Food contact materials (FCMs) and food contact articles are ubiquitous in today's globalized food system. Chemicals migrate from FCMs into foodstuffs, so called food contact chemicals (FCCs), but current regulatory requirements do not sufficiently protect public health from hazardous FCCs because only individual substances used to make FCMs are tested and mostly only for genotoxicity while endocrine disruption and other hazard properties are disregarded. Indeed, FCMs are a known source of a wide range of hazardous chemicals, and they likely contribute to highly prevalent non-communicable diseases. FCMs can also include non-intentionally added substances (NIAS), which often are unknown and therefore not subject to risk assessment. To address these important shortcomings, we outline how the safety of FCMs may be improved by (1) testing the overall migrate, including (unknown) NIAS, of finished food contact articles, and (2) expanding toxicological testing beyond genotoxicity to multiple endpoints associated with non-communicable diseases relevant to human health. To identify mechanistic endpoints for testing, we group chronic health outcomes associated with chemical exposure into Six Clusters of Disease (SCOD) and we propose that finished food contact articles should be tested for their impacts on these SCOD. Research should focus on developing robust, relevant, and sensitive in-vitro assays based on mechanistic information linked to the SCOD, e.g., through Adverse Outcome Pathways (AOPs) or Key Characteristics of Toxicants. Implementing this vision will improve prevention of chronic diseases that are associated with hazardous chemical exposures, including from FCMs.

College of Global Public Health and Grossman School of Medicine and Wagner School of Public Service New York University New York NY USA

Department of Environmental Health Sciences School of Public Health and Health Sciences University of Massachusetts Amherst Amherst MA USA

Department of Environmental Toxicology Eawag Swiss Federal Institute of Aquatic Science and Technology Dübendorf Switzerland

Department of Immunology Tufts University School of Medicine Boston MA USA; Centre Cavaillès Ecole Normale Supérieure Paris France

Dept of Analytical Chemistry I3A University of Zaragoza Zaragoza Spain

Dept of Biological and Environmental Sciences University of Gothenburg Sweden

Dept of Biological Sciences North Carolina State University Raleigh NC USA

Dept of Biology Faculty of Natural Sciences Norwegian University of Science and Technology Trondheim Norway

Dept of Chemistry Carnegie Mellon University Pittsburgh PA USA

Dept of Chemistry Carnegie Mellon University Pittsburgh PA USA; Environmental Health Sciences Charlottesville VA USA

Dept of Growth and Reproduction Rigshospitalet and Centre for Research and Research Training in Male Reproduction and Child Health Copenhagen University Hospital Rigshospitalet Copenhagen Denmark

Dept of Population Health Sciences Faculty of Veterinary Medicine University of Utrecht Netherlands

Food Packaging Forum Foundation Zurich Switzerland

Healthy Environment and Endocrine Disruptor Strategies Durham NC USA

IDiBE and CIBERDEM Miguel Hernández University of Elche Alicante Spain

Independent Consultant Frederick MD USA

Mel and Enid Zuckerman College of Public Health University of Arizona Tucson AZ USA

Plastic Waste Innovation Hub Department of Arts and Science University College London UK

RECETOX Masaryk University Brno Czech Republic; Department of Environmental Systems Science ETH Zurich Switzerland

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Evidence for widespread human exposure to food contact chemicals