HJAR Mar/Apr 2024

46 MAR / APR 2024 I  HEALTHCARE JOURNAL OF ARKANSAS ADH CORNER COLUMN ADH CORNER ARKANSAS is one of several states with cases of high blood lead levels reported in children who consumedWanaBana, Schnucks, orWeis cinnamon-containing applesauce products with high levels of lead. The recalled prod- ucts have been taken off the store shelves, but the help of all healthcare workers is needed to ensure people who purchased the prod- ucts before the recall know to remove the items from their homes and, if needed, to get a blood lead test. Lead consumed by people is a neurotoxin. It is especially damaging to children, even at low levels. TheWanaBana apple cinnamon fruit puree pouches, Schnucks-brand cinnamon-flavored applesauce pouches and variety pack, and Weis-brand cinnamon applesauce pouches were recalled in November 2023 after four ill- nesses linked to the products were reported in North Carolina. TheWanaBana product was the only product sold in retail stores located in Arkansas, which was sold through Dollar Tree and Family Dollar/Dollar Tree combina- tion stores. It was also sold through online retailers like Amazon and could have been shipped to homes across the state. Arkansas Department of Health (ADH) staff used social media, written materials, and its Health Alert Network (HAN) to inform con- sumers, businesses, and healthcare providers of the product recall. By Dec. 8, 2023, ADH Environmental Health staff had visited each Dollar Tree and Family Dollar/Dollar Tree combination store in the state to discuss the recall and confirm that the recalled products had been removed from store shelves. Most stores had placed corporate flyers about the recall in the section where the product would typically be found to alert consum- ers. An ADH-created flyer was available for the stores that needed one. In addition, our ADH-lead surveillance team is monitoring reports of children with elevated blood lead levels and continues to be on alert for any cases that may be linked to the recall. As of mid-January, Centers for Disease Control and Prevention (CDC) had linked 404 cases of high lead levels to the recall, and the U.S. Food and DrugAdministration (FDA) had received 90 confirmed complaints/reports of adverse events related to the products. The differing counts are due to the CDC and FDA having different data sources — the FDArelies on self-reported information submitted by healthcare providers, consumers, and some state partners. Arkansas has experienced two known cases, with one reported by the FDA. The second case was detected through anADH-lead surveillance team investigation. Product recalls are an important safety feature of the U.S. food supply. However, this particular recall stands out because it involves an environmental toxin rather than bacteria or a foreign object, such as a piece of metal. Lead is toxic to humans and can harm a child’s health even at low levels by causing damage to the developing brain and nervous system, resulting in slowed growth and devel- opment, learning and behavior problems, and hearing and speech problems. Lead poisoning can also occur in adults. However, the effects of low levels of lead exposure are not as seri- ous in adults compared to children. The recalled products also have been found to contain a high level of chromium, which is a naturally occurring chemical element. The most common forms of chromium are tri- valent chromium and hexavalent chromium. Trivalent chromium is considered an essential nutrient and can be found in dietary supple- ments. Hexavalent chromium is a known car- cinogen, and chronic, prolonged respiratory and skin exposure has been associated with chronic lung disease and ulceration of skin andmucous membranes. FDAtesting cannot identify which of the two forms of chromium is the one found in the recalled product. Lead chromate contains hexavalent chromiumand has previously been reported as a contami- nant in spices and food. Hexavalent chromi- ummay be converted to trivalent chromium in acidic environments such as in applesauce or the stomach. While harm from ingesting lead-contaminated food is relatively well- known, the effects of eating food contami- nated with hexavalent chromium as a lead chromate component are not well understood. The contaminated products were widely distributed and have a long shelf life. This means consumers could have the product stored at home to eat later. The ADH is ask- ing for your assistance to ensure Arkansans know to check their homes and discard any recalled items on their shelves. To properly discard the product, the FDA recommends ADH Calls for Healthcare Professionals to StayVigilant inAftermath ofApplesauce ProductRecall