Despite tap water laced with fluoride being the traditional focus of the tin-hat brigade, harmful chemicals leaching from plastic containers such as water bottles have been linked to a range of endocrine diseases – with a significant price tag for the healthcare system.
The Endocrine Society of America (ESM) has issued a warning that endocrine-disrupting chemicals (EDCs) in plastics pose a serious threat to public health and cost the US an estimated $250 billion in increased health care costs in 2018: implicated in reproductive disorders, the neurological impairment of developing foetuses and even death.
“These costs are equivalent to 1.22% of the Gross Domestic Product. The diseases due to plastics run the entire life course from preterm birth to obesity, heart disease and cancers,” according to lead author Dr Leonardo Trasande from New York University’s Grossman School of Medicine.
The ESM pointed out that new chemicals have proliferated since 1950 (alongside the advent of plastics) with regulations and testing unable to keep pace.
“Since then, only half of an estimated 140,000 newly invented chemicals (which include plastic additives) have been tested for safe toxicity levels prior to broad use,” Dr Trasande said.
The researchers analysed existing studies on EDCs to identify how many diseases and disabilities were attributed to chemicals in plastics. The chemicals they studied commonly found in plastics included polybrominated diphenyl ethers, phthalates, bisphenols, and poly- and perfluoroalkyl substances.
“Most of the cost burden was from PBDE exposure which is associated with diseases such as cancer. Sixty-seven billion in health costs was due to phthalate exposure, and $22 billion was due to PFAS exposure,” Dr Trasande explained.
Phthalates were of particular concern as these chemicals have been shown to leach into food from vinyl plastic equipment and materials, personal care products, food preparation gloves, and food packaging materials – in addition to being transferred from mother to foetus during pregnancy.
The study noted that a recent review on the impact of phthalates produced by researchers from the European Centre for Environment and Human Health (ECEHH) reported “robust evidence for an association with lower semen quality, neurodevelopment, and risk of childhood asthma, and moderate to robust evidence for impact on anogenital distance in boys.”
“We also identified moderate evidence for an association between phthalates/metabolites and low birthweight, endometriosis, decreased testosterone, ADHD, type 2 diabetes, and breast/uterine cancer; as well as some evidence for anofourchette distance, fetal sex hormones, pre-term birth, lower antral follicle count, reduced oestradiol, autism, obesity, thyroid function, and hearing disorders.”
Significantly, the ECEHH highlighted that health risks could occur “at exposure levels below the “safe dose” levels set out by regulators and are of particular concern given potential additive or synergistic “cocktail effects” of chemicals.”
The European Food Safety Authority has recommended tolerable daily intake for DBP, BzBP, and DEHP at 10, 500, and 50 μg/kg bw/day, respectively; while the US’s FDA has suggested a TDI of 0.6 mg/kg bw/day for DEHP, with tolerable exposures of 42 mg/day for adults, 6 mg/day for children, and 2.1 mg/day for neonates (body masses of 70 kg for adults, 10 kg for children, and 3.5 kg for neonates).
In Australia, PFAS made headlines last year due to the environmental contamination caused by their use in fire-fighting foams, with elevated levels detected in waterways by the government’s PFAS Taskforce long after the fires had been extinguished.
The taskforce noted at the time that “while understanding about the human health effects of long-term PFAS exposure is still developing, there is global concern about the persistence and mobility of these chemicals in the environment.”
“Many countries have discontinued, or are progressively phasing out, their use, and the Australian Government has worked since 2002 to reduce the use of certain PFAS.”