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" Juanna Graham will never know exactly when her son Jarnell Brown swallowed a metal charm from the bracelet she&amp;#039;d gotten free with her Reebok sneakers. But she&amp;#039;ll always remember when her 4-year-old got sick: Valentine&amp;#039;s Day 2006. &amp;quot;We had lots of candy and heart-shaped stuff in the house,&amp;quot; says Juanna, 35, of Minneapolis. &amp;quot;The charm was heart shaped. Maybe he got confused.&amp;quot; When Jarnell became uncharacteristically listless and tired, she thought he had a cold. When he started vomiting, she rushed him to the hospital, but doctors said it was probably just the flu. A day later, Jarnell was glassy-eyed, disoriented, and acting bizarrely agitated, even trying to bite his mom and dad. Doctors still didn&amp;#039;t know what was wrong, but they knew it was no flu. Jarnell&amp;#039;s brain began to swell with fluid and he slipped into a coma. Then an X-ray revealed a metal object, later discovered to be the heart-shaped charm, in his stomach. A test showed his blood-lead level was 180 micrograms per deciliter (mcg/dl) \u2014 about three times the level that&amp;#039;s considered a medical emergency.  Six days after he first got sick, Jarnell&amp;#039;s family took him off life support, and he died in his mother&amp;#039;s arms. Cause of death: entirely preventable lead poisoning. All kids are exposed to lead \u2014 from such sources as paint dust, water, and old water pipes \u2014 says Philip Landrigan, M.D., director of the Center for Children&amp;#039;s Health and the Environment at Mount Sinai School of Medicine in New York City. &amp;quot;Lead in kids&amp;#039; products offers one more route of exposure, which is all cumulative,&amp;quot; he explains. So the parent&amp;#039;s job seems clear: Have your child tested to see if his or her blood-lead level is too high.  But what is &amp;quot;too high&amp;quot;? It&amp;#039;s a basic question, but even the Centers for Disease Control and Prevention (CDC) can&amp;#039;t give a clear answer. On one hand, the agency says that there is no known &amp;quot;safe blood-lead level&amp;quot; in children; on the other hand, it flags 10 mcg/dl as the level at which medical intervention is necessary for kids. But if there is no &amp;quot;safe&amp;quot; level, then why intervene only at 10 mcg/dl or higher? Presented with this contradiction, the CDC says there hasn&amp;#039;t been enough research to gauge exactly how harmful the lower concentrations are or how effective treatment of kids with those levels would be.  What scientists do know: An estimated 310,000 children nationwide have blood-lead levels that qualify as toxic (10 mcg/dl or higher), which can damage their development. Ten to 20 mcg/dl &amp;quot;may not cause noticeable symptoms,&amp;quot; Dr. Landrigan says, &amp;quot;but these levels can cause brain damage, which can lead to a loss of IQ points and a shortened attention span.&amp;quot; A 2003 study at Cornell University found that the IQ scores of children with blood-lead levels of 10 mcg/dl were five or more points lower than children with only 1 mcg/dl. And the study estimates that one in 10 kids have levels of 5 mcg/dl or higher; research shows that even those levels can negatively affect IQ and problem-solving skills. Colton Burkhart, 8, of Redmond, OR, is living with a blood-lead level of 17 mcg/dl. But that elevated level is actually a relief to his mom, Kara, compared with the acute poisoning that almost killed him in 2003. It was July 4 weekend when Colton, then 4, got violently ill on a family camping trip. As in Jarnell&amp;#039;s case, doctors first assumed Colton&amp;#039;s vomiting was due to the flu. But an X-ray revealed he had swallowed a medallion that Kara, then 25, and her husband, Todd, recognized as one of the 25-cent vending machine trinkets they had bought their sons. Colton had endoscopic surgery to remove the metal and &amp;quot;we thought, Yay, he&amp;#039;ll feel better,&amp;quot; Kara says. &amp;quot;Two days later, he bit the inside of his cheek and it swelled up to the size of a golf ball.&amp;quot; The medallion turned out to be about 39 percent lead, enough of which leached into Colton&amp;#039;s bloodstream to push his level to a potentially fatal 123 mcg/dl. His life was saved by a course of chelation (a punishing treatment that uses chemicals to bind to certain toxic metals and pull them out of the body), and the Burkharts&amp;#039; case prompted a nationwide recall of 150 million pieces of vending machine jewelry.  In the Burkhart and Brown cases, lead was definitely what threatened the children&amp;#039;s lives. Kara and Joe La Russa of Fallbrook, CA, belong to a presumably larger group of parents who believe lead may be implicated in their kids&amp;#039; problems but will never know for sure. In 2004, the La Russas&amp;#039; pediatrician ran a blood-lead test on their 2-year-old son, Anthony, after noticing developmental delays. &amp;quot;He was six months to a year behind in terms of talking and motor skills,&amp;quot; recalls Kara, 45, &amp;quot;and he was diagnosed with a mild form of autism.