AT A GLANCE
The Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and state and local partners are investigating a link between blood lead levels (BLLs) ≥3.5 µg/dL in children consuming certain cinnamon-containing apple purée and applesauce products.
Update
FDA product testing has also identified high levels of chromium, in addition to lead, in cinnamon samples and recalled applesauce pouch products. (See https://www.fda.gov/food/outbreaks-foodborne-illness/investigation-elevated-lead-levels-cinnamon-applesauce-pouches-november-2023 for a list of affected products.)
Potential health effects
Consumers should be aware of these elevated levels of chromium and lead found in the cinnamon applesauce pouches and the potential for adverse health effects.
Chromium is a naturally occurring element with trace levels normally found in the diet. The most common forms of chromium found in chromium compounds are trivalent chromium [chromium (III)] and hexavalent chromium [chromium (VI)]. Chromium (III) is considered an essential nutrient and can be found in a normal diet and in some dietary supplements. Chronic, prolonged exposure to chromium (VI) in occupational settings through inhalation and skin exposure has also been associated with chronic lung disease and ulceration of skin and mucous membranes. Chromium (VI) is a known carcinogen. The exact form of chromium in the recalled applesauce products is unclear. However, lead chromate has previously been reported as a contaminant in spices and foods.
There is limited information about health effects from consuming food contaminated with chromium compounds such as lead chromate. The main health problems seen in laboratory animals following ingestion of chromium (VI) compounds are irritation and ulcers (in the stomach and small intestine) and anemia.
However, the health effects of eating food contaminated with chromium (VI), in the form of lead chromate, are not well understood. Chromium (VI) compounds may be converted to chromium (III) in acidic environments. It is difficult to predict the amount of chromium (VI) and chromium (III) absorbed from ingestion of contaminated food.
While the health effects of chromium are difficult to predict in this scenario, we know that there is no safe level of lead. CDC recommends discarding all affected products and not eating any of them. Anyone who may have eaten the affected products should talk with their healthcare provider.
What can I do?
Do not eat cinnamon-containing apple purée or applesauce products included in the FDA recall announcements. Anyone who may have eaten the affected products should talk with their healthcare provider. Medical treatment for chromium exposure focuses on treating symptoms. There is no specific antidote to treat chromium exposure and there is no evidence to support the use of chelation therapy.
Additionally, if you suspect that you or your child may have been exposed to lead, talk with your healthcare provider about getting a blood lead test. Healthcare providers and most local health departments can test for lead in the blood. Many private insurance policies cover the cost of testing for lead in the blood. The cost of blood lead testing for children enrolled in Medicaid is covered by the Centers for Medicare & Medicaid Services.
Does Your Back-to-School Checklist Include Vaccination?
From newborns to college, you can help protect your children from 16 serious diseases by getting them vaccinated. Make sure your kids get any needed vaccines before the back-to-school rush! Schedule an appointment with your pediatrician or county health department now.
As a parent, making sure your children are vaccinated on time is an important step toward ensuring their long-term health. Vaccination also helps protect the health of classmates, friends, relatives, and others in the community.
- Immunization Schedule Birth through 6 Years Old
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- Back to School Immunization Checklist
The Alabama Department of Public Health (ADPH), Immunization Division (IMM); Center for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP); and the American College Health Association (ACHA) recommend that it is better and safer, in most cases, to vaccinate or revaccinate instead of titer testing. See ACHA Guidelines - Recommendations for Immunizations for more information.
In addition, ADPH and CDC encourage all colleges to consider utilizing Alabama's immunization registry, Immunization Patient Resources with Integrated Technology (ImmPRINT), to access all vaccine histories for all students.
See our ImmPRINT Vaccine Coverage Rate Report flyer for information about comparing your practice's immunization coverage rate to that of the state and all providers in your county.
To contact your local Immunization Compliance Manager (ICM), please view our ICM map to obtain the contact information.