Journal of Water Resource and Protection, 2013, 5, 25-33 Published Online April 2013 (
A Perspective on Human Exposures to Plastics Additives
in Water- Packaging Materials
Syam S. Andra
Water and Health Laboratory, Cyprus International Institute for Environmental and Public Health in Association with
Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
Received February 18, 2013; revised March 20, 2013; accepted April 2, 2013
Copyright © 2013 Syam S. Andra. This is an open access article distributed under the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Plastic and polymer additives (PA) have unique rational advantages for various water and food packaging applications.
However, their (bio)chemical natures are recently recognized for their negative human health impacts. The major ad-
verse consequence of these additives in consumer products is in the form of endocrine-disruption related health-down-
grades. Such findings still remain underappreciated in most parts globally; part of which could be ascribed to frag-
mented studies towards better understanding on the occurrence, release and migration, human exposure, epidemiology
and risk assessment of PA from packaging materials. In addition there is limited and disconnected dissemination of re-
search findings on PA effects and mitigation measures to society at present. In light of appropriateness of this topic, a
trans-disciplinary research agenda is required for addressing exposure routes to PA, human health burden and preven-
tion measures. This perspective article discusses important research questions relating to PA, which try to shed light to a
grey scientific area and help increase consumers’ awareness and intervention to such exposures.
Keywords: Bottled Water; Endocrine Disrupting Chemicals; Food Contact Material; Packaging Material; Plastic
Additives; Water Contact Material
1. Introduction
Plastic and polymer additives (PA) have unique rational
advantages for various water and food packaging appli-
cations. Use of PA in every-day consumer products
worldwide is estimated to reach ~230 million tons by
2015 [1]. Polyethylene terephthalate (PET) among all
types of plastics is expected to have the highest annual
growth rate (11%) [1]. Bottles for packaging drinking-
water represent one of the most popular uses of plastic
and polymer additives. The impact of global stressors,
such as, population and consumption, demographic and
land-use changes, urbanization, and climate change on
water demand and supply dynamics have largely affected
the booming growth of the bottled water industry. The
bottled water market enjoyed a 25% global increase in
average consumption per capita between 2004 and 2009
[2]. Increases in global population and urbanization
along with climate change effects on water supply and
availability have been charged with increasing consumer
preference towards bottled water in both developed and
developing countries. Current estimates showed that
United States is the leading consumer of bottled water at
about 8500 million gallons contributing to 15.8% of
global consumption, while Mexico tops the global per
capita annual bottled water consumption (234 L·capita1)
[2]. It is noteworthy that 12 out of the top 20 countries
leading the global per capita consumption list of bottled
water come from the EU [2].
Public concerns related to widespread consumption of
bottled water stem from accusations on inadequate sus-
tainability metrics application and conformity to public
health standards [3]. It was only recently that the scien-
tific community began to deal with the presence of toxic
contaminants and bacteria in the finished water whether
initially present in the raw water or as a result of leaching
mechanisms. Water contact materials (primarily plastic)
have been recently charged with the release of endocrine
disrupting compounds (EDCs) into bottled water, such as,
bisphenol A (BPA), organo-brominated compounds, per-
fluorinated compounds, antimony (Sb) and other alkyl
phenols like 4-nonylphenol, adipates, phthalates, etc.,
[3-6]. Despite having useful applications to PA use, their
(bio) chemical natures are recently recognized for their
negative human health impacts. A major adverse conse-
quence of these additives in consumer products are in the
opyright © 2013 SciRes. JWARP
form of endocrine-disruption related health-downgrades
such as reproductive [7] and thyroid health abnormali-
ties [8], which has exposed poor understanding on their
safety and superimposed an urgency to control the poten-
tial future risks. The count of occurrence of diseases and
disorders from plastics additives is mounting. With the
decline in communicable diseases worldwide, chronic
diseases from environmental and occupational chemicals
is gaining attention. Wittassek et al. [9] review on phtha-
lates provides the magnitude of phthalates usage in in-
dustrial and commercial applications and details on mag-
nitude of associated human exposure and health out-
comes (in particular male reproductive dysfunctions, also
known as phthalate syndrome). Extensive reviews on
occurrence and exposures to plastics additives that are
widely in use are available for 1) bisphenol A [10,11], 2)
phthalates [9,12,13] and 3) polybrominated biphenyl
ethers [14-16]. These latest reviews on estimating risks to
human health from endocrine-disrupting chemicals (EDC)
from plastics additives in packaged containers calls for
further research.
