title: Lead in candy consumed and blood lead levels of children living in Mexico City.
abstract: BACKGROUND
  Recent studies have shown that lead exposure continues to pose a health risk in Mexico. Children are a vulnerable population for lead effects and Mexican candy has been found to be a source of exposure in children. There are no previous studies that estimates lead concentrations in candy that children living in Mexico City consume and its association with their blood lead level.
  
  
  OBJECTIVE
  To evaluate whether there is an association between reported recent consumption of candies identified to have lead, and blood lead levels among children in Mexico City.
  
  
  METHODS
  A subsample of 171 children ages 2-6 years old, from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) cohort study was assessed between June 2006 and July 2007. The candy reported most frequently were analyzed for lead using ICP-MS. The total weekly intake of lead through the consumption of candy in the previous week was calculated. Capillary blood lead levels (BLL) were measured using LeadCare (anodic stripping voltammetry).
  
  
  RESULTS
  Lead concentrations ≥0.1ppm, the FDA permitted level (range: 0.13-0.7ppm) were found in 6 samples out of 138 samples from 44 different brands of candy. Median BLL in children was 4.5µg/dl. After adjusting for child's sex, age, BMI, maternal education & occupation, milk consumption, sucking the candy wrapper, use of lead-glazed pottery, child exposure behavior, living near a lead exposure site and use of folk remedies, an increase of 1µg of lead ingested through candy per week was associated with 3% change (95% CI: 0.1%, 5.2%) in BLL.
  
  
  CONCLUSIONS
  Although lead concentrations in candy were mostly below the FDA permitted level, high lead concentrations were detected in 4% of the candy samples and 12% of brands analyzed. Although candy intake was modestly associated with children's BLL, lead should not be found in consumer products, especially in candy that children can consume due to the well documented long-lasting effect of lead exposure.
authors.affiliation: National Council of Science and Technology, Avenida Insurgentes Sur 1582, Benito Juárez, Crédito Constructor, 03940 Ciudad de México, D.F, Mexico; National Institute of Public Health, Universidad No. 655 Colonia Santa María, Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, Morelos, Mexico. Electronic address: marcela.tamayo@insp.mx.
authors.forename: Marcela
authors.initials: M
authors.lastname: Tamayo y Ortiz
authors.affiliation: National Institute of Public Health, Universidad No. 655 Colonia Santa María, Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, Morelos, Mexico. Electronic address: mmtellez@insp.mx.
authors.forename: Martha María
authors.initials: MM
authors.lastname: Téllez-Rojo
authors.affiliation: University of Toronto, Dalla Lana School of Public Health, 6, 155 College St, Toronto, ON, Canada M5T 3M7. Electronic address: howard.hu@utoronto.ca.
authors.forename: Howard
authors.initials: H
authors.lastname: Hu
authors.affiliation: National Institute of Public Health, Universidad No. 655 Colonia Santa María, Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, Morelos, Mexico. Electronic address: mhernan@insp.mx.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Hernández-Ávila
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029, United States. Electronic address: robert.wright@mssm.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Wright
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029, United States. Electronic address: chitra.amarasiriwardena@mssm.edu.
authors.forename: Chitra
authors.initials: C
authors.lastname: Amarasiriwardena
authors.affiliation: Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States. Electronic address: nicolalupoli@yahoo.com.
authors.forename: Nicola
authors.initials: N
authors.lastname: Lupoli
authors.affiliation: National Institute of Public Health, Universidad No. 655 Colonia Santa María, Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, Morelos, Mexico. Electronic address: adrianam@insp.mx.
authors.forename: Adriana
authors.initials: A
authors.lastname: Mercado-García
authors.affiliation: National Institute of Perinatology, Calle Montes Urales #800, Miguel Hidalgo Lomas Virreyes, 11000 Ciudad de México, D.F, Mexico. Electronic address: ivandpantic@gmail.com.
authors.forename: Ivan
authors.initials: I
authors.lastname: Pantic
authors.affiliation: National Institute of Public Health, Universidad No. 655 Colonia Santa María, Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, Morelos, Mexico. Electronic address: hlamadrid@insp.mx.
authors.forename: Héctor
authors.initials: H
authors.lastname: Lamadrid-Figueroa
mesh_terms: D002182:Candy / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007854:Lead / Q000097:blood*; D008297:Male; D008800:Mexico
chemical_list: D007854:Lead
keywords: Candy; Children; Lead; Mexico