Literature review suggests $2.2 trillion annual health burden from synthetic food chemicals — Evidence Review

Scientists warn that widespread synthetic chemicals in the food system contribute to billions in annual health costs and are linked to cancer, infertility, and ecosystem damage. Related studies broadly support these findings, highlighting growing concerns over metabolic diseases, endocrine disruption, and population-level risks associated with chemical exposures (1, 2, 3).

• Multiple reviews have linked exposure to synthetic chemicals such as phthalates, bisphenols, pesticides, and PFAS to increased rates of diabetes, obesity, reproductive disorders, and cancers, corroborating the new study’s conclusions about health burdens (1, 2, 5).
• Evidence from occupational and vulnerable population studies demonstrates higher risks of certain cancers, neurological disorders, and metabolic dysfunction among groups exposed to these chemicals, supporting the new report’s focus on health and demographic impacts (3, 4, 5).
• Several studies call attention to the lack of regulatory oversight and the knowledge gap regarding the safety or cumulative effects of thousands of chemicals used in food production and packaging, echoing concerns raised in the new report (8, 9, 10).

Study Overview and Key Findings

The widespread use of synthetic chemicals in the global food system has escalated since the mid-20th century, with their health and environmental impacts now coming under increasing scientific scrutiny. This new report, produced by an international team led by Systemiq and including institutions such as the Institute of Preventive Health, the Center for Environmental Health, and universities in the US and UK, aims to quantify the health and ecological burden of four major chemical groups prevalent in food production. The study is especially noteworthy for estimating the economic costs of health impacts and projecting demographic consequences if current exposure trends continue.

Property	Value
Study Year	2023
Organization	Institute of Preventive Health, Center for Environmental Health, Chemsec, University of Sussex, Duke University, Systemiq
Authors	Philip Landrigan
Population	Exposure to synthetic chemicals in food production
Methods	Literature Review
Outcome	Health burden from synthetic chemicals, ecosystem damage
Results	$2.2tn annual health burden from synthetic chemicals

The report highlights the following key findings:

• The annual global health burden attributable to synthetic chemicals in the food system—specifically phthalates, bisphenols, pesticides, and PFAS—may reach up to $2.2 trillion, comparable to the profits of the top 100 publicly listed companies.
• Additional, often unpriced, ecosystem damages—including agricultural productivity losses and the costs of maintaining safe water standards—could account for another $640 billion annually.
• If exposure to endocrine-disrupting chemicals remains unchanged, the report projects 200–700 million fewer births worldwide between 2025 and 2100.
• The study underscores a lack of adequate regulatory oversight and risk assessment for most industrial chemicals, especially compared to pharmaceuticals.
• The authors emphasize that the chemicals assessed here represent only a fraction of the thousands in use, suggesting that the overall burden may be substantially underestimated.

Literature Review: Related Studies

To assess how this study fits into the broader scientific context, we searched the Consensus database of over 200 million research papers using the following queries:

1. synthetic chemicals health impact
2. economic burden of food additives
3. health risks of food system chemicals

Below, we organize key insights from related studies under major thematic questions:

Topic	Key Findings
What is the impact of synthetic chemicals on human metabolic and reproductive health?	- Synthetic chemicals—especially endocrine disruptors—are linked to metabolic diseases (e.g., diabetes, obesity) and reproductive disorders (1, 2, 5). - Evidence suggests increased risk of cancers, birth defects, and neurodevelopmental conditions due to exposure to phthalates, bisphenols, pesticides, and PFAS (2, 3, 5).
How do synthetic chemicals in food systems affect vulnerable populations and communities?	- Agricultural workers and communities near industrial sites face higher risks of cancers, neurological disorders, and other adverse health effects due to greater exposure (3, 4, 5). - Vulnerable populations (e.g., low socioeconomic status, racial/ethnic minorities) are disproportionately affected, with gaps in research and monitoring (4, 5).
What are the environmental and ecological consequences of synthetic chemical use?	- Widespread use of pesticides and persistent chemicals contributes to ecosystem degradation, with risks to agricultural productivity and biodiversity (6, 9). - PFAS and other persistent chemicals accumulate in water, soil, and food chains, posing long-term challenges for environmental health and food safety (7, 8, 9).
How adequate are current regulatory and safety assessments for food system chemicals?	- There are significant data gaps and lack of hazard information for many food contact chemicals; most are not systematically tested or monitored (8, 9, 10). - Regulatory frameworks lag behind scientific understanding, with thousands of chemicals in use whose cumulative or low-dose effects remain poorly characterized (10).

What is the impact of synthetic chemicals on human metabolic and reproductive health?