While we are identifying new and acknowledging ex-
isting research gaps, we propose the need and outlook for
more coherent way(s), with input from a range of disci-
plines, to fill in the knowledge gaps on human exposures
to water packaging contact materials. The purpose of this
perspective article is not to rehash and/or update the
relevant literature; but to present in a nutshell the current
research status and knowledge gaps in an attempt to
reach a wider inter-disciplinary research community.
2. Research Status: Current and Next Steps
The overall hypothesis of community health research on
plastics additives (PA) exposure is to understand whether
current understanding on plastics additives exposure is
sufficient to understand community health risks and to
invent prevention measures. This research question puts
together in a nutshell the long term quest of environ-
mental and public health researchers for understanding
the association between contaminants levels in exposure
environmental media, biomonitored levels in human
body tissues/fluids, and disease endpoints. The research
questions sketched here, proactively, is expected to pro-
mote sharing of research ideas and help combine and
recombine in novel ways to evolve into new research
areas; which gets quickly filtered in research collabora-
2.1. Is Release of Plastics Additives to Contained
Water Ongoing over Time or Are There
Special Circumstances That Enhance These
2.1.1. Current Stat us
Migration is a term used for release of both intention-
ally and non-intentionally added substances to the poly-
mers; while induced leaching (also referred to as “re-
lease”) occurs from degradation of polymers under
physical and environmental conditions such as exposure
to UV light, heat, polymer age etc. [17]. Consumer con-
cerns take the form of episodic chemical leaching from
water-contact materials (WCM) [18], but these are often
considered unfounded [19]. Examples of chemical leach-
ing from bottled water are: antimony [20-22], bisphenol
A [23], phthalates [24], adipates [25], and 4-nonylphenol
[6]. Leaching of PA from container material to contained
food and water products by diffusion [26] and other
physico-chemical processes are reported for bisphenol A
[27-31] and phthalates [28,32]. Migration of PA, such as
BPA and 4-nonylphenol, was reported occurring from
container material to bottled water [33]. Based on BPA
migration, the calculated total daily intake estimate was
0.00004 mg·kg1 body weight·day1 [33], which was sig-
nificantly lower than the total daily intake limit of 0.05
mg· k g 1 body weight·day1 set by CEF/AMU [34]. How-
ever, despite the observed total daily intake for BPA in
polycarbonate bottled water being lower than the set total
daily intake limit, is it prudent to consider it safe? This
could be supported by the observation that BPA was
present at higher levels in human matrices, which are
above those that could induce harmful effects in both in
vitro and in vivo tests [10]. In the EU, a migration limit
of 0.3 mg di-n-butyl phthalate per kg food stimulant and
1.5 mg di-2-ethylhexyl phthalate per kg food stimulant
applies [9,35]. Triclosan was one intentionally added
food contact material as a way to extend food shelf life,
the use of which was unauthorized in US and withdrawn
from use in the EU [17]. Environmental factors such as
exposure to sunlight for ten weeks increased BPA levels
in bottled water [28]. In addition, PA leaching into food
and water under actual conditions were much higher in
comparison to standardized migration tests using distilled
water [36]. However there are several components of
these polymers and several other factors that promote
their release that are yet to be tested in migration studies.
