Child Health

Environmental health professionals work to support schools, childcare facilities, and local agencies to ensure the health and safety of children in our communities.

COVID-19 Early Care and Education (ECE) Collaborative

Early in the COVID-19 pandemic response the Agency for Toxic Substances and Disease Registry (ATSDR) provided support to establish the COVID-19 Early Care and Education (ECE) Collaborative. The ECE Collaborative was convened by us and served as a forum to bring together key environmental health organizations, each with their own specialization and constituents, to better coordinate activities and messaging.

Convening a broad range of organizations ensured that messaging was both coordinated and tailored to the ECE community including ECE facilities, home-based childcare settings, clinicians and other health care providers, and public health organizations.

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Criss Cross Applesauce: Identification of Lead-Contaminated Cinnamon in Applesauce and Apple Puree' Products as an Exposure Source for Children with Lead in Their Blood

April 9, 2024

Clear communication and listening to families are critical pieces when investigating for a child who has tested positive for lead in their blood. Comprehensive interviews with parents during childhood lead poisoning investigations in North Carolina resulted in the identification of cinnamon applesauce as a possible source of lead exposure. The next steps taken by North Carolina and their work with FDA resulted in cinnamon being identified as the ingredient of concern in three different brands.

Learn how this information was shared with other Childhood Lead Poisoning Prevention Programs and Food Programs around the country and the impact it had on the way investigations were conducted. The multi-agency response at both state and national levels, including a Health Alert Network (HAN) notice from CDC, resulted in the dangerous products being pulled from store shelves nationwide and in the identification of over 450 cases where the consumption of these products was linked to children with blood lead levels > 3.5 mcg/dL. Further testing by FDA has also identified high levels of chromium in these same products.


  • M.L. Tanner, Program Manager for the South Carolina Childhood Lead Poisoning Prevention Program
  • Perri Ruckart, DrPH, MPH, Team Lead for the Strategic Partnerships and Policy Team in the Lead Poisoning Prevention and Surveillance Branch in the National Center for Environment Health
  • Alan Huneycutt, Children’s Environmental Health as a Regional EHS
  • Michele Howard, State Liaison for HAFE3 (formerly the Atlanta District), FDA

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