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Bellingham M, Sharpe RM Chemical Exposures During Pregnancy: Dealing with Potential but Unproven Risks to Child Health. 2013;

European Food Safety Authority. Scientific Opinion on the risks to public health related to the presence of bisphenol A (BPA) in foodstuffs. 2015. https://doi.org/https://doi.org/10.2903/j.efsa.2015.3978

Food Standards Agency. Bisphenol-A (BPA) frequently asked questions. 2016. http://tinyurl.com/jcaqhxj (accessed 21 December 2016)

Pregnancy safety advice prompts criticism. 2013. http://www.bbc.co.uk/news/health-22754944 (accessed 21 December 2016)

Science and Environmental Health Network. Wingspread Conference on the Precautionary Principle. 1998. http://www.sehn.org/wing.html (accessed 21 December 2016)

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Plastics, pregnancy and precaution

02 January 2017
Volume 25 · Issue 1

Abstract

The precautionary principle advocates avoiding potential risks even in the absence of clear evidence of cause and effect. George Winter explores how this relates to pregnant women using everyday items.

In 1967's The Graduate, Mr McGuire advises Dustin Hoffman's character Benjamin on career prospects: ‘I just want to say one word to you. Just one word… Plastics.’ McGuire was right; Wilcox et al (2015) demonstrated that global production of plastic has doubled every 11 years since the 1950s, and up to 580 000 pieces of plastic per square kilometre now pollute the world's oceans. So it's unsurprising that we humans host a diversity of plastic-related compounds, the health effects of which are keenly debated, often in the context of the precautionary principle (PP). According to a consensus statement from the Science and Environmental Health Network (1998): ‘When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically.’

Let's consider bisphenol A (BPA), which is used in food and drink cans, bottles and clear food packaging. Although typically consumed by ingestion, it can be absorbed through the skin or by inhaling dust. BPA is also an endocrine disruptor, mimicking oestrogen, and ‘has been linked to cancer, neuron damage, behavioural problems, and stunted health development in children’ (Turnage, 2013: 32). The French Agency for Food, Environment and Occupational Health & Safety investigated exposure to BPA, finding concerns ‘strong enough to encourage “pregnant women working as cashiers” to be careful’ when touching receipts (Turnage, 2013: 32).

When the Royal College of Obstetricians and Gynaecologists (RCOG) published a report on chemical exposure during preg nancy, including BPA-containing plastics, the recommendation was for pregnant women to put safety first: ‘That is, to assume that risk is present even when it may be minimal or eventually proven to be unfounded. This is often referred to as the “precautionary approach”’ (Bellingham and Sharpe, 2013: 3).

But according to Roberts (2013), the RCOG was accused of offering ‘unhelpful, unrealistic and alarmist’ advice in publishing this report, with some feeling it was inap-pro priate to recommend that pregnant women should, for example, avoid tinned food, shower gel and new cars. One can only imagine the challenge to mid wives of promoting abstinence from such items.

In January 2015, France became the first European country to ban BPA in all food and drink packaging, yet the UK Food Standards Agency (2016) states: ‘The levels of BPA found in food from food contact materials are not a concern to health.’ The European Food Safety Authority (EFSA, 2015: 1) offers the rather nuanced opinion that ‘there is no health concern for any age group from dietary exposure and low health concern from aggregated exposure.’ The EFSA made no fewer than nine recommendations for further research, acknowledging ‘the uncertainties surrounding this risk assessment of BPA.’

BPA is one chemical, but we're exposed to a range of endocrine-disrupting chemicals (EDCs). Toxico-pathologist Emeritus Professor C Vyvyan Howard of the University of Ulster encourages a reduction in the bulk production of such chemicals: ‘The question is, how much is dangerous? That is subject to continuing research but we can be confident that low doses are significant. There is an overwhelming case for removing any food contact uses of products containing EDCs. We are increasingly helping manu facturers with product reviews as they start to realise the potential for legal liability.’

So are we to tolerate the undoubted adv antages conferred by BPA—enriched plas tics at the expense of possible adverse health outcomes—or should we assert the PP, banning BPA from certain products? Further studies will determine whether BPA constitutes an unknown danger or an insignificant one, leaving society to weigh up the knowledge provided by science against its value. Appleyard (1993: 16) cites the philosopher Wittgenstein: ‘We feel that even when all possible scientific questions have been answered, the problems of life remain completely untouched.’

I wonder whether Benjamin went into plastics, after all.