A common practice of bottle reuse for refilling tap
water has shown an increase of antimony release with
each reuse cycle [22]. Frequency of reuse has never been
tested before with respect to its influence on chemical
leaching from drinking-water plastic containers. Our
study showed that frequency of reuse exerted greater
influence on Sb and Br leaching from PET and PC con-
tainers when compared with that attributed to UV expo-
sure duration and temperature. Our cost-effective ex-
perimental approach in studying main and interaction
effects of three major tested factors influencing chemical
leaching enables us to classify the studied factors ac-
cording to their contribution to chemical leaching from
frequency of reuse > UV exposure duration > tempera-
Copyright © 2013 SciRes. JWARP
S. S. ANDRA 27
ture [22]. This study illustrated the importance of so far
unaccounted factor, i.e., frequency of bottle reuse in
various everyday activities that could enhance chemical
leaching. Antimony leaching from PET seems to be the
most concerning observation, while the reasons and
health implications behind leaching of soluble Br (asso-
ciated with organo bromine compounds, such as PBDE)
in this study are yet to be determined.
2.1.2. Ne x t Steps
Assessment of migrants levels using partition models is
required taking into consideration the complexity of
packed food and water matrices compared to the matrices
in current use for testing. It is important to understand the
factors that affect migration of PA in mixtures at low
concentrations rather than single chemicals. So far food
contact materials toxicity assessment is performed using
a single chemical approach, while it is shown that
chemicals migrate in groups as a mixture having whole
effects that can’t be explained by toxicological aspects of
one or few known PA [37,38].
2.2. Do Concentrations of Plastics Additives in
Body Tissues/Fluids Indicate the Stage and
Extent of Disease/Disorder Condition?
2.2.1. Current Stat us
Body burden of PA is widely reviewed recently by Koch
and Calafat [12]. Non-communicable diseases, such as
cancer, diabetes, cardiovascular and chronic respiratory
diseases are predicted to cost more than US$ 30 trillion,
representing 48% of global gross domestic product in
2010 over the next 20 years [39]. Such comprehensive
disease predictive models often assume a constant num-
ber of annual new incidence cases for a specific outcome,
but often this is not the case. An illustrating example is
thyroid cancer, which appears as the outcome with the
highest change in annual excess number of new cases in
the developed world. Endocrine-disrupting chemicals, or
particularly, thyroid-disrupting chemicals are synthetic
chemicals used in everyday consumer products mimick-
ing or antagonizing natural thyroid hormone processes
[8]. While polybrominated diphenyl ethers (PBDE) lev-
els have been quantified in several subgroups and bio-
markers for thyroid health were measured, no significant
trend in dose relationships with thyroid hormones levels
were identified [8]. Similarly, almost all studies that were
mentioned in the exclusive reviews on 1) bisphenol A
[10,11], 2) phthalates [9,12,13] and 3) polybrominated
biphenyl ethers [14-16], attempted quantifying body
burden of each PA of their study interest; but did not
correlate them with a disease endpoint.
2.2.2. Ne xt Ste p s
Quantification of disease incidence or a physiological
response in terms of extent of exposure is very funda-
mental in making precise risk assessments, which at pre-
sent is an inadequate science that can and should be ad-
dressed. Focus should be on higher prevalence specific
disorders such as thyroid disruption, fertility rate decline
etc; as well as on general health status such as endocrine
disruption that impacts number of physiological mecha-
nisms downstream. How relevant is a smaller or larger
body burden of a given PA related to a disease endpoint?
Answers are still needed on what the body burden num-
bers mean in a human toxicological perspective. Addi-
tional studies are required to pinpoint disease endpoints
for each or a mixture of PA exposures. There is also a
need for longitudinal studies in understanding changing
reproductive functions in males, increasing in thyroid
disruption in females, and pronounced endocrine disrup-
tion outcomes in young adults.
2.3. Do a Certain Set of Populations Tend to Be
More Exposed to Plastics Additives and/or
Are There Sensitive Life Stages to Such
2.3.1. Current Status
Children are one hundred percent of our community fu-
ture, and it seems less than one percent understanding is
attained on their direct and/or indirect exposures to plas-
tics additives and subsequent health outcomes. It is be-
coming clearer that variations in responses to PA expo-
sure among populations is enormous, which differs based
on genetic makeup, ethnical and cultural factors, socio-
economic-nutrition-occupational variables, age and gen-
der differences, etc. Attention needs to be paid to the
certain observation that some individuals, within the
general population, show excess body levels for one or
more phthalates above the recommended tolerable daily
intake levels [9]. Phthalates exposure is high in children
compared with adults [9]. Children had maximum expo-
sure to phthalates compared to adults, and are speculated
to experience phthalates exposure from playing with toys.
