As the nation re-emerges from a year of toy recalls, here is advice pediatricians can use when counseling parents
Michael W. Shannon, M.D., M.P.H., FAAP

Remarkable gains have been made toward the elimination of childhood lead poisoning over the last decade. Nationally, the average blood lead level of children 1-5 years old has fallen to less than 2 mcg/dl. However, increasing data show that lead is a nothreshold toxicant; there is no blood lead level that can be considered completely safe.

With this in mind, even though the primary source of lead poisoning remains deteriorated paint in old homes, all sources of lead require identification and elimination to completely minimize exposure.   

The year 2007 will go down in history as one of the worst ever for the recall of children's toys because of lead contamination. More than 29 distinct product recalls occurred over the calendar year. More than 175 million pieces of toy jewelry alone were recalled because they contained excess amounts of lead, according to the Consumer's Union.

These recalls clearly illustrate the ongoing threat of lead exposure from toys and other children's products. Despite the role of the U.S. Consumer Product Safety Commission (CPSC) in regulating and monitoring the safety of consumer products, an unprecedented number of items have escaped its reach. As a result, parents must be more vigilant about the products they purchase for their children.

From toys to backpacks

The lead in children's products is not confined to toys or even paint. Lead also has been found in jewelry and vinyl or plastic objects.

Lead contamination can be found in at least four different forms: 1) paint on the surface of a toy, 2) pigment that can be found throughout the toy, 3) lead in jewelry and 4) lead in vinyl or plastic.

Toy jewelry appears as the greatest threat because it can have the highest lead content; a child died in 2006 after ingesting a leaded charm. Even though lead-based jewelry may have a nontoxic veneer, e.g., brass or nickel, the lead beneath can be bioavailable if the child mouths or ingests the object.

Lead is a common plasticizer, added to vinyl and plastic to keep them soft and pliable. Like lead in paint, lead in vinyl can be invisible to the consumer. Even clear objects can have toxic quantities of leachable lead that can be absorbed if children chew, suck or significantly mouth these products. Lead-containing vinyl and plastic products include not only toys but also non-toy products such as bibs, backpacks, car seats and lunch boxes.

The CPSC has created standards for allowable lead in toys, permitting toys to contain up to 0.06% (600 parts per million [ppm]) lead by weight. Despite these standards, toys exceeding this threshold repeatedly have entered the consumer market, indicating a clear need for greater oversight by CPSC, manufacturers and retailers. Also of note, CPSC regulates the lead content of toy jewelry but not costume jewelry marketed to adults but often given to children.

Limitations of testing kits

Lead test kits, created to identify hazardous amounts of lead in paint, are being widely recommended by some consumer groups for home testing of toys. According to field tests conducted by these groups, lead test kits have reasonable accuracy in identifying significant amounts of lead in toys. However, given the many ways in which lead can be found in children's products and their rate of false-negative results, these kits may be falsely reassuring; their use should not be encouraged.

Local public health agencies and private companies may have the facilities to test products. However, public health programs generally do not have the capacity for consumer product testing, and private testing can be costly. With so few options left for parents to identify lead in toys, prevention through greater regulation, monitoring and enforcement are key.

AAP efforts to reduce risks

The AAP Committee on Environmental Health has been working to address the problem of lead-containing children's products. AAP representatives recently testified before Congress regarding the regulation of lead under the proposed Consumer Product Safety Modernization Act. The Academy has made several recommendations to reduce the threat of childhood lead exposure from toys and other children's products:

Reduce the total permissible lead content of children's products from 0.06% by weight (600 ppm) to 40 ppm, consistent with the levels of lead commonly found in uncontaminated soil.

Broaden the definition of children's products, covering all products used by or in connection with children, including jewelry, toys, children's furniture and other products.

Redefine "children's product" as those items used by or with children under the age of 12.

Until more protective regulations are enacted, responsibility for protecting children from the threat of lead in toys and other products must be shared by parents. A few simple strategies will help to reduce the risk of purchasing lead-contaminated products, protecting children from this ongoing threat.

Courtesy of American Academy of Pediatrics