Despite strong efforts to limit lead exposure from sources like paint and gasoline, the U.S. government doesn’t broadly limit lead levels in food, a blind spot that’s become all the more glaring, experts say, as cases of lead poisonings in young children linked to contaminated cinnamon applesauce continue to mount.
As of Tuesday, lead poisoning had been reported in at least 65 children, all younger than 6, who ate pouches of now-recalled cinnamon apple puree and cinnamon applesauce, up from 57 cases two weeks ago, according to the Food and Drug Administration.
Children under the age of 6 are most vulnerable to lead poisoning, the Centers for Disease Control and Prevention says. The heavy metal can lead to developmental problems, damage to the brain and nervous system, and problems with learning, behavior, hearing and speech. Lead exposure can lead to lower IQ and underperformance in school, according to the CDC.
Efforts to set guidelines to limit lead exposure in children go as far back as the 1980s, when the government began work to reduce children’s exposure to lead from paint and gasoline as well as from food packaging, like lead-soldered cans, said Dr. Leonardo Trasande, director of environmental pediatrics at NYU Langone Health.
The U.S. was successful in driving down exposure to lead-based paint, which remains the leading cause of lead poisoning in children, Trasande said; however, it has not until more recently focused on limiting lead directly in food. In 2022, the FDA introduced limits for levels of lead in apple juice and juice blend drinks, and it also set lead standards for candy made with sugar.
Lead is a naturally occurring element in the Earth’s crust, and can be found in soil, water and air. Trace amounts can infiltrate the food supply in various ways, including in places where foods are grown, raised or processed, he said.
This makes it essentially impossible to eliminate all traces of lead in food, Trasande said. Still, “we need to test our food, and we need to support the FDA’s efforts to test food,” he said.
The FDA does routinely monitor levels of toxic elements in foods, including lead, said Dr. Adam Keating, a primary care pediatrician at the Cleveland Clinic. It can also investigate certain products and initiate recalls, as it did with the cinnamon applesauce pouches after getting numerous reports from parents about children with elevated blood lead levels.
However, the agency’s oversight of food is not as strenuous as its oversight of prescription drugs, which includes monitoring the testing, manufacturing, marketing and distribution of the drugs, Keating said. The FDA instead puts much of the responsibility for oversight of food on the farmers or manufacturers of the products.
“And so there is an increased risk of those being contaminated relative to those that are monitored from a medication standpoint,” he said.
And though the FDA cannot eliminate all traces of lead in food, it can set a minimal acceptable standard for products, Keating said.
Laurie Beyranevand, director of the Center for Agriculture and Food Systems at Vermont Law and Graduate School, said that the FDA has been working to set more limits for lead in foods for years, but began taking more “targeted action” to set limits in baby food in 2021.
That’s when a congressional investigation found that major commercial baby food brands were contaminated with significant levels of arsenic, lead, cadmium and mercury.
Joanne Slavin, a professor in the department of food science and nutrition at the University of Minnesota, applauded the FDA’s work to set new limits, saying it can be difficult to agree on recommended lead levels because fruits, vegetables and whole grains all contain varying amounts of the heavy metal.
“New regulations are welcome,” she said.
Still, Beyranevand noted, the FDA could have acted sooner.
“More often than not, it takes a crisis or pressure from Congress to force an issue on the foods side which is what we see with this particular situation,” she said.
The FDA did not respond to a request for comment.
In January, the agency proposed limits on lead levels in processed baby food that, it says, could reduce exposure to the contaminant by as much as 27%.
The agency’s guidelines — which are not expected to be finalized until 2025 — would limit the concentration of lead in fruit, yogurt and certain vegetable products to 10 parts per billion. It would also limit lead in dry cereals and single-ingredient root vegetable products, like mashed potatoes, to 20 parts per billion. (One of the recalled applesauce pouches tested by the FDA had lead levels of 2.18 parts per million, more than 200 times the proposed levels, the FDA said.)
Beyranevand said the agency’s new guidelines would be helpful in reducing lead exposure in children, calling it a “strong stance.”
Brian Ronholm, director of food policy for Consumer Reports, a nonprofit group that does research on the safety of the food system, said it makes sense for the FDA to focus on foods meant for babies and young children first, considering children are a “critical population” to protect from lead exposure.
However, he said that the proposed limits on lead in baby food appear to be based on what the agency thinks the industry can achieve, rather than what would be most protective for public health. “In my opinion, they’re not low enough,” Ronholm said.
In 2018, Consumer Reports measured lead levels in 50 baby foods and found that 80% had levels below 10 parts per billion.
While there is no safe level for lead in food, Ronholm said the limit should be closer to 3 parts per billion.
It’s possible the FDA could get additional help from Congress in setting limits for heavy metals in foods, he noted.
There has been legislation, including the Baby Food Safety Act from Democratic Sens. Tammy Duckworth, of Illinois and Amy Klobuchar, of Minnesota, which was introduced in 2021 and would establish limits for heavy metals in baby foods.
The legislation did not pass in the last Congress, but a spokesperson for Klobuchar’s office told NBC News in a statement that the senators plan to reintroduce the legislation soon. Among other provisions, it would set the limit for lead allowed in most baby foods to 5 parts per billion.
In the meantime, experts say there’s a limit to what the FDA — or the public — can do.
The FDA can take regulatory action on certain products, including opening an investigation or forcing a recall, if it deems that the product is unsafe, Ronholm said. But oftentimes, he said, that doesn’t happen until the agency has already gotten reports of people getting sick and determines that it is an “imminent threat.”
Keating, of the Cleveland Clinic, said parents can protect their children by routinely getting them tested for lead in their blood as well as seeing a doctor for wellness checks to make sure they’re still developmentally on track.
