Children who consumed the recalled lead-contaminated WanaBana cinnamon applesauce pouches may also have been exposed to the heavy metal chromium, the Food and Drug Administration said Friday.
The FDA tested samples of the recalled product as part of its investigation into cases of lead poisoning in the U.S. that are linked to the applesauce. In addition to WanaBana cinnamon applesauce, the recall included two other products made by the company: the supermarket brands Schnucks applesauce pouches with cinnamon and Weis cinnamon applesauce.
As of Dec. 29, the Centers for Disease Control and Prevention had received 287 confirmed, probable and suspected reports of elevated blood lead levels linked to the pouches across 37 states.
Chromium occurs naturally in two forms: chromium-3, which is an essential nutrient, and chromium-6, which is a known carcinogen, according to the CDC.
Due to testing limitations, the FDA said it couldn’t determine which form of chromium was in the applesauce pouches. However, the ratio of lead to chromium found in the samples suggested it might be chromium-6, the FDA said. That’s because the lead-to-chromium ratio in the applesauce was consistent with that of a chemical compound called lead chromate, which contains both lead and chromium-6.
The FDA’s analysis found chromium levels of 0.590 parts per million in one sample and 0.566 ppm in another.
Dr. Laura Breeher, an occupational and environmental medicine physician at the Mayo Clinic in Rochester, Minnesota, said both of those levels are over five times the Environmental Protection Agency’s limit for drinking water. The limits include both chromium-3 and chromium-6 because each form can be converted into the other in the human body.
The FDA does not have a limit for chromium in foods.
It’s unclear whether children exposed to chromium are at risk for serious health problems, as information on the health effects of eating food contaminated with chromium-6 is limited, the FDA said.
Symptoms of chromium exposure from eating contaminated food may be nonspecific and are similar in both children and adults, according to the FDA. Some people might not experience any symptoms, it said.
Consuming large amounts of chromium may cause abdominal pain, nausea and vomiting, Breeher said. It can also cause diarrhea, anemia, and kidney and liver dysfunction, according to the FDA.
Prolonged exposure through inhalation has been associated with chronic lung disease, and prolonged skin contact can lead to ulcers, according to the CDC.
Breeher said that while the chromium contamination in applesauce is concerning, she would be more concerned about the health risks of the lead contamination.
“While the levels of chromium are significantly above the EPA drinking water limits, applesauce volume ingested would be low,” she said. “The body tries to protect itself from toxic chromium. Chromium-6 is fairly rapidly converted to the less toxic chromium-3 in the stomach.”
The FDA said it is advising parents with children impacted by the recall to inform their health care provider.
WanaBana, the maker of the applesauce, did not immediately respond to a request for comment. It has previously said it is working with the FDA on its investigation.
The FDA also conducted testing for arsenic and cadmium, but those elements were not detected above trace levels, the agency said.