States have lead levels below 3.5 micrograms per deciliter of blood.

Some experts have even begun to question the CDC’s position that there is “no safe level” of lead, given its ubiquitous nature and the minor effects that low levels have had on millions of children in the United States.

Parents can rest assured that their children are receiving a healthy diet rich in calcium and iron, minerals that are absorbed through the same pathways as lead, said Dr. Ana Navas-Acien, research chair of the Department of Environmental Health Sciences. from Columbia University.

He said another good strategy is to feed young children a wide variety of foods, an approach that can limit the harm of consuming too much of a contaminated product. If children have exposures that affect their development, Dr. Navas-Acien said, parents can counteract some of the effects by keeping children in a stimulating educational environment and talking, reading and playing with them.

The Biden administration has invested billions of dollars to upgrade housing and aging lead water pipes.

The FDA says it is reviewing applesauce poisoning to determine if the agency needs to make changes. So far, officials have said little about the failure of thousands of food importing companies to launch programs to test foreign foods.

The FDA also says it wants to move forward with its “Closer to Zero” initiative, asking Congress to give it authority to set limits on lead in foods marketed to babies and young children and require companies to test. A group of 20 attorneys general has asked the FDA to use its existing powers to take the action.

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