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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. doi: 10.17226/26381.
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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health Committee on Environmental Impact of Currently Marketed Sunscreens and Potential Human Impacts of Changes in Sunscreen Usage Ocean Studies Board Board on Environmental Studies and Toxicology Board on Health Sciences Policy Division on Earth and Life Studies Health and Medicine Division Consensus Study Report Prepublication Copy

NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by a contract between the National Academy of Sciences and the U.S. Environmental Protection Agency. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/26381 Library of Congress Catalog Number: 2022XXXXXX This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2022 by the National Academy of Sciences. National Academies of Sciences, Engineering, and Medicine and National Academies Press and the graphical logos for each are all trademarks of the National Academy of Sciences. All rights reserved. Printed in the United States of America. Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/26381. ii Prepublication Copy 

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. Prepublication Copy iii 

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. Rapid Expert Consultations published by the National Academies of Sciences, Engineering, and Medicine are authored by subject-matter experts on narrowly focused topics that can be supported by a body of evidence. The discussions contained in rapid expert consultations are considered those of the authors and do not contain policy recommendations. Rapid expert consultations are reviewed by the institution before release. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. iv Prepublication Copy 

COMMITTEE ON ENVIRONMENTAL IMPACT OF CURRENTLY MARKETED SUNSCREENS AND POTENTIAL HUMAN IMPACTS OF CHANGES IN SUNSCREEN USAGE Members CHARLES A. MENZIE (Chair), Exponent, New York MARK R. CULLEN (Vice-Chair), Stanford University (Retired), Palo Alto, California SCOTT BELANGER, Procter & Gamble (Retired), West Chester, Ohio KEVIN CASSEL, University of Hawaii Cancer Center, Honolulu DIRK ELSTON, Medical University of South Carolina, Charleston KAREN GLANZ, University of Pennsylvania, Philadelphia CHRISTOPHER P. HIGGINS, Colorado School of Mines, Golden REBECCA D. KLAPER, University of Wisconsin–Milwaukee CARYS L. MITCHELMORE, University of Maryland Center for Environmental Science, Solomons ROBERT H. RICHMOND, University of Hawaii at Manoa EMMA J. ROSI, Cary Institute of Ecosystem Studies, Millbrook, New York KANADE SHINKAI, University of California, San Francisco PAUL WESTERHOFF, Arizona State University, Tempe CHERYL M. WOODLEY, National Oceanic and Atmospheric Administration, Charleston, South Carolina Staff EMILY TWIGG, Study Director, Ocean Studies Board VANESSA CONSTANT, Associate Program Officer, Ocean Studies Board SUSAN ROBERTS, Director, Ocean Studies Board CLIFFORD DUKE, Director, Board on Environmental Studies and Toxicology CAROLYN SHORE, Senior Program Officer, Health and Medicine Division TRENT CUMMINGS, Senior Program Assistant, Ocean Studies Board (until June 2021) GRACE CALLAHAN, Program Assistant, Ocean Studies Board Prepublication Copy v