A maximum daily intake of about 400 µg·kg1·day1 for
di-2-ethylhexyl phthalate was found in two to four chil-
dren in Germany [9]; while the total daily intake limit
value for di-2-ethylhexyl phthalate is 50 µg·kg1·day1 in
Europe [40,41]. Premature neonates in intensive care units
are exposed to very high doses of phthalates (in particu-
lar, di-2-ethylhexyl phthalate) [42], and exposure to di-
ethyl phthalate and di-n-butyl phthalate containing tables
from long term medication in adults [43].
Metabolically dysfunctional physiological states such
as obesity, insulin resistance, diabetes etc are found cor-
related with environmental toxicants exposures and as
well as from toxicant susceptibility factors. In case of
PBDEs, child-bearing age women and pregnant mothers
are highly susceptible compared with adult men with re-
Copyright © 2013 SciRes. JWARP
spect to thyroid health as indicated by respective thyroid
hormones levels [8]. Research provides evidence that the
metabolic programming that occurs in pre-and post-natal
period can be modified by environmental exposures. A
small volunteer group of people studying or working in
the Cyprus University of Technology were recruited to
study their water use and sources habits via administer-
ing them a questionnaire while also a spot urine sample
was collected. It was shown that there is 1) a major con-
tribution of unexplored routes of bottled water use in the
form of cold and hot beverages that increased the cumu-
lative per capita water consumption significantly, which
translates to a thus far under-estimation of health risk
assessment [44,45]; 2) a significant (p = 0.02) positive
association between daily water consumption from poly-
ethylene terephthalate (PET) bottles and urinary Sb, a
biomarker for exposures to plastics additives in PET bot-
tled water [44]; and 3) a similar significant (p = 0.02)
positive association between daily water consumption
from polycarbonate (PC) bottles and urinary bisphenol A
(BPA), a biomarker for exposures to plastics additives in
PC bottled water [45].
Reports are available on transgenerational persistence
of a disease from chemical exposures on an individual’s
epigenome [46]. Exposures to PA in the early life stages
such as pre-natal through young ages were shown lead-
ing to later life or next generational health effects as a
carry-over effect. Examples of prenatal exposures to such
PA having postnatal effects, such as pregnant mothers’
exposure to: 1) phthalates impacting child’s mental and
behavioral development [47], 2) BPA resulting in de-
creased thyroid-stimulating hormone and affecting thy-
roid health in male infants [48], and 3) brominated flame
retardants adversely affecting child neurodevelopment
[49]. Co-exposures to different endocrine disrupting and
other chemical contaminants in drinking water should be
also prioritized by focusing on mixtures of water con-
taminants and their contribution to biologically relevant
exposures. Community studies thus far points out which
PA have emerged as key health imposters. Clear and
present dangers of endocrine disruption are breast cancer
and endometriosis in females, testicular and prostate
cancer in males, abnormal sexual development and low-
ered fertility in both genders; while known trans-genera-
tional effects were immune suppression and neurobe-
havioral effects in infants and children.
2.3.2. Ne xt Ste p s
There is a need for identifying early-stage as well as
critical-stage exposure biomarkers that goes beyond as-
sociations derived from literature, and helps in testing at
individual level and live up to their promise and potential.
Attention should be focused on individual practices, life
stage, socio-economic-occupational status, and geographi-
cal location of maximum exposure in identifying vari-
ables for high level PA exposures and/or greater frac-
tion of exposed subgroups. Identifying critical time win-
dows of sensitivity and susceptibility of subgroups to
each plastic additive and as well in a mixture helps in
designing intervention measures. Do early stage expo-
sures change the future genome and do exposures in a
previous generation shapes the future genomes? Under-
standing the PA exposures during development (pre- and
postnatal) will help understand the genetic contribution
from shared gene loci among different endocrine disrup-
tion outcomes. There is also a need to understand the
complex interactions between PA exposure media, indi-
viduals’ vulnerability factors, disease development, and
time to disease appearance for pin pointing the suscepti-
ble groups. This helps to avoid discriminatory actions
such as “blame the victim” trends based on understand-
ing the underlying causes rather single out the suscepti-
ble groups based on socio-economic-cultural factors.