&amp;quot; Anthony&amp;#039;s lead level proved to be 4.3 mcg/dl \u2014 below the CDC&amp;#039;s intervention level but high enough to trouble the couple and the pediatrician. Looking for a possible source of exposure, Kara and Joe found one right in Anthony&amp;#039;s mouth: the metal necklaces that Kara had picked up at a Claire&amp;#039;s Stores outlet. &amp;quot;I bought a lead-test kit and all of these seemingly harmless necklaces Anthony had sucked and chewed on turned up positive for lead,&amp;quot; she says.  It&amp;#039;s unclear what role, if any, lead exposure played in Anthony&amp;#039;s developmental problems. The toxicologist who tested the boy \u2014 Aaron Schneir, M.D., of the University of California, San Diego Medical Center \u2014 thinks it&amp;#039;s very unlikely that lead caused Anthony&amp;#039;s delays. But some experts argue that it&amp;#039;s very difficult for doctors to determine the effects of lead exposure under 10 mcg/dl on a child. &amp;quot;Would he have had fewer problems without the lead exposure?&amp;quot; asks Joe. &amp;quot;We&amp;#039;ll never know.&amp;quot; Kara still can&amp;#039;t believe these easily available toys are so dangerous. &amp;quot;I had no idea it would even be legal for them to put lead in a children&amp;#039;s product,&amp;quot; she says.  Why Toxic Toys Are Still on Shelves Jarnell Brown&amp;#039;s autopsy revealed that the Reebok charm he&amp;#039;d swallowed was 99 percent lead \u2014 an astronomically high percentage compared with the federal government&amp;#039;s voluntary safety standard for lead in kids&amp;#039; jewelry: 0.06 percent, or 600 parts per million (ppm). Reebok recalled more than 500,000 bracelets worldwide. But the company won&amp;#039;t comment on how such a hazardous bracelet ended up in stores in the first place. &amp;quot;We reviewed our quality control program and found the process clearly wasn&amp;#039;t as tight as it needed to be,&amp;quot; Denise Kaigler, Reebok&amp;#039;s head of corporate global communications, told Good Housekeeping. Although the La Russas never pursued Anthony&amp;#039;s case with Claire&amp;#039;s Stores, the company recalled seven children&amp;#039;s necklaces for lead this year. Company spokesperson Marisa F. Jacobs, vice president of corporate communications and investor relations, says: &amp;quot;We&amp;#039;ve pinpointed what happened and taken care of the problem.&amp;quot; She adds, &amp;quot;Lead has been used in making costume jewelry for literally thousands of years.&amp;quot;  But why is it being used now, when it&amp;#039;s been proven a poison? U.S. companies are buying these items from overseas manufacturers, most of them located in China, who use lead as a low-cost way of adding weight to items like charms. Since lead is also malleable, it can make flexible goods, such as vinyl lunch boxes and backpacks, more resistant to wear and tear. Companies that buy from these makers are either ignorant of this money-saving but dangerous ingredient or turn a blind eye to it.  Since 2003, the U.S. Consumer Products Safety Commission (CPSC) has recalled more than 165 million pieces of toy jewelry and thousands of other kids&amp;#039; products, including bibs and key chains. And it&amp;#039;s not just cheap trinkets that can contain lead: In June, the agency recalled 1.5 million train cars and other railway items sold under the name Thomas and Friends, a high-end brand; the products were imported and distributed by RC2 Corp. The recall stoked national concern over whether the CPSC and U.S. companies should be doing more to keep hazardous toys from entering the country.  ClearCorps USA, an organization that works to protect children from lead poisoning, has also found hazardous levels of lead in hundreds of other items, including two vinyl bags for girls and the plastic cap on a glue stick, says Sue Gunderson, executive director. &amp;quot;Our tests turned up dangerous levels of lead in a Dora the Explorer purse, for example,&amp;quot; she adds. &amp;quot;But a product like that is often made by more than one manufacturer, and not all use lead. So another Dora purse could be safe \u2014 but you can&amp;#039;t tell for sure without testing it.&amp;quot;  Nonintervention There are no mandatory federal regulations to prevent lead-laced children&amp;#039;s products from hitting shelves (unless they have lead paint on them, in which case they&amp;#039;re regulated under the lead-in-paint law). But some state and local legislators are taking action. This month, for example, regulations in California, Minnesota, and Baltimore will ban children&amp;#039;s jewelry that contains more than the recommended standard, 600 ppm. While these efforts may force chains to meet stricter standards, many experts say we still need federal legislation to really make them clean up their acts. Senator Barack Obama (D-IL) and Congressman Henry Waxman (D-CA) agree; in November 2005, they introduced the Lead Free Toys Act, which would require the CPSC to ban children&amp;#039;s products with more than trace amounts of lead. Though that bill is still in Congress (Sen. Obama reintroduced it in May 2007), the CPSC took a separate step last December, voting to begin