Analyses were performed using an external calibration method with lutetium as the internal standard for lead. Acid-digested samples were analyzed by an inductively coupled plasma mass spectrometer (Agilent 8800 ICP-MS QQQ). Candy samples were weighed (~2 g) into a 50 mL plastic tube and digested with 2 mL of concentrated nitric acid for 24 hours and then diluted to 25 mL with deionized water. Lead concentrations in candy were analyzed in the Lautenberg Environmental Health Sciences Laboratory at the Icahn School of Medicine at Mount Sinai. In the present study candy were purchased and analyzed in 2018 and we also included samples from: two of the candy reported among our previous study that did not have high lead concentrations, but had been reported by the FDA with high lead- namely “Miguelito” and “Pulparindo” and three brands of lollipops- “Rockaleta Junior”, which is a variety of “Rockaleta Diablo” (0.7 ppm lead concentration in previous study), and “Bubbaloo Extreme” lollipops- for which the same brand of “Bubbaloo” chewing gum was reported in our previous study. The selection of the candy in our previous study was based on a detailed candy consumption questionnaire for children, which allowed us to detect the 20 most-consumed candy reported in 2008 (the study was published in 2016). We analyzed 5 samples from each of 5 candy brands reported in our previous study with higher lead concentrations (≥0.1 ppm) that were still available (1 brand had been taken off the market). In follow-up to our prior report, herein we report findings from re-analysis of 50 candy samples selected from brands previously reported to have lead concentrations above 0.1 ppm. In response, the Mexican Senate issued two resolutions: 1) calling the federal health authorities to implement a surveillance program for lead in food, water and consumer products and 2) to develop a blood lead monitoring program, particularly in children younger than 5 years of age and pregnant women. These results caught the interest of Mexican media resulting in a wide media coverage. Moreover, each 1 μg increment in weekly ingested lead via candy was associated with a 3% increase (95% CI: 0.1%, 5.2%) in blood lead levels after adjustment for a robust set of covariates. Notably we found that 6 candy units had concentrations above 0.1 ppm. Candy samples were collected in 2008 and we reported the concentrations in 100 units. Selected candy brands were included based on children’s report of the more frequently consumed candies. Our group previously published a study on the association of lead concentrations in candy and blood lead levels in children participating in the ELEMENT birth cohort in Mexico City. After detecting blood lead levels >10 μg/dL in Mexican migrant children (CDC, 2002), the California Public Health Department was charged with the implementation of Assembly bill 121, forbidding the importation of candy exceeding the FDA limit of 0.1 ppm of lead. In the early 2000’s Mexican candy producers faced a controversy due to candy with elevated lead levels being exported to the US. Lead affects nearly every organ and system in the human body and is a potent neurotoxic impacting children’s neurodevelopment even at very low levels. Preventing exposure to lead is crucial, especially in vulnerable populations such as children, who can absorb between 50% and 100% of the lead ingested in a meal or an empty stomach respectively.
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