What spice in pumpkin spice has been associated with lead poisoning?
November 1, 2024
Pumpkin spice is often a combination of cinnamon, nutmeg, allspice, cloves, and ginger. Cinnamon was the source of lead poisoning from WanaBana Apple Cinnamon Fruit Puree pouches that were recalled on October 31, 2023 by the manufacturer.
A MMWR published July 18, 2024 described multiple children with elevated blood levels in June-August 2023 in North Carolina with the unifying exposure being WanaBana brand apple cinnamon fruit puree pouches. The pouches were found to contain 1.9-3.0 ppm of lead (10 mcg/dl is approximately 0.1 ppm concentration of lead in blood).1 Further analysis discovered the ground cinnamon processed by Carlos Aguilera of Ecuador to be the probably source of the contamination. The Carlos Aguilar processed the cinnamon for the company Negasmart which supplied the cinnamon to Austrofoods. Austrofoods was the manufacturer for WanaBana for the pouches. The FDA confirmed the source of the lead and chromium in these products as lead chromate. Lead chromate has been used illicitly to increase the weight and alter the color of spices in order to enhance their economic value. Per the Agencia Nacional de Regulación, Control y Vigilancia Sanitaria (ARCSA) in Ecuador, the unprocessed cinnamon sticks from Sri Lanka did not have lead contamination. Per the FDA: “The FDA has limited authority over foreign ingredient suppliers who do not directly ship product to the U.S. This is because their food undergoes further manufacturing/processing prior to export. Thus, the FDA cannot take direct action with Negasmart or Carlos Aguilera.”2 As of February 29, 2024, the FDA reported Ecuadorian Officials stated that Carlos Aguilera of Ecuador is no longer in business.
The recalled pouches were WanaBana apple cinnamon fruit puree pouches including 3-pack, Weis-brand cinnamon applesauce pouches, and Schnucks-brand cinnamon-flavored applesauce pouches and variety packs. These were sold through multiple companies including Dollar Tree and Amazon.3
As of October 23, 2024, the CDC reports 531 probably or confirmed cases of lead poisoning related to these products. Even though it is over a year since the initial recall, the products have a long shelf life and recommend to discard any of the recalled pouches: WanaBana Issues Voluntary Recall of WanaBana Apple Cinnamon Fruit Purée Pouches Due to Elevated Lead Levels | FDA and WanaBana Recalls WanaBana, Weis, and Schnucks Apple Cinnamon Fruit Purée Pouches & Cinnamon Apple Sauce Due to Elevated Lead Levels | FDA. If a child has been exposed to these pouches even if it has been several months (lead can remain in the body for months to years), recommend to check a blood lead level. If using a capillary screen, it is important to follow up with a venous blood lead level. The following link contains how to report lead levels to the state of TN (all tests must be reported): Tennessee Childhood Lead Poisoning Prevention Program Lead Reporting (1)
Lead poisoning can result in multiple symptoms including cognitive deficits including loss of IQ, difficulties with attention, irritability, abdominal pain, vomiting, and constipation. At levels >= 70 mcg/dl in children, it can result in lead encephalopathy which is associated with life threatening seizures and cerebral edema. For any questions regarding lead poisoning and management, the Tennessee Poison Center is available 24/7/365 at 1-800-222-1222.
References:
1. Napier MD, Huneycutt A, Moore C, et al. Childhood Lead Exposure Linked to Apple Cinnamon Fruit Puree Pouches — North Carolina, June 2023–January 2024. MMWR Morb Mortal Wkly Rep 2024;73:622–627. DOI: http://dx.doi.org/10.15585/mmwr.mm7328a2
2. Investigation of Elevated Lead & Chromium Levels: Cinnamon Applesauce Pouches (November 2023) Link: Investigation of Elevated Lead & Chromium Levels: Cinnamon Applesauce Pouches (November 2023) | FDA Accessed: November 1, 2024
3. TDH Reminds Tennesseans About Lead Poisoning Linked to Recalled WanaBana Applesauce Pouches. December 19, 2023 Link: TDH Reminds Tennesseans About Lead Poisoning Linked To Recalled WanaBana Applesauce Pouches Accessed: November 1, 2024.
Question Prepared By: Rebecca Bruccoleri, MD, Medical Director, Tennessee Poison Center