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Check that toybox
Leaded toys: RC2 Corp
recalled its Thomas & Friends Wooden Railway
toys, because of lead paint. Mattel recalled items,
including "Sarge," the die cast truck from the
"Cars" toys. Other toys, from Mattel's Fisher
Price line, included Sesame Street and Dora the
Explorer items.
Dangerous attraction:
Polly Pocket playsets from Mattel, and some Barbie,
Batman and Doggie Day Care sets were recalled
because of improperly attached, small-but-powerful
magnets. If more than one of these is dislodged
and swallowed, attraction between them can interrupt
GI motility in the intestines. If parents can't
bear to toss the toys, they should at least remove
the magnets.
Pickled PJs: Charles
Parsons Superlux blankets and TWL pyjamas were
pulled from several stores' shelves in New Zealand
when found to contain high levels of formaldehyde.
A probable carcinogen, formaldehyde also irritates
the eyes, skin and respiratory tract, and high
levels are bad news for the nervous system. There
were also several reported cases of the flannelette
pyjamas easily catching fire, causing serious
burns. Formaldehyde is added to the products to
prevent mildew.
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Last month toymaker Mattel recalled
millions of toys sold in Canadian stores after discovering
"impermissible levels of lead" in their paint. Dr Margaret
Thompson, medical director at the Ontario Poison Centre
and a clinical toxicologist at the Hospital for Sick
Children, expects you might see some extra parents with
kids in tow, brimming with questions about the hazards
of Elmo and Barbie. Some will even demand you perform
a battery of tests to make sure their child's not been
poisoned.
Dr Thompson suggests you start
by telling parents that lead toxicity from contaminated
paint on toys is extremely rare. They'll probably still
have a lot of questions. Here are the most common, and
how to answer them.
"What are the symptoms of lead
poisoning?" Signs and symptoms include weakness
and fatigue, stomach ache, fever and vomiting. A child
may develop a pale complexion due to anemia. With extensive
poisoning, the child may experience irritability and
cognitive difficulty due to neural toxicity.
"Should my child be tested?"
If anything, lead contamination in children will most
likely be picked up in a routine screening during visits
with the pediatrician. "Family doctors should be attuned
to the risk, and let parents know this," says Dr Thompson.
But parents may not be willing
to wait until a routine check-up if they've found their
child with a tainted toy in their mouth. "If a child
has mouthed one of these toys a couple of times, parents
shouldn't panic," says Dr Thompson. "There's not an
easy, reliable test for lead contamination," she adds.
"It's expensive to do, done using atomic absorption.
That capability isn't available in many labs —
so it has to be indicated."
More extensive exposure to lead
is a better reason to consider testing. "If a child
has sucked all of the paint off of one of the contaminated
toys, or may have swallowed an item made of lead, it
would be a good reason to see the family doctor, or
do tests," says Dr Thompson. Since lead accumulation
may occur gradually over time, a child may appear normal
while lead concentrations are slowly increasing.
"What if my kid does have lead
poisoning?" The standard cut-off for a diagnosis
of lead poisoning is 10 µg/dL. There have recently
been rumblings in the scientific community that even
blood levels below this concentration are associated
with significant IQ impairment. Some have called for
the cut-off to be drastically lowered. Severe poisoning
can also cause slowed body growth, hearing problems,
behaviour or attention problems and kidney damage. Lead
poisoning can be fatal in children in extreme doses,
above 70 µg/dL.
"If screening confirms high levels,"
says Dr Thompson, "you can get in touch with a toxicologist,
or a poison control centre. Get advice on treatment,
and do a proper history." A history is important, because
the source of contamination should be determined. "Remove
the source from the child's environment, of course,"
says Dr Thompson. If the source might be an ingested
object, radio-opacity in the gastro-intestinal system
should show up in an x-ray.
"How do you treat lead poisoning?"
For mild cases, reducing lead ingestion and observation
are best. For very high levels, some pretty harsh meds
will be needed. "A prescription should be written for
a chelation medication." These are not without their
downsides, though, and they should only be used when
blood levels reach the 45 µg/dL range. It's still
critical parents find and remove the source as well.
"Where else are my kids exposed
to lead?" "There have been many toy recalls across
the country," says Dr Thompson, "but I'm not aware of
any child who's developed lead poisoning because of
a toy." The threat of lead contamination from toys should
also be weighed against other lead sources. Old house
paints are just as, if not more, dangerous to kids.
"I've prescribed children chelating agents a total of
five times in my whole career, and the contamination
was never from toys," says Dr Thompson. A couple of
these cases were from children living in an old group
home, she adds. "They had a particular propensity for
abnormal gnawing behaviour." Another case of hers involved
contamination from a 'medication' given by an alternative
medicine practitioner.
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