Organochloride pesticides (OCPs) and heavy metals are endocrine-disrupting chemicals (EDCs) that disrupt hormone function, causing adverse effects on organisms, offspring, and populations (Kelemen et al., 2019). EDCs can stimulate, block, or change natural hormone synthesis, consequently producing false or abnormal signals (UNEP, 2017). EDCs, found in various industries, are persistent in the environment and can be created by burning materials (Braun, 2017; Yesildemir & Akdevelioglu, 2021). Even intentionally engineered chemicals like OCP can pose potential harm (Boué et al., 2018; de Mendonça Pereira et al., 2020).
Babies’ consumption of contaminated formula is a global public health concern since EDCs are associated with various health issues such as asthma, learning difficulties, early puberty, infertility, cancer, Parkinson's disease, and obesity ( Muncke, 2011; Birnbaum, 2013). EDCs also disrupt thyroid signaling leading to testicular mal-development and disturbance of the central nervous system (Jaacks & Prasad, 2017; Kent, 2012; Sharma et al., 2021). Babies’ increasing vulnerability even to lower doses is attributable to their frequent hand-to-mouth or object-to-mouth behaviour, greater consumption of food and liquids relative to body weight compared with adults, lack of defensive or adaptive mechanisms, and rapid growth (Boué et al., 2018; de Mendonça Pereira et al., 2020; Eticha et al., 2018; Pettoello-Mantovani et al., 2021; UNEP, 2017). Several studies show that EDCs are active at low doses with persistent negative health effects (Alexandra & Gugoasa, 2020; Fernandino et al., 2022; Groh et al., 2021; Kahn et al., 2020). In Africa, paediatric obesity is increasing coinciding with increased consumption of baby formulas with public health and economic implications (Ferreira et al., 2023).
OCPs like Dieldrin (1,2,3,4,10,10-Hexachloro-6,7-epoxy-1,4,4a,5,6,7,8,8a-octahydro-endo,exo-1,4:5,8-dimethanonaphthalene), Heptachlor (1aR,2R,2aS,3S,6R,6aR,7S,7aS)-3,4,5,6,9,9-hexachloro-1a,2,2a,3,6,6a,7,7a-octahydro-2,7:3,6-dimethanonaphtho[2,3-b]oxirene), Chlordane ( 1,2,4,5,6,7,8,8-Octachloro-3a,4,7,7a-tetrahydro-4,7-methanoindene), DDT (1,1,1-Trichloro-2,2-bis(4-chlorophenyl)ethane), 1,1,1-Trichloro-2,2-bis(4-chlorophenyl)ethane (1,1,1-Trichloro-2,2-bis(4-chlorophenyl)ethane), Lindane (1α,2β,3β,4α,5α,6β)-1,2,3,4,5,6-Hexachlorocyclohexane) and Gamma-hexachlorocyclohexane (1α,2β,3β,4α,5α,6β)-γ-Hexachlorocyclohexane are harmful to humans, animals, and aquatic life due to their high bioaccumulation and toxicity. Consumption of contaminated baby formulas by the girl child predisposes her to longer menstrual cycles, missed or irregular periods, and abnormal bleeding upon reaching puberty (Encarnação et al., 2019; Predieri & Iughetti, 2022; Hatzidaki et al., 2023; Street et al., 2023). Exposure to bio-toxic heavy metals can occur when they leach from printed surfaces or are introduced through manufacturing processes (Jaishankar et al., 2014; McKinlay et al., 2008; Yesildemir & Akdevelioglu, 2021).
Gilbert et al. (2019) highlighted the need for comprehensive risk assessment for EDC safety in Africa through the enactment of laws and enforcement. There is a need for closer quality monitoring of the baby formula as it targets a sensitive group of consumers (Fernandino et al., 2022; Kim et al., 2018; Rotondo & Chiarelli, 2020). The Codex Alimentarius Commission recommends maximum upper limits for OCPs and heavy metals but varies slightly across Europe and the USA (UNEP, 2017). In Malawi, baby formula compliance with the specifications of mandatory Malawi Standard (MS 90:2018) is enforced by the Malawi Bureau of Standards. This standard among others, prescribes maximum residual limits of pesticides with reference to the CAC, microbiological limits, and specifications for iron, zinc, and folic acid. However, enforcement remains challenging due to rampant smuggling and informal distribution channels (Bornman et al., 2017; Gálvez-Ontiveros et al., 2020).
The ubiquitous nature of EDCs makes human exposure almost unavoidable. Nevertheless, it is expedient to reduce exposure to EDCs, through eating organic, eco-labelled products in glass rather than plastic packaging (Gálvez-Ontiveros et al., 2020; Street et al., 2018). The use of supercritical carbon dioxide extraction as a green separation process helps to reduce the presence of EDCs in infant formula (Torres-Torres et al., 2019).
In Malawi, there are an estimated 8.9 million children under the age of 2 years (UNICEF, 2023). Economic disparities in the country impact the baby formula market, with most families facing significant affordability challenges (Gilbert et al., 2019). The Malawian government promotes exclusive breastfeeding for the first six months of life and public health campaigns emphasize its affordability (Salim & Stones, 2020). Nutritional assistance programs like the Malawi Social Cash Transfer Scheme provide financial support to vulnerable households (UNICEF, 2023). However, challenges persist, such as limited access to clean water, inadequate healthcare infrastructure, and poverty, which may impact families' ability to afford commercial infant formula (Wiyo & Kadewa, 2020). There is a lot of formal and informal trade including pesticide and foodstuffs among these neighbouring countries but also within the region and beyond. Smuggling remains a challenge for the government as it causes losses in customs duty revenue and also increases the risk of sale and distribution and ultimately consumption of non-certified products (Liza et al., 2017).
Few studies conducted on baby formula in Malawi focused on nutrient and mycotoxin quality (Gilbert et al., 2019). There is generally a lack of information on the EDC quality of baby formulas sold on the Malawi market. This study will provide a baseline as a basis for control initiatives for the safety of baby formulas. Therefore we conducted this research: i) to determine the occurrence of OCP and heavy metals in baby formulas sold in Malawi, and ii) to evaluate the risk to the consumer of dietary exposure through consumption of baby formula at different ages and body weights.