This narrative review examines the potential role of plastic-derived chemicals and micro- and nanoplastics in metabolic diseases. It applies the recently proposed key characteristics (KCs) for metabolism-disrupting agents to evaluate chemicals commonly found in plastics and microplastic and nanoplastic particles. The KC framework, adapted from the KCs of toxicants originally developed for the identification of carcinogens, was applied to evaluate evidence from epidemiological, animal, and cellular studies. The review specifically evaluates compounds such as perfluorooctanoic acid (PFOA), bisphenol-S (BPS), and diisonyl phthalate (DINP), as well as emerging evidence relating to microplastics and nanoplastics (MNPs). Evidence shows that exposure to chemicals derived from plastics, including PFOA, BPA substitutes (eg, BPS) and phthalate substitutes, is linked to metabolic dysfunction, obesity, diabetes, and MASLD. BPS and DINP exhibit properties consistent with metabolism-disrupting agents, suggesting they are “regrettable substitutes.” Although human data on MNPs are limited, animal and cellular studies indicate they may also contribute to metabolic diseases, though mechanisms remain unclear. Rising exposure to chemicals in plastics poses significant risks to metabolic health. Identifying metabolic disruptors among thousands of plastic-associated chemicals is urgently needed. Increasing awareness and promoting the use of safer, inert, and reusable materials are essential steps to reduce health risks associated with plastic-derived pollutants and support more sustainable consumption.

Antimony (Sb) is a group 15 metalloid that is used as a catalyst in the production of polyethylene terephthalate (PET) plastic, a common food contact material (FCM). PET accounts for over 44% of single-use beverage packaging units and is also used in the production of food trays, storage containers, and other items. Due to its frequent co-occurrence with other metals, Sb is also a common contaminant in crystalware, ceramics, and metal FCMs. In light of the increasing use of Sb-containing FCMs in modern society, a thorough evaluation of Sb's potential effect on public health is warranted. Burgeoning evidence suggests Sb is linked to common cardiometabolic conditions, including dyslipidemia, obesity, diabetes, hypertension, heart failure, and atherosclerotic cardiovascular disease. Thus, this review aims to (1) perform a comprehensive systematic assessment of Sb migration from FCMs into foodstuffs and food simulants, (2) obtain an overview of antimony-related health risks, and (3) inform the generation of harm-reduction guidelines at the individual and systems levels.

Background The normal and intended use of plastic food packaging and other food contact articles (FCAs) leads to the migration of micro- and nanoplastics (MNPs) into food and beverages, resulting in human exposure. In 2022, we systematically assessed the state of science on this topic. However, at the time, reliable data on MNP release from FCAs into food were scarce, and since then, research has expanded significantly.Objectives We aim to update our dataset with the latest evidence of MNPs detected in foodstuffs in contact with plastic FCAs. To achieve this, we will systematically map the literature based on a Population, and Outcomes (PO) framework.Search strategy and eligibility criteria We will search Web of Science, PubMed, and Science Direct for combinations of search terms related to FCAs, packaging, foodstuffs/food simulants, plastic particles, and abrasion/release. Cited references from relevant reports will also be included. In a two-step screening process, we will apply predefined eligibility criteria to titles and abstracts of all references, followed by a screening of full texts.Data extraction According to defined data categories, we will collect information on types and characteristics of the FCAs, MNPs, food/food simulant, and the experimental design.Synthesis and visualization Results will be published as a narrative summary, and data in the freely accessible, filterable FCMiNo dashboard.

Background Food contact chemicals (FCCs) are known to migrate from food packaging and other food contact articles into food. This leads to human exposure to FCCs, and some FCCs have been linked to human health effects such as chronic and non-communicable diseases. However, a systematic overview of the health effects of FCCs is missing.Objectives The objective of this study is to systematically map the relations between exposure to FCCs and human health effects within the Population, Exposure, Comparator, Outcomes, and Study Design (PECOS) framework.Search strategy and eligibility criteria We will search PubMed for combinations of search terms related to the identity of the chemical and the epidemiological study design. The references will be screened at the title-and-abstract level, followed by the full-text level. Eligible references will be included according to predefined criteria, further specifying the elements of the applied PECOS framework.Data extraction and coding Information on human exposure to FCCs will be collected and linked to human health effects according to previously defined data categories and standardized terms. The human health effects will be classified based on the Six Clusters of Disease (SCOD) framework.Synthesis and visualization Results will be published in a narrative summary, and data will be made available in a freely accessible interactive dashboard, the Food Contact Chemicals Health Effect Matrix (FCChelix).

