International Investigation of Lead and Chromium Contamination in Imported Apple Puree.

In October 2023, the Food and Drug Administration (FDA) was notified about four children in North Carolina who had high blood lead levels that were associated with consumption of apple cinnamon fruit puree from pouches. FDA and the Centers for Disease Control and Prevention (CDC), along with state and local partners, launched an international investigation into the source of lead contamination. FDA received 90 consumer complaints from 32 states, while CDC identified 556 cases of high blood lead levels with a variety of symptoms in 44 states. Novel laboratory methods were developed to identify the specific contaminant: lead chromate. Testing of products produced in Ecuador found lead concentrations 100- to 600-times above the FDA action level. The traceback investigation identified a cinnamon processor as the likely source of the contaminant. The investigation found that the lead and chromium in the apple cinnamon fruit puree pouches were likely due to lead chromate found in the ground cinnamon. The investigation led to the recall of these apple puree products and enhanced surveillance of cinnamon. The findings highlight the potential for children to be exposed to toxic elements from nontraditional sources and could help inform blood lead investigations in children.