OCEAN STUDIES BOARD Members CLAUDIA BENITEZ-NELSON (Chair), University of South Carolina, Columbia MARK R. ABBOTT, Woods Hole Oceanographic Institution, Woods Hole, Massachusetts ROSIE ‘ANOLANI ALEGADO, University of Hawaii at Manoa CAROL ARNOSTI, University of North Carolina at Chapel Hill AMY BOWER, Woods Hole Oceanographic Institution, Woods Hole, Massachusetts LISA CAMPBELL, Duke University, Durham, North Carolina THOMAS S. CHANCE, ASV Global, LLC (Retired), Broussard, Louisiana DANIEL COSTA, University of California, Santa Cruz JOHN DELANEY, University of Washington (Retired), Seattle TIMOTHY GALLAUDET, Ocean STL Consulting, LLC, North Beach, Maryland SCOTT GLENN, Rutgers University, New Brunswick, New Jersey MARCIA ISAKSON, The University of Texas at Austin LEKELIA JENKINS, Arizona State University, Tempe NANCY KNOWLTON (NAS), Smithsonian Institution (Retired), Washington, District of Columbia ANTHONY MACDONALD, Monmouth University, West Long Branch, New Jersey GALEN MCKINLEY, Columbia University, Lamont-Doherty Earth Observatory, New York, New York THOMAS MILLER, University of Maryland Center for Environmental Science, Solomons S. BRADLEY MORAN (Ex-Officio Member), University of Alaska Fairbanks RUTH M. PERRY, Shell Exploration & Production Company, Houston, Texas DEAN H. ROEMMICH, Scripps Institution of Oceanography, San Diego, California JAMES SANCHIRICO, University of California, Davis MARK J. SPALDING, The Ocean Foundation, Washington, District of Columbia PAUL WILLIAMS, Suquamish Indian Tribe, Seattle, Washington Staff SUSAN ROBERTS, Director STACEE KARRAS, Senior Program Officer KELLY OSKVIG, Senior Program Officer EMILY TWIGG, Senior Program Officer MEGAN MAY, Associate Program Officer (until January 2022) ALEXANDRA SKRIVANEK, Associate Program Officer (until February 2022) VANESSA CONSTANT, Associate Program Officer SHELLY-ANN FREELAND, Financial Business Partner (until January 2022) KENZA SIDI-ALI-CHERIF, Senior Program Assistant (until April 2022) ELIZABETH COSTA, Program Assistant GRACE CALLAHAN, Program Assistant vi Prepublication Copy

BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY Members FRANK W. DAVIS (Chair), University of California, Santa Barbara ANN M. BARTUSKA, U.S. Department of Agriculture (retired), Washington, District of Columbia DANA BOYD BARR, Emory University, Atlanta, Georgia GERMAINE M. BUCK LOUIS, George Mason University, Fairfax, Virgina FRANCESCA DOMINICI, Harvard University, Boston, Massachusetts GEORGE GRAY, The George Washington University, Washington, District of Columbia R. JEFFREY LEWIS, ExxonMobil Biomedical Sciences, Inc., Annandale, New Jersey LINSEY C. MARR, Virginia Polytechnic Institute and State University, Blacksburg MARIE LYNN MIRANDA, University of Notre Dame, Indiana R. CRAIG POSTLEWAITE, U.S. Department of Defense, Burke, Virginia REZA J. RASOULPOUR, Corteva Agriscience, Indianapolis, Indiana JOSHUA TEWKSBURY, Smithsonian Tropical Research Institute, Panamá SACOBY M. WILSON, University of Maryland, College Park TRACEY JEAN WOODRUFF, University of California, San Francisco Staff CLIFFORD S. DUKE, Director RAYMOND A. WASSEL, Scholar and Director of Environmental Studies KATHRYN GUYTON, Senior Program Officer NATALIE ARMSTRONG, Associate Program Officer LAURA LLANOS, Finance Business Partner LESLIE BEAUCHAMP, Program Assistant THOMASINA LYLES, Program Assistant Prepublication Copy vii

BOARD ON HEALTH SCIENCES POLICY Members1 SHARON TERRY (Chair), Genetic Alliance DAVID BLAZES, Bill & Melinda Gates Foundation ROBERT CALIFF, Duke University, Verily Life Sciences ARAVINDA CHAKRAVARTI, New York University Langone Health LINDA HAWES CLEVER, California Pacific Medical Center; RENEW BARRY S. COLLER, The Rockefeller University BERNARD A. HARRIS, JR., Vesalius Ventures MARTHA N. HILL, Johns Hopkins University School of Nursing FRANCES E. JENSEN, Medicine Translational Neuroscience Center, University of Pennsylvania Perelman School of Medicine STORY C. LANDIS, National Institute of Neurological Disorders and Stroke (Emerita) FRANK R. LIN, Johns Hopkins Cochlear Center for Hearing and Public Health SUZET M. MCKINNEY, Sterling Bay LYNNE D. RICHARDSON, Icahn School of Medicine at Mount Sinai Health System DIETRAM SCHEUFELE, University of Wisconsin–Madison UMAIR A. SHAH, Harris County Public Health ROBYN I. STONE, LeadingAge MATHEW WYNIA, University of Colorado Denver Study Staff CLARE STROUD, Senior Director (from July 2022) ANDREW M. POPE, Senior Director (until July 2022) CAROLYN SHORE, Senior Program Officer 1 Roster reflects membership and affiliations in 2021. viii Prepublication Copy

