Overview
Cataldo and colleagues at FDA, CDC and North Carolina describe the 2023 to 2024 investigation into high blood lead in children who ate apple cinnamon fruit puree pouches made in Ecuador. State and FDA laboratories found lead in the pouches at 144 to 643 times the FDA action level for processed fruit for young children. Traceback pointed to ground cinnamon, adulterated with lead chromate during or after grinding.
Key numbers
- Apple cinnamon puree pouches: lead 1.44 to 6.43 ppm across state and FDA samples; highest single result “6.43” ppm (Table 1).
- Pouch chromium 0.59 to 1.71 ppm in Table 1 (text says 0.59 to 1.41).
- Ground cinnamon from the manufacturer: lead “5,110” and “2,270” ppm, chromium “1,200” and “531” ppm (Table 1).
- Post-incident retail cinnamon: 30 surveillance samples with “high lead levels (2-20 ppm)” led to alerts for 13 brands (p. 25; Table 2).
Methods (brief)
FDA’s multi-laboratory validated ICP-MS method for lead and chromium, used by FDA and most state laboratories, with Raman microspectroscopy to identify lead chromate particles in cinnamon. Traceback followed records through importers, distributors and the cinnamon grinder.
Evidence Fitness
Strong analytical work, but these are targeted outbreak and recall samples of one adulterated product line, not survey data, and they must never stand for background lead in fruit purees. The North Carolina health department rows in Table 1 were already reported in Childhood Lead Exposure Linked to Apple Cinnamon Fruit Puree Pouches — North Carolina, June 2023–January 2024 and are not re-extracted. A fruit puree is a proxy for the non-root vegetable purees page, not a vegetable puree.