Experts Advise Parents to Inspect Recalled Toys

Child Needs Lead Test if Paint Is Sullied

Parents whose children have toys that were recently recalled because they contain lead paint should inspect the playthings, and if they see that paint is missing or damaged, they may want to have the child's blood tested for lead.

That is the advice of two experts in lead poisoning, both of whom said the chance of harm from the Chinese-made toys is probably very low.

Nevertheless, "parents should take this very seriously," said Richard L. Canfield, a developmental psychologist at Cornell University who has done research on the effects of low levels of lead in children. "If there is evidence that the child has been chewing on the toys, or any evidence that the paint is rubbed off or has been disturbed, that would be a matter of concern."

James H. Ware, a biostatistician and lead poisoning expert at the Harvard School of Public Health, concurred. He said that if the paint is intact and the child has not been mouthing the toy, "I would not take my child for a blood-lead test but would request one on the next visit to the pediatrician."

Children should not be allowed to play with any of the affected toys, no matter what condition the toys are in. (A list and photos of the toys in the recall are at http://service.mattel.com/us/recall/39054_IVR.asp?prod=)

Lead can damage nerve cells and cause cognitive and behavioral problems. Young children are particularly at risk because their brains are still growing. Problems with brain functioning often remain even after blood-lead concentrations fall back to levels that are average for the population.

The toymaker Fisher-Price this month recalled 967,000 toys -- more than 80 different objects including stacking rings, dolls and musical instruments -- because they were found to contain lead paint. Mattel recalled 436,000 die-cast metal cars (253,000 in the United States) for the same reason. Fisher-Price is a division of Mattel.

The toys had paint with lead levels of more than 600 parts per million, the upper limit permitted by the government in household items since 1978.

About two-thirds of the Fisher-Price toys were recalled before they were sold. Some 300,000 may be in the hands of consumers, said Jules Andres, a Mattel spokeswoman. The number of recalled Mattel cars still in consumers' hands was not available yesterday.

The lead content of the paint on any of the toys -- a figure experts say would help them assess the hazard they pose -- has not been announced.

The testing that revealed prohibited paint was done by the toy companies, which notified the Consumer Product Safety Commission (CPSC). The federal agency is not testing the toys itself, said Patty Davis, a CPSC spokeswoman. Mattel is not releasing the results of its tests except to say that the paint violated lead-content limits.

Andres, the Mattel spokeswoman, noted that some toys are only partly covered with the paint.

"The [Mattel] Sarge car that was recalled, for example, had non-approved paint in specific areas, like a part of the wheel. The affected paint was not covering the entire product," she said.

Davis said that as of yesterday, "no incidents or injuries have been reported in either the Fisher-Price recall or the Sarge toy car."

As part of routine health care, blood-lead levels are measured at least once in toddlers, who are at greatest risk for lead poisoning. The main source of exposure to the metal is paint dust and chips from wooden surfaces in residential buildings built before the 1970s. Lead vaporized in the burning of leaded gasoline also contaminates soil in yards and lots bordering heavily trafficked roads.

In the decades since lead was banned from house paint and automobile fuel in the United States, the average American child's lead "burden" has fallen dramatically. Fifty years ago, it was about 15 micrograms per deciliter of blood. Today, it is about 2 micrograms in children under age 6.

While children's exposure has gone down, however, scientists have learned that lead levels once thought to be safe can cause damage.

In the 1960s, lead levels were not considered elevated until they reached 60 micrograms per deciliter. Now, lead is considered elevated by the Centers for Disease Control and Prevention (CDC) when it is over 10 micrograms.

In a particularly troubling study published in 2003, Canfield and colleagues measured blood lead seven times in 172 children up to age 5 and gave them IQ tests at ages 3 and 5. They found that each 10-microgram increase in lifetime average blood lead levels was associated with a 4.6-point drop in IQ. To their surprise, this effect was even seen in children whose highest lead levels never rose above 10 micrograms.

Another study published at the same time found that black and Mexican American girls with blood lead levels of 3 micrograms had slightly delayed puberty compared with girls with lead levels of 1 microgram.

These findings "gave little comfort that the exposures below the CDC level are indeed safe," said Ware, who is also dean for academic affairs at the Harvard School of Public Health.

A 2001 study found that when a lead-lowering drug called a chelator was given to children with blood lead levels of 20 to 44 micrograms, the counts came down, but the therapy did not improve their scores on tests of cognition, behavior and psychological function.

In most cases, the current medical "best practice" for children with elevated lead levels is to make sure they are well nourished, in particular with adequate iron, calcium and zinc. In addition, affected children should get the maximum intellectual and social stimulation at home, as those factors are far more important than lead levels in determining a child's level of functioning in the long run.

Given all this, Ware said, "the very notion that you would make a toy with lead paint and then have a child use it is so patently inexcusable."