A substantial body of research indicates that synthetic chemicals commonly used in food production can disrupt metabolic and endocrine systems, leading to a range of chronic conditions. The new study’s findings on cancer, neurodevelopmental disorders, and fertility decline are well-supported by epidemiological and experimental evidence from recent reviews.

• Multiple studies link endocrine-disrupting chemicals (EDCs)—such as phthalates, bisphenols, and PFAS—to increased risks of diabetes, obesity, reproductive tract disorders, and hormone-related cancers (1, 2, 5).
• Experimental data demonstrate that low-dose and chronic exposures can affect glucose homeostasis and insulin action, contributing to the global diabetes epidemic (1, 5).
• Associations have been found between EDC exposure and developmental, intellectual, and behavioral impairments, particularly in children (2, 5).
• The evidence base supports the new report’s assertion that synthetic chemicals are significant contributors to the burden of non-communicable diseases (1, 2, 5).

How do synthetic chemicals in food systems affect vulnerable populations and communities?

Studies highlight that certain groups—such as agricultural workers, residents near industrial facilities, and low-income communities—face disproportionate exposure and associated health risks. The new report’s focus on demographic and population-level impacts aligns with findings from these studies.

• Agricultural workers exposed to synthetic pesticides are at higher risk for cancers, neurological disorders, DNA damage, and metabolic dysfunction (3, 5).
• Communities living near industry ("fenceline" communities) experience cumulative impacts from multiple chemical exposures, compounded by social and economic stressors (4).
• Research on vulnerable populations is limited, particularly for racial/ethnic minorities and those of low socioeconomic status, representing a critical knowledge gap (5).
• There is evidence that environmental justice issues exacerbate health disparities linked to chemical exposures (4, 5).

What are the environmental and ecological consequences of synthetic chemical use?

The environmental footprint of synthetic chemicals extends beyond human health, with persistent pollutants affecting ecosystems, agricultural productivity, and water safety. The new study’s estimates of ecological costs are consistent with ongoing scientific concern.

• Pesticide use and chemical pollution have been shown to degrade soil health, harm non-target species, and threaten biodiversity (6, 9).
• PFAS and similar persistent chemicals accumulate in environmental matrices, entering food chains and presenting long-term challenges for remediation and regulation (7, 8, 9).
• Monitoring and risk assessments highlight widespread contamination of food and water with chemicals that have adverse effects on both human and ecosystem health (7, 9).
• The literature emphasizes the need for a transition to more sustainable agricultural practices and chemical management (6, 8).

How adequate are current regulatory and safety assessments for food system chemicals?

A recurring theme in the literature is the insufficiency of current regulatory frameworks and the lack of comprehensive safety data for most chemicals used in the food system. The new report’s call for better oversight is widely echoed in recent studies.

• Databases of food contact chemicals reveal thousands of substances with unknown or poorly characterized hazards, indicating significant research and regulatory gaps (8, 10).
• Only a minority of chemicals are subject to systematic toxicological assessment, with cumulative and low-dose effects often overlooked (10).
• Regulatory standards frequently lag behind emerging scientific evidence, resulting in continued exposure to chemicals with potential or known risks (9, 10).
• There is broad consensus on the need for improved monitoring, hazard identification, and substitution of hazardous chemicals in food production and packaging (8, 10).

Future Research Questions

Current evidence underscores the complexity and scope of health and environmental risks posed by synthetic chemicals in the food system. However, substantial gaps remain in our understanding of cumulative exposures, vulnerable populations, and effective mitigation strategies. Addressing these questions is critical for more informed policy, regulation, and public health action.

Research Question	Relevance
What are the cumulative health effects of long-term exposure to multiple synthetic chemicals in the food system?	Understanding combined exposures is crucial, as most people encounter complex mixtures, not single chemicals. Current studies often investigate individual compounds, leaving cumulative risks underexplored (2, 5, 10).
How do synthetic chemical exposures impact reproductive health and population demographics?	The new study projects substantial impacts on global birth rates, but further empirical research is needed to clarify mechanisms and quantify demographic effects of endocrine disruptors (2, 5).
What are the specific mechanisms by which food system chemicals cause metabolic and neurological diseases?	Detailed mechanistic studies would enable more precise risk assessments and targeted interventions. Many observed associations still lack clear biological explanations (1, 2, 5).
Which populations are most at risk from food system chemical exposures, and how can disparities be addressed?	The literature identifies vulnerable groups but highlights research gaps, especially regarding racial, socioeconomic, and occupational disparities in exposure and health outcomes (4, 5).
What effective regulatory and technological interventions can reduce synthetic chemical risks in the food system?	Identifying and evaluating policy, regulatory, and technological solutions is essential to mitigate current and future risks, given the limitations of existing oversight (8, 9, 10).