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Don’t use these six cinnamon products, FDA warns after concerning lead tests

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More lead —

The FDA is putting manufacturers on notice to do more to keep contaminants out.

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Don’t use these six cinnamon products, FDA warns after concerning lead tests

Six different ground cinnamon products sold at retailers including Save A Lot, Dollar Tree, and Family Dollar contain elevated levels of lead and should be recalled and thrown away immediately, the US Food and Drug Administration announced Wednesday.

The brands are La Fiesta, Marcum, MK, Swad, Supreme Tradition, and El Chilar, and the products are sold in plastic spice bottles or in bags at various retailers. The FDA has contacted the manufacturers to urge them to issue voluntary recalls, though it has not been able to reach one of the firms, MTCI, which distributes the MK-branded cinnamon.

Products identified by the FDA as containing elevated lead levels.

Enlarge / Products identified by the FDA as containing elevated lead levels.

The announcement comes amid a nationwide outbreak of lead poisoning in young children linked to cinnamon applesauce pouches contaminated with lead and chromium. In that case, it’s believed that a spice grinder in Ecuador intentionally added extreme levels of lead chromate to cinnamon imported from Sri Lanka, likely to improve its weight and/or appearance. Food manufacturer Austrofoods then added the heavily contaminated cinnamon, without any testing, to cinnamon applesauce pouches marketed to toddlers and young children across the US. In the latest update, the Centers for Disease Control and Prevention has identified 468 cases of lead poisoning that have been linked to the cinnamon applesauce pouches. The cases span 44 states and are mostly in very young children.

The alarming contamination spurred the FDA to conduct more sampling of cinnamon products, focusing an initial survey on products from discount retail stores, the agency said. The FDA makes note that the elevated lead levels found in the six products announced this week are significantly lower than what was seen in the cinnamon added to the applesauce pouches. The six products contained lead at levels ranging from 2.03 to 3.4 parts per million (ppm), while samples of the cinnamon added to the applesauce had levels ranging from 2,270 ppm to 5,110 ppm in the cinnamon.

The FDA has previously reported that 2.5 ppm is the limit being considered for bark spices, which includes cinnamon, by the international standard-setting body, Codex Alimentarius Commission.

So the six newly identified products are right around or just over that potential threshold and do not pose the same level of risk as the applesauce pouches. But the FDA warned that the elevated levels in the ground cinnamon could cause elevated blood lead levels after prolonged use, which the agency defined as months to years. This, in turn, could contribute to harmful health effects, particularly in children who absorb lead more readily than adults and are still developing. Lead is a potent neurotoxic metal that can damage the brain and nervous system, which for young children can lead to learning, behavior, and developmental problems.

“Today’s actions serve as a signal to industry that more needs to be done to prevent elevated levels of contaminants from entering our food supply,” Jim Jones, the FDA’s Deputy Commissioner for Human Foods, said in a statement. “Food growers, manufacturers, importers, and retailers share a responsibility for ensuring the safety of the foods that reach store shelves. The levels of lead we found in some ground cinnamon products are too high and we must do better to protect those most vulnerable to the negative health outcomes of exposure to elevated levels of lead.”

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We may now know who’s behind the lead-tainted cinnamon in toddler fruit pouches

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Tragedy —

At least 413 people, mostly young children, in 43 states have been poisoned.

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The three recalled pouches linked to lead poisonings.

Enlarge / The three recalled pouches linked to lead poisonings.

A spice grinder named Carlos Aguilera of Ecuador is the likely source of contaminated cinnamon containing extremely high levels of lead and chromium, which made its way into the apple cinnamon fruit pouches of US toddlers, according to an announcement by the Food and Drug Administration this week.

To date, there have been 413 cases of poisoning across 43 US states, according to the Centers for Disease Control and Prevention.

The FDA said Ecuadorian officials at the Agencia Nacional de Regulación, Control y Vigilancia Sanitaria (ARCSA) identified Aguilera as the cinnamon processor and reported to the FDA that his business is no longer operating. Aquilera received raw cinnamon sticks sourced from Sri Lanka, which, according to raw sample testing conducted by ARCSA, had no lead contamination upon their arrival. After Aguilera processed the cinnamon, it was supplied by a company called Negasmart to Austrofoods, the manufacturer of the apple cinnamon pouches.

According to FDA inspection documents obtained by CBS News, Austrofoods never tested its product for heavy metals at any point in production and repeatedly failed to identify the cinnamon as a raw ingredient needing such testing. “[Y]ou did not sample and test the raw material or the finished product for heavy metals,” the FDA wrote in its inspection report. Testing by the FDA immediately identified high levels of lead in the finished apple cinnamon puree and in the ground cinnamon powder Austrofoods used for the purees. The regulator also observed problems with Austrofood’s pasteurization and sanitation procedures, and noted equipment in poor condition that could have allowed metal pieces to break loose and get into food products.

Austrofood’s apple cinnamon fruit puree pouches were sold under three brands, all of which have been recalled: WanaBana apple cinnamon fruit puree pouches, Schnucks brand cinnamon-flavored applesauce pouches, and Weis brand cinnamon applesauce pouches.

The FDA reported that ARCSA’s investigation and legal proceedings are still ongoing to determine the ultimate responsibility for the contamination. The FDA acknowledged that it has “limited authority over foreign ingredient suppliers who do not directly ship product to the US. This is because their food undergoes further manufacturing/processing prior to export. Thus, the FDA cannot take direct action with Negasmart or Carlos Aguilera.”