Dietary interventions can buffer PA exposure and as-
sociated health risks, which raises the question of “how
can safe and green packaging materials fit into the expo-
sure mitigation paradigm?” Short term exposures are
evident in infants and children, while a longer term ones
were not seen until adulthood. Not only pain and human
suffering associated with PA exposure in short and long
term effects, but also economic impact of infants and
children health is a substantial burden to the community.
Since the prenatal time window seems most vulnerable
developmental phase, it seems studying prenatal expo-
sures will help in understanding exposome of PA chemi-
cal mixtures and as well where in intervention measures
can prevent or minimize exposures, resulting in a greatest
cost to benefit ratio for the society.
2.4. Is a Continuous and Cumulative Effect from
a Single Plastics Additive Exposure More
Harmful Compared to a Snap-Shot Mixtures
2.4.1. Current Stat us
Chemicals having a common disease endpoint, act syn-
ergistically when exposed in mixtures. Studies show that
cumulative exposures to phthalates tend to be more
harmful compared to a single exposure in animal studies,
and more potent in a synergistic way when exposed
along other endocrine disruptors compared to single class
of chemicals exposure. At least fifty chemicals that were
used as food contact materials exhibited endocrine dis-
ruption properties [5], and studies are lacking on under-
standing whether the disease outcome is more influenced
by a brief exposure from a mixture of these or by a long
term cumulative exposure from a single additive. Despite
availability of decent number of studies on exposure
routes to the noted PA and on their levels in human ma-
Copyright © 2013 SciRes. JWARP
S. S. ANDRA 29
trices, not much information on factors which guide the
magnitude of such exposures in mixtures [16]. However
studies are still lacking for the new and emerging plastics
additives. Animal studies are becoming available for
toxicological effects of other brominated flame retardants
(other BFRs), but there are only limited human studies
While much scientific attention has been drawn upon
single contaminant leaching from plastic bottled water,
no study has paid attention to concomitant leaching of
two or more contaminants within the same bottle. In a
recent study, both Sb and brominated compounds, as
expressed by total soluble Br measurements, including
those for polybrominated biphenyl ethers (PBDE) were
measured in bottled water [50] in a representative basket
survey sampling of bottled water in randomly selected
Boston, MA, USA supermarkets. Different bottled water
classes were sampled ranging from: 1) non-carbonated
(NCR), 2) carbonated (CR), and 3) non-carbonated and
enriched (NCRE). In addition, different bottled water
plastic materials were sampled ranging from polyethyl-
ene terephthalate (PET), high-density polyethylene
(HDPE), and polycarbonate (PC), and polystyrene (PS).
The objectives of this study were: 1) determine the ef-
fects of plastic material (PET, HDPE, PC, and PS), bot-
tled water classes (non-carbonated, carbonated, and non-
carbonated and enriched), and storage time on the simul-
taneous co-leaching patterns of antimony and brominated
compounds from bottled water, and 2) qualitatively cha-
racterize the type of brominated compounds leaching
from plastic bottled water. Results showed that average
Br and Sb concentrations after 60-days of storage fol-
lowed the order of NCR < CR = NCRE, and NCR < CR
< NCRE, respectively, suggesting that the presence of
dissolved carbon dioxide in CR samples coupled to addi-
tions of flavors and color to NCRE could explain the
elevated leaching of Br and Sb [50]. Among samples
with the highest soluble Br concentrations, BDE-209
congener was qualitatively confirmed in three out of four
bottled water samples. The PC, HDPE, and PS samples
exhibited significantly (p < 0.05) lower Sb and Br leach-
ing than PET [50]. A group of PA can be occurring in
bottled water at any given time, and the composition
varies with the chemical nature of the packaging mate-
2.4.2. Ne xt Ste p s
Little or no information exists on exposure and dose re-
sponse for chemical mixtures. Meta-analyses of literature
data existing for identification and confirmation of trends
in exposure risk factors, target life stages and subgroups,
and interventions (if any) are necessary. Only few of the
several PA and associated health outcomes have good
epidemiological studies, which thus prohibit obtaining a
grasp on the complete magnitude of the problem, making
creation of effective intervention measures difficult. Epi-
cohorts are needed to rapidly test and identify potential
biomarkers for single and multiple stressors. There is
also a need for in vitro and/or in vivo studies to study
responses from single vs. multiple PA exposure, to look
at the responsome based on phenotypic or chemical
markers, to compare differences in metabolome, etc.
