If your toddler's been playing with one of the 18.6 million Barbies, Batmans or Sarges recalled Tuesday, here's a bit of advice:

First, get rid of the toys.

Second, make sure those tiny but powerful magnets in the Polly Pocket, Doggie Day Care, Barbie and Tanner play sets haven't come dislodged. If so, make sure your child hasn't swallowed them.

"Those things, if they get free and they get swallowed, they can erode through the esophagus and cause major damage," says Dr. William Martens II of Red Rose Pediatrics.

Third, don't panic — but take a close look at Sarge, the lovable but potentially toxic die-cast car from the animated film "Cars." Is the paint chipped off? Has your child been gnawing on it?

If so, you'll want to have the pediatrician check his lead level.

"If it looks like your child has been chewing it, the smartest thing to do is to get a blood test," says Dr. Steven Killough of Lancaster Pediatric Associates.

Mattel's worldwide recall involved 436,000 Sarge cars because they contained lead paint. It also extended a November 2006 recall of toys that contain magnets that can be swallowed by children; they included Polly Pocket dolls and Batman action figures. That recall now encompasses 18.2 million magnetic toys worldwide.

Lynn Kramer, a registered nurse certified in pediatrics and the practice manager at Eden Park Pediatric Associates, said parents should take the recalled toys away from their children — but otherwise stay calm.

"In the end, it's more dangerous to drive down Route 30," she says. "The lead exposure today is really minimal. We don't have lead plumbing. We don't have lead in our gas. Even children we've had who live in deteriorating housing with lead-based paint, we rarely get a reading over 9, and that's even with peeling windows. "

Federal guidelines define lead poisoning as occurring at a measurement of 10 micrograms of lead per deciliter of blood, but health officials in some states define lead poisoning at even lower limits.

While lead poisoning affects hundreds of thousands of U.S. youngsters, most get it from paint chips and dust in deteriorating buildings — not recalled toys, U.S. health officials say.

And no children have been reported harmed by the lead paint in the toys, which were sold at retail stores between May and August. But lead poisoning's effects are cumulative so it's important to remove tainted toys from children.

"Simply put, you should remove the toy," said Dan Miller, a spokesman for the state Department of Health.

Killough, of Lancaster Pediatric, added: "Lead is a thing that loves to stick to the bones, so once you ingest it, it's very hard to get out of the body, and it does accumulate there, which is why it causes so much trouble.

"The other problem with lead is it tastes good. Lead-based paint is sweeter and tastes better than non-lead-based paint," he said. "Kids love to chew the stuff."

It is highly unlikely toddlers could get lead poisoning from chewing on one of the recalled toys, but only a blood test could confirm that.

"Anything above 10 and your child, or any child, needs to be chelated. That means to swallow a chemical that helps to mobilize lead so the child urinates it out," Killough said.

The long-term effects of lead poisoning range from hyperactivity to developmental delays. Most of the cases involved children who are chewers or suckers.

"If they're just playing with the toys with their hands, that's probably not a problem with lead-painted toys," Killough said.

In fact, children who live in older houses probably pick up scraped-off lead paint chips that have fallen between the floorboards as they crawl around on their hands.

Children under 2 are at a greater risk of ingesting lead from the recalled toys, says Martens.

"Kids who are 10 months, 12 months, they're going to be exploring everything with their mouths," he says. "Unless the paint is chipping, they're not going to be getting much lead exposure from those toys. Even kids putting it in their mouth, if the paint is intact they're going to get a fairly minimal amount.

"We don't know of any level of lead that's safe, but everyone's exposed to lead because it's in the environment," he says. "I don't want to make light of it because lead's a bad thing, but on the other hand the exposure they're going to get from those toys is probably pretty small."

The number of children with confirmed elevated levels of lead in Lancaster County is on the rise, however, according to state health department statistics.

In 2006, there were 114 cases in children ages 7 and under. That's up 13 percent from 2005, when there were 101 cases. In children ages 1 to 2, there were 58 confirmed cases in 2006, up 49 percent from the 39 cases a year earlier.

Miller said most of those cases involve children who live in older homes, which were painted with lead-based paint.

Lead-based paint was banned from use in housing in 1978, but young children are living in more than 4 million U.S. homes that have deteriorated leaded paint and elevated levels of lead-contaminated house dust, health officials estimate.

"A lot of times what we've found is that the numbers are higher in cities, based on the fact that the architecture, the construction of the building is pre-1978," Miller said.

Tuesday's Mattel recall was the second time in two weeks the giant toymaker pulled toys from shelves due to elevated levels of lead. Mattel's Fisher-Price brand recalled 1.5 million toys earlier this month — Elmo, Big Bird, Dora and Diego figures — because a Chinese factory had used lead paint on them.

Mattel urged consumers to take the products away from children and contact the company to arrange returns. The hotline is (888) 597-6597. The Web site is http://service.mattel.com.

The news follows June's recall of more than 1 million Thomas & Friends wooden train sets due to lead paint.

In addition, some vinyl baby bibs sold at Toys "R" Us stores have been found to have high levels of lead, according to the California-based Center for Environmental Health. The New York Times reported the problem this morning.

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