Testing by the FDA hints that the cinnamon was contaminated with lead chromate, a vibrant yellow substance often used to bolster a spice’s appearance and weight artificially. It’s frequently been found contaminating turmeric sourced from India and Bangladesh.

The children exposed to the purees face uncertain long-term health effects. The effects of ingesting chromium are unclear, and it’s also not clear what form of chromium the children ingested from the pouches. Lead, on the other hand, is a potent neurotoxic metal that can damage the brain and nervous system. In young children, the effects of acute exposures could manifest as learning and behavior problems, as well as hearing and speech problems in the years to come.

Last year, the CDC reported that exposed children had shown blood lead levels as high as 29 micrograms per deciliter (µg/dL), more than eight times the 3.5 µg/dL threshold the agency considers the cutoff for high exposure.

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Chromium found in lead-tainted fruit pouches may explain contamination

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Nightmare —

Lead chromate, an artificial coloring, has been used in other spices to conceal poor quality.

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The three recalled pouches linked to lead poisonings.

Enlarge / The three recalled pouches linked to lead poisonings.

The Food and Drug Administration has discovered a second metal contaminant—chromium—in the recalled cinnamon applesauce pouches found to contain cinnamon contaminated with extremely high levels of lead. The products have now poisoned nearly 300 young children in 37 states.

The health implications of the additional contaminant are not clear. There is no antidote for chromium exposure, and the Centers for Disease Control and Prevention recommends supportive care. But the finding does hint at the possible motivation behind the tragic poisonings.

In the FDA’s announcement, the agency noted that “The lead-to-chromium ratio in the cinnamon apple puree sample is consistent with that of lead chromate (PbCrO4).” This is a notorious adulterant of spices used to artificially bolster their color and weight.

Lead chromate is a vibrant yellow substance that has frequently turned up in turmeric sourced from India and Bangladesh. In a 2017 study by public health researchers at Boston University, 16 of 32 turmeric products bought in markets in the Boston area had lead levels over the FDA’s allowable lead level for candy (the FDA does not have guidelines for lead levels in spices, specifically). Two samples, the only two samples sourced from Bangladesh, exceeded the allowable lead level by two orders of magnitude. The researchers had conducted the study after a string of lead poisoning cases in US children were linked to contaminated spices, including turmeric. Other studies have also identified spices as a source of lead exposure in US children.

The 2017 study highlighted the reason that lead chromate is used as an adulterant. A media outlet in Bangladesh quoted one turmeric trader’s explanation: “Traders use the artificial color [lead chromate] to hide the marks of pest attacks and other spots on raw turmeric. It is used during boiling and polishing to make the spice look brighter to attract big buyers, including spice processing firms.”

The FDA’s testing does not definitively conclude that lead chromate was in the contaminated cinnamon, which was sourced from an Austrofoods manufacturing facility in Ecuador and used in the recalled applesauce pouches. But it does bolster the FDA’s suspicion that the poisonings were the result of “economically motivated adulteration,” a specific category of food fraud defined by the FDA.

Jim Jones, FDA’s deputy commissioner for human foods, told Politico in December that the agency believed then that the contamination was economically motivated. “My instinct is they didn’t think this product was going to end up in a country with a robust regulatory process,” Jones said. “They thought it was going to end up in places that did not have the ability to detect something like this.”

Health effects

For the hundreds of US children poisoned by the applesauce pouches, the finding of chromium adds yet more nightmarish uncertainty of possible long-term health effects. Lead is a potent neurotoxic metal that can damage the brain and nervous system. In developing toddlers and younger children, the effects of the acute exposures could manifest as learning and behavior problems, as well as hearing and speech problems in the years to come.

The effects of chromium exposure are less clear. Chromium is a naturally occurring metal and an essential trace nutrient. But there are two notable forms: chromium III and the more toxic chromium VI. The FDA’s testing couldn’t identify which form of chromium was present in the cinnamon applesauce pouches, but the more toxic chromium VI is what’s present in lead chromate. Chromium VI is considered a carcinogen, and chronic, prolonged inhalation and skin exposure is associated with chronic lung disease and ulceration of skin and mucous membranes, the CDC notes. But the effects of eating chromium VI are not well studied or understood beyond the immediate, nonspecific effects of an acute exposure—which might include abdominal pain, nausea, vomiting, diarrhea, anemia, and kidney and liver dysfunction.

The CDC and the FDA note that it’s possible that even if chromium VI contaminated the applesauce pouches, the acidity of the applesauce and the stomach may have converted the chromium VI to chromium III.

The FDA recommends that the families of children exposed to the recalled pouches—especially those with elevated blood lead levels—should inform their health care providers of potential chromium exposure. The CDC provided clinical guidance for doctors on how to test and care for children with exposure.

The recalled cinnamon applesauce pouches include WanaBana apple cinnamon fruit puree pouches (sold nationally and through multiple retailers, including Amazon and Dollar Tree), Schnucks-brand cinnamon-flavored applesauce pouches and variety packs (sold at Schnucks and Eatwell Markets grocery stores), and Weis-brand cinnamon applesauce pouches (sold at Weis grocery stores).

According to the CDC’s latest numbers, which, as of the time of publication, were last updated on December 29, there have been a total of 287 cases identified across 37 states.

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