2 infants with high lead levels prompt warnings against skin cream

Two infants in the Portland area with high lead levels in their blood prompted a warning Thursday by health officials about a skin cream used for eczema, a common condition in children.

Both children – in Multnomah and Washington counties – were younger than 1 and were exposed to Diep Bao, a cream made in Vietnam that’s advertised as a treatment for eczema, which causes dry, itchy and inflamed skin, and other skin conditions. The parents had used the cream on the children’s faces. 

Tests showed the tubes of cream in both cases contained dangerously high lead levels. Oregon investigations are triggered by levels above 5 micrograms per deciliter. The Washington County child had a blood lead level of 11.8 micrograms per deciliter, and the level in the Multnomah County child was 7.3 micrograms per deciliter, said Ryan Barker, who leads the lead poisoning program at the Oregon Health Authority. 

“We believe this product caused or significantly contributed to the elevated blood lead levels in these children,” Barker said during a news conference. “Any product containing such lead levels should be considered extremely dangerous and parents should immediately stop using it on their children.”

Previously, federal authorities investigated blood lead levels above 5 micrograms a deciliter but the the Centers for Disease Control and Prevention has lowered the bar to 3.5 micrograms per deciliter. Barker said the state is proposing a rule change to match that of the CDC.

The Food and Drug Administration does not regulate lead in medications but the allowed level in cosmetics is 10 parts per million. The tube in the Washington County case contained 9,670 parts per million of lead, while the Multnomah County sample contained 7,370 parts per million.

Officials diagnose about 270 cases of lead poisoning in Oregon every year, and about one-third are children younger than 6. The most common cause is the ingestion of lead-contaminated paint and paint dust but some cases are due to cosmetics and imported spices, the Oregon Health Authority said.

Health officials said they’re not worried about lead poisoning from having the cream applied to the skin, but rather they are concerned by children ingesting it.

“We’re not worried about skin absorption but rather children getting this cream in their mouth either directly through contact with their face, or parents potentially or caregivers potentially interacting with their children with some of this residue on their hands,” said Dr. Jennifer Vines, health officer for Multnomah County. 

At very high levels, lead poisoning can damage organs and cause abdominal pain, nausea, vomiting and weakness. But for children, the chief concern is its effect on their development.

“It can affect brain development and their nervous system,” Vines said. “That can have lifelong effects on things like intellectual development, growth and behavior.”

The children did not have any symptoms. The poisoning of one child was found by a “vigilant and involved parent,” said Perry Cabot, who leads the lead prevention program in Multnomah County. The other case was discovered by routine screening by a medical clinic that tests all children for blood lead levels, he said.

State officials have no idea whether other children have been poisoned by the cream.

“At this time we don’t know how widespread the contamination from this product is,” Barker said.

Health officials said parents of children with a skin condition should consult a provider about prevention and treatment. Dr. Christina Baumann, Washington County’s health officer, recommended that any parents who’ve used Diep Bao cream on their children to consider getting them tested for lead. Families who have the cream can get tubes tested for free by the state. 

The cream appears to be only available online. The families purchased tubes through a Facebook link, officials said. They urged parents and providers to test children for their lead levels, especially families that have used the cream within the past six months. They told the public to stop using the product while the investigation continues.

Oregon Capital Chronicle

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