When Eleilia Preston gave birth to her first child, the last thing she worried about was lead in toys.
The stay-at-home mom, who describes herself as "over-the-edge careful," made sure that little Megan was always within eyesight. She documented each bite her daughter ate and washed all her toys, several times a week.
That's why Preston, 29, was so shocked when doctors diagnosed the toddler with lead poisoning.
At 21 months, Megan far exceeded every developmental milestone for her age group. She spoke in sentences. She knew her colors. She could count to 20. But then, over a period of just a few weeks, Megan suddenly stopped talking.
"She would follow orders but wouldn't speak," Preston says. "Her speech kept getting worse and worse. I was frantic."
Fortunately, the Prestons had moved to New York, a state that requires mandatory blood lead testing of children at both 12 and 24 months of age. Megan's level came back at 26 micrograms per deciliter (mcg/dL) -- a number that doctors consider extremely dangerous for young children. A second test, performed two weeks later at Preston's insistence, showed a blood lead level of 32 mcg/dL.
According to Preston, health officials determined that the source of Megan's poisoning was crayons she had been eating.
Lead in Toys: Toys Still on Shelves
Most lead poisoning in this country is caused by lead-based paint. Although banned in 1978, it continues to be a hazard in 25% of U.S. homes with kids under age 6. However, about 30% of the childhood lead poison cases followed by the CDC are not caused by paint. Many experts believe that the culprit is lead in toys and jewelry.
In 2006, a 4-year-old Minneapolis boy died after swallowing a trinket made by Reebok, which contained more than 90% lead. The incident brought to light the fact that many American toy companies have been violating federal safety standards for almost 30 years, according to Scott Wolfson of the U.S. Consumer Product Safety Commission (CPSC).
The death also paved the way for the growing list of recalls which continues to plague parents today.
During the past 14 months, the CPSC has overseen 31.7 million voluntary recalls, of which nearly 4 million were due to excessive lead in toys. The overwhelming majority of those toys were made in China, which manufactures 80% of the toys sold in this country.
Jewelry, also frequently made in China, has been the target of even more recalls. Since 2004, manufacturers have recalled more than 45 jewelry products involving 170 million units due to excessive lead. Even non-recalled jewelry, however -- including some labeled "lead-free" -- has proven to be dangerous.
The New York Times, the U.S. Public Interest Research Group (PIRG), Consumer Reports, and the Ecology Center of Ann Arbor, Mich., all recently found that dangerous products for children are still widely available. The Ecology Center has compiled a database of more than 1,200 toys it tested for lead and other dangerous chemicals at www.healthytoys.org/home.php.
"What we're seeing are far too many companies who have let down the bar or who fail to do quality assurance through their contractors and subcontractors," says Wolfson. "That's where the breakdown has happened."
Wolfson says that while the recalls are far from over, parents need not panic because the majority of toys in the U.S. are safe.
"We have billions of toys being brought into the marketplace each year," he says, "and we are going to capture all the toys that need to be recalled. Hope is on the way in 2008."
Lead in Toys: Effects of Lead Poisoning
John F. Rosen, a nationally recognized lead poisoning specialist, is angered that hazardous toys and jewelry continue to be sold to children.
"I've seen the devastating effects of lead and it's horrible," says Rosen, professor of pediatrics at Children's Hospital at Montefiore Medical Center in New York City. Rosen has treated more than 30,000 childhood victims of lead poisoning. "It's horrible and it shouldn't happen."
Although most lead poisoning has no obvious, immediate symptoms, it can affect a child's brain, nervous system, heart, and red blood cells. In extreme cases, it causes seizures, comas, and death.
A recently published study from Cornell University showed that very small amounts of lead in children's blood -- amounts below the current federal standard of 10 mcg/dL -- are associated with reduced IQ scores at 6 years of age. The CDC recently confirmed that children with lead levels of less than 10 mcg/dL can suffer lowered IQ, speech delays, hearing loss, learning disabilities, slowed or reduced growth, and behavioral difficulties that range from hyperactivity and attention deficit disorder to violence and aggression.
According to the Cornell study, approximately one out of every 50 children in the U.S. between ages 1 and 5 has a blood lead level above 10 mcg/dL. Still, CDC figures show that the number of young children with lead levels of 10 mcg/dL or greater has steadily decreased since lead point was banned.
Public health advocates argue that any amount of lead poisoning is unacceptable. "The bottom line," says Richard Canfield, senior researcher in Cornell's division of nutritional sciences and senior author of the study, "is that lead is a persistent neurotoxin that causes brain damage. The fact that lead has been found in millions of toys, even toys specifically designed for children to put into their mouths, presents an unacceptable risk."
