The Pew Charitable Trusts, Washington, DC.
JAMA Intern Med. 2013;173(22):2032-6. doi: 10.1001/jamainternmed.2013.10559.
Food and Drug Administration (FDA) guidance allows food manufacturers to determine whether additives to food are "generally recognized as safe" (GRAS). Manufacturers are not required to notify the FDA of a GRAS determination, although in some instances they notify the agency. The individuals that companies select to make these determinations may have financial conflicts of interest.
To determine the extent to which individuals selected by manufacturers to make GRAS determinations have conflicts of interest between their obligations to ensure that the use of the additive is safe and their financial relationships to the company. DESIGN Using conflict of interest criteria developed by a committee of the Institute of Medicine, we analyzed 451 GRAS notifications that were voluntarily submitted to the FDA between 1997 and 2012.
Number of GRAS notices submitted to the FDA; frequency of various types of relationships between decision maker and additive manufacturer; frequency of participation on GRAS panels by individuals; and number of GRAS safety determinations identified by the FDA that were not submitted to the agency.
For the 451 GRAS notifications, 22.4% of the safety assessments were made by an employee of an additive manufacturer, 13.3% by an employee of a consulting firm selected by the manufacturer, and 64.3% by an expert panel selected by either a consulting firm or the manufacturer. A standing expert panel selected by a third party made none of these safety assessments. The 290 panels that made GRAS determinations had an average of 3.5 members, with a maximum of 7. Ten individuals served on 27 or more panels; 1 individual served on 128 panels (44.1%). At least 1 of the 10 individuals with the most frequent service was a member of 225 panels (77.6%).
Between 1997 and 2012, financial conflicts of interest were ubiquitous in determinations that an additive to food was GRAS. The lack of independent review in GRAS determinations raises concerns about the integrity of the process and whether it ensures the safety of the food supply, particularly in instances where the manufacturer does not notify the FDA of the determination. The FDA should address these concerns.
食品和药物管理局(FDA)的指导允许食品制造商确定食品添加剂是否“普遍认为是安全的”(GRAS)。制造商无需向 FDA 通知 GRAS 决定,尽管在某些情况下他们会通知该机构。公司选择做出这些决定的个人可能存在财务利益冲突。
确定制造商选择做出 GRAS 决定的个人在确保添加剂使用安全的义务与其与公司的财务关系之间存在利益冲突的程度。
使用医学研究所委员会制定的利益冲突标准,我们分析了 1997 年至 2012 年期间自愿提交给 FDA 的 451 份 GRAS 通知。
提交给 FDA 的 GRAS 通知数量;决策者与添加剂制造商之间各种关系的频率;个人参与 GRAS 小组的频率;以及 FDA 确定但未提交给该机构的 GRAS 安全决定数量。
对于这 451 份 GRAS 通知,22.4%的安全评估由添加剂制造商的员工完成,13.3%由制造商选择的咨询公司的员工完成,64.3%由咨询公司或制造商选择的专家小组完成。第三方选择的常设专家小组没有进行这些安全评估。做出 GRAS 决定的 290 个小组平均有 3.5 名成员,最多 7 名。有 10 个人服务于 27 个或更多小组;有 1 个人服务于 128 个小组(44.1%)。在服务最频繁的 10 个人中,至少有 1 人是 225 个小组的成员(77.6%)。
在 1997 年至 2012 年期间,食品添加剂被认为是 GRAS 时,财务利益冲突普遍存在。GRAS 决定缺乏独立审查引起了对该过程完整性的关注,以及它是否确保了食品供应的安全,特别是在制造商未向 FDA 通知该决定的情况下。FDA 应解决这些问题。