Plastics are composed of complex chemical mixtures, resulting in many chemicals being released during plastic's life cycle, alongside a range of actual or potential impacts on human health and the environment. Many plastic chemicals also hinder technological solutions toward a safe and sustainable circular economy. Hence, there is broad agreement to address so-called plastic chemicals of concern, including under the Global Plastics Treaty. However, debate on how to identify such chemicals of concern is ongoing, particularly around whether their risk (and by extension, exposure) should be considered. In this perspective, we provide a review of the difficulties associated with understanding human and ecosystem exposure to and risks from plastic chemicals. Based on this, we highlight benefits of applying a hazard-based approach for identifying plastic chemicals of concern in a timely manner, and argue that additional consideration of exposure/risk would result in unjustified and costly delays, complications, and uncertainties, and therefore should not be required. A hazard-based approach to identifying plastic chemicals of concern would enable efficient action toward mitigating the impacts of plastics on human health and the environment, and facilitate a transition to a safe and sustainable plastics economy.

Humans are widely exposed to synthetic chemicals, especially via food. The types of chemical contaminants in food (including food contact chemicals) are diverse, and many of these are known to be hazardous, with mounting evidence that some contribute to noncommunicable diseases. The increasing consumption of ultra-processed foods, which contain synthetic chemicals, also contributes to adverse health. If the chemical contamination of foods were better characterized, then this issue would likely receive more attention as an important opportunity for disease prevention. In this Review, we discuss types and sources of synthetic food contaminants, focusing on food contact chemicals and their presence in ultra-processed foods. We outline future research needs and highlight possible responses at different food system levels. A sustainable transition of the food system must address the health impacts of synthetic chemicals in food; we discuss existing solutions that do justice to the complexity of the issue while avoiding regrettable substitutions and rebound effects.

The unchecked rise in global plastic production has resulted in widespread pollution and exposure to hazardous chemicals. Over 16,000 chemicals are used across the plastics life cycle, with thousands meeting criteria for persistence, bioaccumulation, mobility and toxicity. Many remain unregulated under existing multilateral environmental agreements. In response, the United Nations Environment Assembly has mandated the development of an international, legally binding instrument to end plastic pollution. Current treaty negotiations have begun addressing a short list of chemicals, yet significant gaps remain. These include insufficient regulatory mechanisms, lack of chemical transparency and reliance on ineffective recycling strategies that reintroduce toxic substances into consumer products. The presence of harmful chemicals in plastics contributes to major public health burdens and is an environmental threat, with high annual costs that reduce the potential for economic development through safer recycling. Vulnerable populations, including children, reproductive-aged individuals, and frontline communities, face heightened risks. To address this, we recommend the following three critical actions for the treaty: (1) globally regulating chemicals of concern based on hazard; (2) mandating transparency of plastic chemical composition and (3) designing plastics using safe-by-design principles and essential-use criteria. Group-based regulation, which would consider categories of related chemicals, should replace individual chemical approaches to prevent regrettable substitutions. Binding, global obligations, rather than fragmented or voluntary measures, are vital for sustainability, chemical safety, circularity and accountability across the plastics life cycle. A strong treaty is a critical opportunity to achieve a safer, more sustainable future for human and environmental health.

Agriculture and food systems are major sources of plastic pollution but they are also vulnerable to their diverse lifecycle impacts. However, this problem is not well-recognized in global policy and scientific discourse, agendas, and monitoring of food systems. The United Nations-led Global Plastics Treaty, which has been under negotiation since 2022, is a critical opportunity to address pollution across the entire plastics lifecycle for more sustainable and resilient food systems. Here, we offer aspirational indicators for future monitoring of food systems' plastics related to (1) plastic polymers and chemicals, (2) land use, (3) trade and waste, and (4) environmental and human health. We call for interdisciplinary research collaborations to continue improving and harmonising the evidence base necessary to track and trace plastics and plastic chemicals in food systems. We also highlight the need for collaboration across disciplines and sectors to tackle this urgent challenge for biodiversity, climate change, food security and nutrition, health and human rights at a whole systems level.

