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I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine substituting this week for Donald Lindberg, M.D, the Director of the National Library of Medicine.

Here is what's new this week in MedlinePlus.

To listen to Dr. Lindberg's comments, click here

Although a child's exposure to lead from toys is important to consider, new information from the Nemours Foundation notes how to monitor the safety of playthings during this holiday gift season -- and adds some perspective about lead and kid's health.

First, the Nemours Foundation notes many toy stores and manufacturers are (and we quote) 'buckling down on testing before the products actually hit the shelves' (end of quote) this holiday season because of recent information about toddler lead exposure from toys. In the U.S. there have been recent, highly publicized Congressional hearings about children's lead exposure from toys – including some made in China.

The new information on the Nemours Foundation's website reminds readers that toys have to meet both industry and government standards to be sold in the U.S. While the Nemours Foundation acknowledges it is wise for parents, grandparents and others to be wary of lead exposure from toys, Nemours provides some comforting insights about: dose, testing for lead, symptoms and above all, additional sources of lead in a child's environment besides toys.

First, children can ingest excess lead from toys if a toddler places a toy containing lead in his or her mouth, or places fingers in his or her mouth after playing with a toy.  However, the Nemours Foundation adds an occasional contact with a toy that contains lead is rarely associated with a child's health safety. Instead, most problems occur when a toddler repeatedly plays with a toy for many hours during a day, or for many days after a toy is received. So, health problems stem from cumulative exposure – not occasional contact.

To prevent difficulties, the Nemours Foundation reminds us to throw away any toy recalled for safety reasons. The U.S. Centers for Disease Control and Prevention (the CDC) keeps track of all recalled toys on a website that includes photographs plus information about them.

You can find a link to the CDC's website on MedlinePlus.gov's lead poisoning health topic page. To find MedlinePlus' lead poisoning health topic page, type 'lead poisoning' in the search box on MedlinePlus.gov's home page. Then, click on 'lead poisoning (National Library of Medicine).' The link to the CDC's website called 'lead recalls (Centers for Disease Control and Prevention)' is found within the 'related issues' section.

The Nemours Foundation adds children should be routinely tested for lead exposure at age one and again, at age two. A simple blood test reveals if a child has been exposed to excessive lead from all sources, including toys. The blood test cannot explain if any one source, such as a toy, resulted in a higher than normal lead accumulation in a child's blood stream.

The Nemours Foundation's website explains the first blood test for lead is usually a finger prick. If this test shows elevated levels, then, a physician often will conduct a second test of blood drawn from a child's vein.

Some symptoms of high levels of lead include when a child is:

• Tired
• Irritable
• Has muscle and joint pain
• Headaches
• Stomach aches
• Cramps
• Loss of appetite
• Is constipated
• Vomits
• And has seizures.

Elevated lead exposure also is linked to children's anemia, severe colic, attention problems, hyperactivity, learning disabilities, and mental retardation.

On the other hand, the Nemours Foundation reminds us that a child's lead exposure usually is not from toys, but from a variety of other sources. These include U.S. homes built and painted before 1978, when lead was permitted within paint. Children receive lead exposure when eating paint peelings, or by inhaling lead particles in dust from walls covered with lead-based paint. In the U.S., all paint distributed since 1978 is lead free.

The Nemours Foundation reports kids also are exposed to lead from:

• Soil contaminated by nearby streets (from lead once used in gasoline). Lead in gas also is now banned, but residual effects persist
• Some children's metal jewelry. Often exposure is through the metal (not the paint). Sadly, metal jewelry containing lead often is inexpensive and is distributed in vending machines, or at discount retailers. This is also important to consider when purchasing inexpensive jewelry from street stands all over the world, including the U.S.

In addition, kids are exposed to lead from some hobby items, such as stained glass, paint and plaster.

Similar to the CDC's website on toy recalls, the full information provided by the Nemours Foundation is found within MedlinePlus.gov's lead poisoning health topic page. To find MedlinePlus' lead poisoning health topic page, type 'lead poisoning' in the search box on MedlinePlus.gov's home page. Then, click on 'lead poisoning (National Library of Medicine).' The Nemours Foundation's website called 'putting lead in perspective this holiday season' is found within the 'latest news' section.

MedlinePlus' lead poisoning health topic page also contains information about:

• Human exposure to environmental chemicals
• The latest news about lead exposure and health
• Diagnosis/symptoms to assess lead in children and adults
• Prevention/screening, such as lead exposure from fishing sinkers, lead in drinking water, reducing lead exposure during home remodeling, testing your home for lead within paint, dust, and soil
• Related issues, including lead in the workplace, and lead exposure from private water wells.
• Current clinical trials about lead poisoning & health
• Lead poisoning and health research from major medical journals
• Plus information targeted for children plus their parents and guardians.

With a few precautions and a little foreknowledge, there is no reason not to delight a child with a nice toy this holiday season. Although we will leave toy advice to others, we hope you will find MedlinePlus is a good resource to boost a child's health and welfare.

Of course, we wish you, your children, friends, and families a happy holidays and a healthy New Year. We look forward to preparing 'Director's Comments' podcasts for you in 2008 and pledge to make continuing improvements.

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