Human studies are more needed, while animal studies
can be used in conjunction and complementation.
2.5. Does an Understanding on Exposure
Processes Require a Single Science Focus or
Multi-Disciplinary Efforts?
2.5.1. Current Stat us
It is widely acknowledged now that although many PA
are linked to endocrine disruption and spiral-down
symptoms, each contribution may not be of equal con-
tribution to end outcome. Cumulative disease burden
occurs when PA is exposed and acts together in mixtures
and even then exposure science alone may not explain
the entire process. Exposure science is becoming a weak
link in environmental health sciences arena and thus
hindering progress in gene-environment science. Systems
biology helps in taking an integrative approach using
animal systems, individuals, subpopulations, and com-
munities in delineating PA exposures and effects. Expo-
some on the other hand captures and integrates the com-
plex multiple exposures across domains and presents a
spatial and temporal view on subjects’ susceptibility.
Exposome also helps in overcoming the traditional
“looking under the lamppost” approaches. Connecting
plastics contact materials exposure to disease through the
study of exposome and metabolome approaches is an
opportunity and important overarching goal to attain to-
2.5.2. Ne x t Steps
Researchers must seek collaborations to induce integra-
tion of technologies. Identifying apt early stage bio-
markers with coordinated trans-disciplinary efforts helps
in taking public health science from “cure” approach to
the next level of predicting, preventing, and personalized
treatment. There is a need to understand why there is
common exposure intensity but different susceptibility of
subgroups. So far there has been a lack of integration of
cross-disciplinary platforms, lack of exposure quantifica-
tion across age groups and subpopulations, lack of com-
parisons across mixtures exposure, and lack of informat-
ics tools to pin point out specific and as well generic
biomarkers for PA exposure. Bioinformatics tools are
necessary for cross platform identification, validation,
quantification, optimization, and integration of PA ex-
posure biomarkers. Furthermore, there is a need for bio-
Copyright © 2013 SciRes. JWARP
markers to work back in understanding exposome but
also responsome (responsome denotes changes in ob-
servable/measurable biological phenomena from expo-
sures). Metabolome approaches helps in finding key ar-
eas to apply translation strategies. With an exposome
approach, a cohort study will help in monitoring the en-
tire processes between exposure occurrence and disease
appearance, and also helps in providing a conceptual
framework on exposure-response relationships and toxi-
Cohort studies should measure methods to assess ex-
posure which happened years ago, relate current expo-
sures with future outcomes, and also promote develop-
ment of low-cost intervention measures that can be as-
sessed repeatedly and as well in large numbers. Inte-
grated exposure biology should become “open sourced”
with information and databases shared that is not or yet
to be published. Integrated exposure biology is intended
to provide measures of toxic materials exposures, dietary
intake, socio-economic and psychosocial status of an
individual and be able to link those measures of an indi-
vidual environment to changes in body physiological
pathways. Exposure biology should provide a snapshot
of the exposome and as well helps in teasing out the in-
teraction between exposure variables and human re-
sponses. An important step would be to continue valida-
tion of new prototypes and establish commercial col-
laborations for making them broadly available. Systems
biology facilitates data handling, analysis, and interpreta-
tion of how human pathway-based response relates to
exposures doses.
