By Laura Smith-Spark
BBC News, Washington
Chinese toothpaste has been at the centre of contamination scares
More products are being imported to the US from China than ever before - but a series of scares has left some wondering whether they are safe.
From pet food to toothpaste, tyres to jewellery and seafood to toys, questions have been raised over the reliability of Chinese-made goods.
As the death of a child who swallowed a magnet from a Chinese-made toy last year and the illness of others who have consumed contaminated food suggest, the risks presented by unsafe goods can be great.
In Panama, the deaths of some 51 people have been blamed on cough syrup tainted with Chinese-made diethylene glycol, commonly used in antifreeze. The same chemical has been found in toothpastes from China sold in the US and Canada.
Earlier this year, more than 100 brands of cat and dog food were pulled from the shelves in the US after pets died from eating food contaminated with the chemical melamine, traced back to wheat gluten from China.
With Chinese imports totalling $288bn last year - nearly triple the figure of five years ago - is enough being done to protect consumers?
The execution for corruption on Tuesday of the former head of China's State Food and Drug Administration, Zheng Xiaoyu, suggests Beijing is keen to show it is taking the problem seriously.
CHINESE PRODUCT SCARES
Pet food - tainted with chemical melamine
Toothpaste - tainted with chemical diethylene glycol and bacteria
Farmed fish - traces of banned drugs and pesticides found
Tyres - fault may cause blow-outs
Toys - contain lead or pose choking hazard
Children's jewellery - contains lead
Ceramic heaters - pose fire safety risk
But part of the problem is that the speed of China's expansion into the global export market has not been matched by the growth of a countrywide regulatory infrastructure.
The Chinese authorities say they are making efforts to improve supervision of safety standards, but that it will take time for them to catch up with the West.
American officials whose job it is to ensure the safety of imported products acknowledge there are problems - but say they are doing all they can to identify suspect goods.
For example, the US Food and Drug Administration (FDA) recently imposed a nationwide hold on the import of five types of farmed fish and seafood from China.
Some shipments were found to have traces of antibiotics and disinfectants that are banned in US fish production. Other inspections uncovered fish products described as "filthy" or tainted with salmonella and pesticides.
The US imports about a fifth of its seafood from China.
'Out of nowhere'
Another danger comes when contaminants which would not normally be tested for end up in the food chain - such as melamine, a chemical used in plastic products which caused kidney failure in pets.
David Acheson, the FDA's assistant commissioner for food safety, said: "The bottom line message is to focus the testing on areas where we have identified problems. We cannot even begin to test on everything.
The US has import controls on five types of Chinese fish and seafood
"There are certain things we can predict are going to be a problem because we've seen it before, other countries have had the problem... but sometimes things come out of nowhere, completely unexpected. The melamine was an example of that."
Meanwhile the FDA has to juggle the need to avoid inaccurate advice or over-reaction with the desire to warn people of a potential risk as quickly as possible.
"I would always like us to react faster. We react as quickly as we can on the information we have," Mr Acheson said.
The FDA does not have the resources to send lots of inspectors into China, Mr Acheson added, so is working with the Chinese authorities to address the issues.
Of course, China is not the only country to experience food safety problems.
US-grown spinach last year caused an E.coli outbreak that left one woman dead and some 200 others unwell. The FDA has previously halted imports of Mexican cantaloupes because of salmonella.
Some American pet owners have started to make their own pet food
The difference, however, seems to be the frequency with which Chinese products are being pulled up.
Dietician Ruth Frechman, a California-based member of the American Dietetic Association, says the recent run of scares has heightened people's anxieties.
While no clients have yet asked her for advice on avoiding Chinese products, she says, one has started making her own dog food following the pet food alert.
The chief problem is that food labels do not identify where all the ingredients have come from - and even restaurants and wholesalers may not know, Ms Frechman said.
"It's very scary for consumers and really as a consumer you have no idea that the product is even coming from China... so there's really not a lot the consumer can do," she said.
The US Consumer Product Safety Commission (CPSC), which monitors the safety of imported non-food goods, says it has seen increased concern among consumers.
Its officials are seeking to co-operate with their Chinese counterparts, with CPSC inspectors travelling to factories in Beijing, Shanghai and big manufacturing regions.
"The first step for us is to educate all of those people who we are working with on US safety standards. Many of those standards have saved lives," CPSC spokesman Scott Wolfson said.
"Our goal is to see as much progress as we can - and what that might mean here for us in the US is fewer recalls of Chinese-made products."
Overall, at least 60% of recalls issued by the agency since last October have involved goods from China.
In the first week of July alone, they included hammock stands, children's toys and metal jewellery, all of which were potentially dangerous.
One of the biggest recalls, in June, involved some 1.5m Thomas and Friends toy trains containing lead paint, which can be toxic to young children if swallowed.
Mr Wolfson urges consumers, particularly worried parents, to subscribe to the CPSC's free e-mail alerts for the latest advice.
A lesson may lie in the approach taken by the fireworks industry, which has focused on education and stringent product testing within China.
In the late 1980s and early 1990s, standards for Chinese-made fireworks were so low that as many as 75% failed US safety tests.
Firework safety has improved with closer monitoring in China
To tackle the problem, US importers were encouraged to pay for a testing operation set up in China - the American Fireworks Standards Laboratory (AFSL) - to monitor production straight from the assembly line.
At least three-quarters of US fireworks importers are signed up to the scheme and the lab has about 50 technicians in China.
Since 1994, injury rates among US consumers have dropped by more than two-thirds and sales of fireworks have increased greatly. About 99% of the fireworks used in the US come from China.
John Rogers, executive director of the AFSL, said: "It's had a very positive impact for the American public, for the government that regulates fireworks and obviously for the companies."
He admits that initially Chinese factories "weren't happy" about the AFSL's checks but, as Chinese-language guidelines were produced to help them meet US requirements, attitudes changed.
"What the manufacturers understand is that safer, better quality fireworks translates into bigger sales, so now they like what we do," he said.
"I think that every industry that imports products from China could very well benefit from this kind of a programme."
Of course, the majority of goods imported from China are perfectly safe - but until standards improve across the board, US consumers must rely on officials to sift out potential hazards before they cause harm.