Lead in Toys: Should It Stay or Should It Go?
Keeping track of the mounting recalls can be daunting.
Joan Lawrence, a spokesman for the Toy Industry of America (TIA), recommends that parents take time to scrutinize the CPSC recall list at www.cpsc.gov/cpscpub/prerel/prerel.html and then return or discard any items deemed unsafe. Parents should also sign up for email alerts from CPSC about future recalls. For additional safety tips and consumer safety advice, as well as current information about recalled toys, consumers can call the TIA's toll-free hotline or visit their web site at www.toyinfo.org.
The question many parents are asking, however, is not about recalled toys. It's what to do with all the toys sitting at home that haven't been recalled, but should be.
It's a legitimate concern. Although Rosen is hesitant to quantify possible exposure dangers from lead in toys, he believes that even one month of hand-to-mouth activity with a toy with lead is enough to create elevated blood lead levels. Jewelry, he says, is an even bigger risk.
Ruth Ann Norton is the executive director of the Coalition to End Childhood Lead Poisoning, a nonprofit group based in Baltimore. Her advice about dealing with lead in toys is simple: When in doubt, throw it out.
Rosen and Norton offer the following recommendations for those with children or grandchildren age 6 and younger:
1. Discard all brightly painted toys -- whether wooden, plastic or metal -- that have been manufactured in Pacific Rim countries, especially China. Toys that are particularly risky are those where the paint can be peeled or chipped off, and those that can be easily mouthed by young children.
2. Discard all ceramic or pottery toys manufactured outside the U.S., especially those made in China, India, and Mexico.
3. Remove all metal jewelry from children immediately. If the jewelry has special significance, parents can have it tested. The CPSC provides a list of laboratories that will test products. Parents can also speak to their local health department.
4. Buy only soy-based crayons. Although lead-filled crayons have not been the subject of a recall since 1996, in rare cases children have been poisoned by eating them. And, as with toys, "nontoxic" labels are not an assurance that a product -- especially one made in China -- adhere to U.S. safety standards.
5. Take caution when exposing children to other items known to contain lead. These include imported vinyl mini-blinds made before 1997, vinyl bibs, vinyl backpacks, canvas lunch boxes (especially those with metallic linings), car keys, children's chalk, pool chalk, Mexican candies, Mexican home remedies, and all pottery and ceramics manufactured outside the U.S.
Items generally considered safe to keep include:
1. All toys manufactured in North America and the European Union.
2. Books, DVDs, and CDs.
3. Most plush toys, although two (Curious George Plush Dolls and Baby Einstein Color Blocks) have recently been recalled for excessive lead, so parents should carefully weigh the risks.
Lead in Toys: To Test or Not to Test?
Rather than throwing caution -- and all of their kid's toys -- to the wind, many parents are turning to home-testing kits. Experts warn, however, that they can be extremely unreliable.
Consumer Reports tested five. Of those, they determined that three were "useful though limited." Because the kits detect only surface, or "accessible," lead, they are ineffective for toys that contain lead embedded below the surface. In most cases, however, a positive result means parents should discard the item.
The CPSC recently came to the same conclusion. The agency performed 104 tests using two different brands of home lead-test kits. Half (56) inaccurately indicated that contaminated products were safe. Two test results came up positive when no lead was present.
"Based on the study, consumers should not use lead test kits to evaluate consumer products for potential lead hazards," the agency advised in an official statement.
For the most accurate results, parents should send suspect items to a lab or visit their county health department.
Lead in Toys: Safe vs. Sorry
After Megan was diagnosed with lead poisoning, her mother began feeding her multivitamins that contained high amounts of iron and calcium. Preston also increased the child's intake of vegetables and fruits. Four months later, Megan's blood lead level was less than 10.
Unfortunately, Megan still suffers from the effects of lead poisoning. Her speech is slowly returning to normal but is markedly delayed, and she struggles to keep up with her peers.
Parents who are worried about possible poisoning from lead in toys can have their child screened with a quick, inexpensive blood lead level test. Norton recommends that all children under age 6 be tested annually, if possible.
If a blood lead level is higher than 1 mcg/dL, says Rosen, doctors or health officials should assist parents in determining the cause and immediately remove it. Treatment begins with removing the lead exposure. A healthy diet can help to limit the body's lead absorption. In most cases, a healthy diet will be sufficient to lower blood lead levels. In rare instances, a child may need to undergo chelation, which involves administration of medication to remove lead from the body.
"One of these days, probably well after I'm dead and buried, there will not be lead in the homes of young children or in the toys and jewelry that parents can purchase for their kids, and that will be a wonderful day," Rosen says. "In the meantime, it remains to be seen how many children have actually been poisoned by these products."