3. Conclusions
Consumers enjoy numerous choices of plastic materials
to temporarily store water or food items before consump-
tion but this convenience is often not accompanied by
appropriate precautionary explanation of possible health
threats. This may be particularly true in the case of PA
found in numerous water-contact materials that could
leach under certain environmental conditions, but science
associated with their possible human health effects is ill
defined. The recent reports of common environmental
processes (i.e., frequency of bottle reuse, temperature,
UV exposure) maximizing the leaching of plasticizers
and other chemicals into packaged water highlight a ne-
glected and much underreported exposure source that
needs to be included in future exposure assessment stud-
ies and derivations of acceptable daily PA intake esti-
Initiatives towards creating and updating epidemiol-
ogical survey databases for global researches access to
information on case and control subjects’ details, ana-
lytical and statistical tools used, and health outcomes and
assessments made will help in developing measures at
several stages such as exposure reduction interventions,
dietary interventions, medical interventions, and policy
interventions. Large scale epidemiological/GIS based
studies are required to identify most impacted risk groups
and as well large scale multi-group/multi-location re-
search groups are required to provide high level evidence
and insight into the exposure epidemiology and interven-
tions programs. There is a need for 1) global bio-banking
and miniaturization of epidemiological study samples for
further use is emphasized, 2) an international task force
on prenatal exposures and disease outcomes, 3) inter-
disciplinary research groups for better understanding
multi-variable nature of prenatal exposures, infant and
children disorders, and adult age diseases, 4) trans-dis-
ciplinary groups should consist of environmental scien-
tists, toxicologists, epidemiologists, clinicians, endocri-
nologists, nutritionists and community educators, 5) cre-
ating enhanced screening tools for environmental ex-
posures in pregnant women, and 6) more systematic
worldwide cohort needs to be established that follows a
defined set of optimized and authentic protocols in sam-
ples collection, analysis and data interpretation; rather
monitoring a small set of chemicals in a small set of sub-
jects in a small set if geography using inconsistent pro-
Green chemists should create new and benign chemi-
cals, based on access to toxicological information, that
have zero endocrine disruption function. When introduc-
ing a new chemical for usage in water and food contact
materials, they need to be tested not only for mutagenic-
ity and genotoxicity, but also for endocrine disruption by
using appropriate in vitro and/or in vivo testing. However
chemists need to be trained in toxicological and envi-
ronmental health sciences for cross-discipline communi-
cation for understanding PA toxicological issues and
databases. Tests need to be actionable, economical, sus-
tainable, reproducible, upgradeable and transparent.
There is a need for an increase in public awareness and
hence pressure to change policy decisions as well as to
find ways for better dissemination of environmental
health education to the communities. Communication
research in collaboration with behavioral and social sci-
ence researchers, sociologists, journalists, non-profit
government organizations can improve providing in-
sights on PA exposure and avoidance measures. Open
access online databases should be available that displays
all the chemicals being used as PA in food and water
contact materials for the general public interest. There is
a need to create an easy-access electronic database for
environmental health assessment and health education
literature particularly for pregnant women. Young adults
should be reached via twitter or other social network sites.
Either or each of the approaches should lead to validated
intervention measures to prevent (in the first place) or
Copyright © 2013 SciRes. JWARP
S. S. ANDRA 31
mitigate (if necessary) the exposures and risks from PA.
It is inevitable that such approaches may only be suc-
cessful if, and only if, collaboration opportunities are
established for scientific fields and expertise, such as,
environmental chemistry, engineering, exposure science,
epidemiologists, risk assessors, social and humanities
science researchers and policy makers.
4. Acknowledgements
I thank my advisor Dr. Konstantinos C. Makris (Assis-
tant Professor of Environmental Health), Cyprus Interna-
tional Institute for Environmental and Public Health in
association with Harvard School of Public Health, Cy-
prus University of Technology, in making this work pos-
sible. I also thank Dr. Helen Bridle, Heriot-Watt Univer-
sity, for editing the special issue papers. Finally, I thank
the European Science Foundation (ESF) for giving me an
opportunity as an Early Career Researcher to present our
work at the ESF Junior Summit “Water: Unite and Di-
vide, Interdisciplinary approaches for a sustainable fu-
ture”, Stresa, Lago Maggiore, Italy (27-30 August 2012).
[1] CIPET (Central Institute of Plastics and Engineering
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