a rule-making process that could prompt a ban on kids&amp;#039; metal jewelry made with more than 600 ppm lead. But that&amp;#039;s not nearly as restrictive as Sen. Obama&amp;#039;s proposed law. And changing CPSC rules is &amp;quot;a multistage process that will take time,&amp;quot; says Julie Vallese, director of information and public affairs. Meanwhile, some advocacy groups are getting impatient. Over the last three years, the Center for Environmental Health (CEH), a nonprofit public and environmental health advocacy group in Oakland, CA, has tested more than 200 lunch boxes and found that 10 to 20 percent of them exceeded the government&amp;#039;s standard of 600 ppm \u2014 in some cases by 90 times. When the CEH released its findings in 2005, the CPSC said that its own testing showed no such risk. &amp;quot;But when we acquired the CPSC&amp;#039;s data, we found that some lunch boxes they tested had lead levels 16 times the standard,&amp;quot; says Alexa Engelman, formerly CEH&amp;#039;s public-interest litigation coordinator.  The CPSC disputes CEH&amp;#039;s claims. Regarding the lunch boxes, Vallese says, &amp;quot;we&amp;#039;ve determined that the accessible lead levels from a lunch box are negligible based on how consumers interact with the product.&amp;quot; She means kids are less likely to put their mouths on a box than they are to swallow a piece of jewelry. But the CPSC doesn&amp;#039;t investigate whether lead can leach from a vinyl lining onto, say, an apple packed inside. &amp;quot;The apple is not under our jurisdiction,&amp;quot; Vallese says. That buck passes to the Food and Drug Administration, which issued a letter to manufacturers in July 2006 urging them &amp;quot;to refrain from marketing such lead-containing lunch boxes.&amp;quot;  If Congress passes Sen. Obama&amp;#039;s bill, the CPSC will be forced to step up regulation of kids&amp;#039; products. Until then, parents should keep track of what their children are exposed to. &amp;quot;I stop moms in stores if I see them buying these products because I want to protect their children too,&amp;quot; says Kara Burkhart. Helping other kids is what keeps Juanna Graham going: &amp;quot;Some days I&amp;#039;m so angry, I can&amp;#039;t get out of bed,&amp;quot; she says. &amp;quot;But some days are better. I just want to help \u2014 to make sure what happened to Jarnell never happens again.&amp;quot; Protect Your Kids Until a national lead-regulation law is passed, follow these tips to keep your children safe. For more information, visit cehca.org, the site of the Center for Environmental Health.  Be suspicious of jewelry made with metal, plastic cords, and fake pearls. Likewise, be cautious with products made in China, where lead is often used in manufacturing. Buy bibs and lunch boxes that are advertised as PVC- or vinyl-free.  Test suspect items with a lead-test kit, available at hardware stores for about $20 for eight swabs. But be aware, these strips aren&amp;#039;t foolproof \u2014 so even if a toy tests negative for lead, you should still try to keep it out of your kid&amp;#039;s mouth.  The Biggest Dangers Paint and water are still the top sources of lead poisoning in kids \u2014 partly because it is so easy for toddlers to ingest those substances. For that reason, something large, like a backpack, is probably not as hazardous as a tiny charm. But all lead-based items are potentially dangerous to kids. Here are the categories of products that have caused concern or prompted recalls because of lead problems. So be cautious when buying, and do your best to keep these items out of your children&amp;#039;s mouths. (Of course, many products in these categories are perfectly safe, because the manufacturers are not using lead.)   Costume jewelry  Metal key chains  Painted toys, which could be covered in lead-based paint  Vinyl bibs  Vinyl lunch boxes  Vinyl backpacks  Jackets with lead-based zippers or buttons  A Timeline of the Toxin The hazards of lead, especially to children, have been known for decades:  1973\u20131995: Lead is phased out of gasoline.  1978: Congress passes a law banning more than 600 ppm of lead from house paint.  1986: Lead piping and soldering is banned from use in water supplies.  1991: The CDC sets the standard for unsafe blood-lead levels at 10 mcg/dl or above, and the medical community adopts that standard. Today, because there is so much controversy and confusion surrounding &amp;quot;safe&amp;quot; levels, some pediatricians won&amp;#039;t alert parents whose kids test below 10 mcg/dl, while others will.  2004: Colton Burkhart&amp;#039;s lead poisoning leads to a recall of 150 million vending machine trinkets. 2005: Senator Barack Obama and Congressman Henry Waxman introduce the Lead Free Toys Act in Congress, where it stalls. 2006: Jarnell Brown&amp;#039;s death makes headlines nationwide.  2007: In May, Sen. Obama reintroduces the Lead Free Toys Act in Congress.  In June, 1.5 million Thomas and Friends train cars and other railway toys are recalled. Click here to see a list of recent recalls. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.goodhousekeeping.com/health/advice/a17691/poisonous-lead-toys-0907/>