Micro- and nanoplastics (MNPs) in foodstuffs lead to widespread human exposure and are often linked to environmental contamination. However, the role of plastics in food contact articles (FCAs) has received less attention, despite being a known source. Thus, we compiled a systematic evidence map of MNPs present in foodstuffs in contact with all types of plastic FCAs. We extracted data on experimental design, FCAs, MNPs, and food or food simulants and critically appraised the general data quality, material identification methods, polymer type reporting, and study design. We included 103 eligible studies and created 600 database entries accessible in an interactive dashboard. Seven studies were appraised as highly reliable. We conclude that the normal/intended use of FCAs can lead to the migration of MNPs. Further research is needed to systematically characterize MNP migration related to materials and use. To better protect human health, regulations could mandate MNP migration testing for FCAs.

The rapid expansion of the global chemical industry, fueled by consumerism and economic growth, has created severe environmental and public health challenges. The current chemicals management approach primarily regulates the "production system", setting standards and imposing large responsibilities on the chemical industry. However, this approach has been found inadequate as it often neglects the vital role of the "consumption system" in driving chemical production and use, and pollution caused by chemicals. To address this imbalance, we propose a systematic integration of behavior-shaping tools into the global and local chemical management strategies, aimed at shifting consumer behavior toward safer and more sustainable chemical consumption. By applying ethical marketing and social- and behavioral-science techniques, consumers, including risk-sensitive groups such as women of childbearing age and children, can be nudged and empowered to make and adopt safer and mindful chemical choices, ultimately reducing their exposure to toxic chemicals. This consumer-oriented approach complements traditional "industry-focused" chemical regulations. Such an integrated approach (with management roles spanning across different stakeholders) is particularly required in regions with outdated or weak regulatory enforcement. Furthermore, fostering consumer demand for safer and more sustainable chemicals consumption will incentivize chemical industry innovations and encourage the market to move toward safer alternatives. Ultimately, a comprehensive integrated approach that focuses on both production and consumption systems could better strengthen global chemicals management, leading to improved environmental and public health outcomes and advancing progress toward the Sustainable Development Goals.

Plastics are a grave, growing, and under-recognised danger to human and planetary health. Plastics cause disease and death from infancy to old age and are responsible for health-related economic losses exceeding US$1·5 trillion annually. These impacts fall disproportionately upon low-income and at-risk populations. The principal driver of this crisis is accelerating growth in plastic production-from 2 megatonnes (Mt) in 1950, to 475 Mt in 2022 that is projected to be 1200 Mt by 2060. Plastic pollution has also worsened, and 8000 Mt of plastic waste now pollute the planet. Less than 10% of plastic is recycled. Yet, continued worsening of plastics' harms is not inevitable. Similar to air pollution and lead, plastics' harms can be mitigated cost-effectively by evidence-based, transparently tracked, effectively implemented, and adequately financed laws and policies. To address plastics' harms globally, UN member states unanimously resolved in 2022 to develop a comprehensive, legally binding instrument on plastic pollution, namely the Global Plastics Treaty covering the full lifecycle of plastic. Coincident with the expected finalisation of this treaty, we are launching an independent, indicator-based global monitoring system: the Lancet Countdown on health and plastics. This Countdown will identify, track, and regularly report on a suite of geographically and temporally representative indicators that monitor progress toward reducing plastic exposures and mitigating plastics' harms to human and planetary health.

