Taking Action: Arsenic and Our Children

By Russell H. Greenfield, MD Clinical Assistant Professor of Medicine UNC Chapel Hill School of Medicine

Posted on | By Russell H. Greenfield, MD

You may have heard that some advocacy groups have discovered arsenic in apple juice, in some cases at levels higher than permissible in US drinking water. Dr. Oz and his staff have performed their own investigation into this matter, and they, too, found high levels of arsenic in some apple juice products. The findings raise significant health concerns for us and for our children, and have generated incredulousness that this could happen in our country.

From This Episode:

Arsenic Apple Juice

Take a breath. Should you be concerned? Yes.

Should you be angry? Yes, but I’ll discuss where you might direct that anger a little later.

Should you be frightened? No.

I repeat – no. It remains very unlikely that you have done any harm to yourself or to your children through the drinking of apple juice.

There are healthier ways to move forward, however, and it all starts with knowing the basics.

First, a disclaimer: I’ve never been a fan of fruit juice for kids, including apple juice, except as an occasional treat. Juices may offer some health benefits, but they’re also typically very high in sugar. Metabolically, the body handles fruit juice much like it does soda. Eating the whole fruit is always a better option.

What Is Arsenic?

Arsenic is the colorless, odorless compound at the center of this discussion. Arsenic is naturally abundant in our environment in such places as rock formations, minerals and soil, and is also a byproduct of human agricultural and industrial pursuits. Keep this in mind, because it’s important to understand we are all exposed to small, background amounts of arsenic on a regular basis from the food we eat, the water we drink, and the air we breathe. Concerns only arise when considering the type of arsenic (organic or inorganic) we are exposed to, and especially the degree of exposure.

Inorganic arsenic, commonly used in the past in pesticides, is considered more toxic than organic forms, but the US government put a stop to the use of inorganic arsenical pesticides years ago. The same action, however, has not been taken by other countries, such as China, which just so happens to be the major source of apple juice products found in American stores. Chinese farmers, including apple farmers, still may use pesticides containing arsenic.

Extremely high doses of arsenic are known to be poisonous, but this type of toxic event is rare in our country. On the other end of the spectrum, low-dose exposure through a single or even a few juice boxes drunk at one time should not be perceived as dangerous. It is possible, however, that prolonged, repeated exposure to low levels of arsenic, whether organic or inorganic, may be harmful. We need better guidance from the Food and Drug Administration (FDA) in this regard.

Most of the arsenic we ingest in food and drink is disposed of within a few days in the urine, but some arsenic is retained and may be distributed throughout the body, where it can remain for months.

Cancer Concerns

Chronic arsenic toxicity can manifest in many ways, but many people are worried about cancer. Inorganic arsenic has been classified a carcinogen by numerous organizations, though most of the concern comes out of studies performed in countries like Bangladesh, where people are exposed to very high levels of arsenic of an order not seen in the US, and on a daily basis. The risk of cancer as a result of chronic, low level arsenic ingestion through food and drink has yet to be well defined, but is considered low in the US.

Child Development

Health concerns exist that are specific to arsenic exposure in childhood. For example, a developing fetus may be exposed to arsenic in the pregnant mother’s environment (arsenic crosses the placenta). Research suggests that chronic childhood arsenic exposure may be associated with cognitive impairment (lower IQ scores) and an increased risk of illness early in life. 

Exposure Guidelines

In 2006, the Environmental Protection Agency (EPA) enacted a stringent health standard with respect to arsenic levels in drinking water, stating concentrations should not exceed 10 parts per billion (ppb). Interestingly, the actual goal for arsenic exposure from drinking water, what is termed the maximum contaminant level goal (MCLG), is zero ppb. That bears repeating – the goal is no arsenic in our drinking water. The 10 ppb level is simply as close as we can reasonably get considering our natural exposure to arsenic in the environment and other limitations. At that level, almost all experts agree our drinking water is quite safe.

Shouldn’t the same goal or, at the very least, similar science-based exposure guidelines, be in place for the juices we commonly give to our children?

The FDA’s Role

The United States Food and Drug Administration (FDA) is charged with maintaining strict standards of food safety to help keep people healthy. The FDA’s role in this regard is necessarily growing, but the agency is ill equipped to meet its obligations. More and more food comes into our country from foreign soil each year, but the FDA is able to inspect only a small and woefully inadequate percentage of the products reaching our shores before they reach our store shelves and then our plates. Why? Because funding for the FDA is consistently on the chopping block in Washington, DC. It is this fact that merits our anger.

Taking Action

What can we do to protect ourselves and our children? We can take control by taking constructive action.

1. Contact your government representatives and insist they vote to adequately fund the FDA so they can do their job of preventing potentially harmful foods from entering the country. Also, request that they apply pressure to improve Chinese agricultural practices, both for our safety and their own population.

2. Demand that health officials develop specific guidelines regarding safe levels of arsenic in apple juice, much like what has been done for drinking water, and monitor products accordingly.

3. Look for the country of origin on your apple juice label. You’re likely much safer drinking a product that comes only from the United States.

4. Go organic when possible. Organic apple juice comes from apples that are, by definition, not treated with harsh pesticides.

5. Consider donating to agencies that help clean up regions where people are exposed to very high levels of arsenic.

Article written by Russell H. Greenfield, MD
Clinical Assistant Professor of MedicineUNC Chapel Hill School of Medicine