Use of Bisphenol A-containing baby bottles in Cameroon and Nigeria and possible risk management and mitigation measures: community as milestone for prevention.

The plasticizer Bisphenol A (BPA) is banned in baby bottles in many industrialized countries due to safety concerns. We provide a pilot view on the potential BPA exposure of bottle-fed children in sub-Saharan Africa through an enquiry on availability, accessibility and affordability of plastic baby bottles, usage pattern, and risk perception. An observational survey was conducted in a randomized group of vending sites (34 pharmacies; 87 shops and markets), in three cities (Yaoundé, Foumbot, Bafoussam) in Cameroon (two regions), and in two cities (Lagos, Port Harcourt) in Nigeria (two states). Interviews in vending sites and group discussions were conducted with 248 mothers. Cameroon and Nigeria showed a largely comparable situation. Plastic baby bottles are largely imported from industrialized countries, where a label indicates the presence/absence of BPA. In pharmacies most plastic baby bottles are labeled as BPA-free, whereas most bottles sold in shops are not BPA-free. BPA-containing bottles are more accessible and affordable, due to sale in common shops and lower costs. The meaning of the label BPA-free is unknown to both vendors and customers: the BPA issue is also largely unknown to policy makers and media and no regulation exists on food contact materials. The wide availability of BPA-containing baby bottles, lack of information and usage patterns (e.g. temperature and duration of heating) suggest a likely widespread exposure of African infants. Possible usage recommendations to mitigate exposure are indicated. Risk communication to policy makers, sellers and citizens is paramount to raise awareness and to oppose possible dumping from countries where BPA-containing materials are banned. Our pilot study points out relevant global health issues such as the capacity building of African communities on informed choices and usage of baby products, and the exploitation of international knowledge by African scientists and risk managers.