BackgroundMicro- and nanoplastics (MNPs) are emerging pollutants of concern with ubiquitous presence in global ecosystems. MNPs pose potential implications for human health; however, the health impacts of MNP exposures are not yet understood. Recent evidence suggests that MNPs can cross the placental barrier, underlying the urgent need to understand their impact on reproductive health and development. ObjectiveThe Actionable eUropean ROadmap for early-life health Risk Assessment of micro- and nanoplastics (AURORA) project will investigate MNP exposures and their biological and health effects during pregnancy and early life, which are critical periods due to heightened vulnerability to environmental stressors. The AURORA project will enhance exposure assessment capabilities for measuring MNPs, MNP-associated chemicals, and plastic additives in human tissues, including placenta and blood. MethodsIn this interdisciplinary project, we will advance methods for in-depth characterization and scalable chemical analytical strategies, enabling high-resolution and large-scale toxicological, exposure assessment, and epidemiological studies. The AURORA project performs observational studies to investigate determinants and health impacts of MNPs by including 800 mother-child pairs from 2 existing birth cohorts and 110 women of reproductive age from a newly established cohort. This will be complemented by toxicological studies using a tiered-testing approach and epidemiological investigations to evaluate associations between maternal and prenatal MNP exposures and health perturbations, such as placental function, immune-inflammatory responses, oxidative stress, accelerated aging, endocrine disruption, and child growth and development. The ultimate goal of the AURORA project is to create an MNP risk assessment framework and identify the remaining knowledge gaps and priorities needed to comprehensively assess the impact of MNPs on early-life health. ResultsIn the first 3 years of this 5-year project (2021-2026), progress was made toward all objectives. This includes completion of recruitment and data collection for new and existing cohorts, development of analytical methodological protocols, and initiation of the toxicological tiered assessments. As of September 2024, data analysis is ongoing and results are expected to be published starting in 2025. ConclusionsAs plastic pollution increases globally, it is imperative to understand the impact of MNPs on human health, particularly during vulnerable developmental stages such as early life. The contributions of the AURORA project will inform future risk assessment. International Registered Report Identifier (IRRID)DERR1-10.2196/63176

Food packaging prevents foods from spoiling and enables traceability, marketing, and sharing of information with customers. But chemicals from packaging can transfer into foodstuffs, a process known as migration, and this is also relevant for other food contact materials (like processing equipment). This article explains the concept of migration, details what conditions lead to increased migration (including the food packaging material types), discusses options for assessing migration, outlines global regulations for food packaging, and touches upon challenges related to food packaging in the circular economy, for example where packaging is reused or recycled, and where increased chemical contamination can occur.

Many nations have food contact material (FCM) legislation purporting to protect citizens from hazardous chemicals, often specifically by regulating genotoxic carcinogens. Despite such regulations, cancers that are associated with harmful chemical exposures are highly prevalent, especially breast cancer. Using the novel Key Characteristics of Toxicants framework, Kay et al. found 921 substances that are potential mammary carcinogens. By comparing Kay et al.'s chemicals list with our own Database on migrating and extractable food contact chemicals (FCCmigex), we found that 189 (21%) of the potential mammary carcinogens have been measured in FCMs. When limiting these results to migration studies published in 2020-2022, 76 potential mammary carcinogens have been detected to migrate from FCMs sold in markets across the globe, under realistic conditions of use. This implies that chronic exposure of the entire population to potential mammary carcinogens from FCMs is the norm and highlights an important, but currently underappreciated opportunity for prevention. Reducing population-wide exposure to potential mammary carcinogens can be achieved by science-based policy amendments addressing the assessment and management of food contact chemicals.

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The ongoing international negotiations on a global plastics treaty will have pivotal implications for future efforts to transform the plastic economy. This is essential since the current use of plastic in the economy impacts the environment beyond the planetary carrying capacity. To ensure that the forthcoming Treaty can provide the foundation for this transition, the best available science must be made available in the negotiations, but with no formal scientific mechanism to inform the negotiations process, this is not ensured. The Scientists’ Coalition for an Effective Plastic Treaty serves as an example of how the global scientific community has self-organized and come together to address this task, working with five different categories of science-policy communication. The Scientists’ Coalition’s work is made transparent here with the hope that it can inspire organization of scientific input into other future policy areas.

PFASs are linked to serious health and environmental concerns. Among their widespread applications, PFASs are known to be used in food packaging and directly contribute to human exposure. However, information about PFASs in food packaging is scattered. Therefore, we systematically map the evidence on PFASs detected in migrates and extracts of food contact materials and provide an overview of available hazard and biomonitoring data. Based on the FCCmigex database, 68 PFASs have been identified in various food contact materials, including paper, plastic, and coated metal, by targeted and untargeted analyses. 87% of these PFASs belong to the perfluorocarboxylic acids and fluorotelomer-based compounds. Trends in chain length demonstrate that long-chain perfluoroalkyl acids continue to be found, despite years of global efforts to reduce the use of these substances. We utilized ToxPi to illustrate that hazard data are available for only 57% of the PFASs that have been detected in food packaging. For those PFASs for which toxicity testing has been performed, many adverse outcomes have been reported. The data and knowledge gaps presented here support international proposals to restrict PFASs as a group, including their use in food contact materials, to protect human and environmental health.