Reviewers This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals for their review of this report: ADEWOLE ADAMSON, The University of Texas at Austin KAREN AKERLOF, George Mason University WILLIAM ARNOLD, University of Minnesota BRYAN W. BROOKS, Baylor University ALLEN G. BURTON, University of Michigan GRAHAM A. COLDITZ (NAM), Washington University in St. Louis SILVIA DÍAZ-CRUZ, Institute of Environmental Assessment and Water Research MICHAEL DOURSON, Toxicology Excellence for Risk Assessment KERRY HANSON, University of California, Riverside CHRISTOPHER HOLMES, Applied Analysis Solutions NANCY KNOWLTON (NAS), Smithsonian Institution PETRA KUNZ, Swiss Federal Office for the Environment HENRY W. LIM, Henry Ford Health System ROBYN L. TANGUAY, Oregon State University MARK R. WIESNER (NAE), Duke University Although the reviewers provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by JUDITH E. McDOWELL, Woods Hole Oceanographic Institution, and DANNY D. REIBLE (NAE), Texas Tech University. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies. Prepublication Copy ix

Acknowledgments This report was greatly enhanced by a number of public information-gathering meetings during the study process. The committee would like to thank all of the experts who presented during these meetings: Eric Adams, Massachusetts Institute of Technology; Adewole Adamson, The University of Texas at Austin; Tom Augspurger, U.S. Fish and Wildlife Service; Larry Barber, U.S. Geological Survey; Tim Bargar, U.S. Geological Survey; Lisa Bishop, Friends of Hanauma Bay; Lee Blaney, University of Maryland, Baltimore County; Autumn Blum, Stream2Sea; Narrissa Brown, U.S. Fish and Wildlife Service; Emily Burns, Personal Care Products Council; Annaleise Conway, University of Maryland Center for Environmental Sciences; Michael Cummings, Hawaii Department of Health; Iain Davies, Personal Care Products Council; Scott Dyer, LeTourneau University; Michelle Embry, Health and Environmental Sciences Institute; Michael Gonsior, University of Maryland Center for Environmental Science; Adele Green, QIMR Berghofer Medical Research Institute; Patricia Holden, University of California, Santa Barbara; Dawn Holman, Centers for Disease Control and Prevention; Kurunthachalam Kannan, NYU Langone Health; Michael Kaplan, Melanoma Research Alliance; Arturo Keller, University of California, Santa Barbara; Marc Léonard, L’Oreal Advanced Research; Len Lichtenfeld, American Cancer Society (Retired); Henry Lim, Henry Ford Health Center; Germaine Buck Louis, George Mason University; Rebecca Luria, Hawaii Dermatological Society; Natasha Atanaskova Mesinkovska, University of California, Irvine; Theresa Michele, U.S. Food and Drug Administration; Jennifer Moore, National Oceanic and Atmospheric Administration; Erinn Muller, Mote Marine Laboratory; Andrew Negri, Australian Institute of Marine Science; Elissa O’Malley, PhD from University of Queensland; Joan Oppenheimer, Stantec; Jennifer Orme-Zavaleta; U.S. Environmental Protection Agency; Frank Perna, National Cancer Institute, National Institutes of Health; João Pestana, Universidade de Aveiro; Véronique Poulsen, L’Oréal Environmental Safety; Sandy Raimondo, U.S. Environmental Protection Agency; Abigail Renegar, Nova Southeastern University; Kurt Reynertson, Johnson & Johnson; Dietram Scheufele, University of Wisconsin–Madison; Daniel Schlenk, University of California, Riverside; Craig Sinclair, Cancer Council Victoria; Suzanne van Drunick, U.S. Environmental Protection Agency; Shuai Xu, Northwestern University. Prepublication Copy xi

Preface It is now broadly recognized that aquatic environments—both marine and fresh water—have undergone substantial degradation over recent decades and remain under threat. Global and local stressors combine to alter and degrade the condition of these vital ecosystems. The recent National Academies consensus study on Interventions to Increase the Resilience of Coral Reefs2 is one example that highlighted the immense threat from global climate change to coral reefs, and described how local conditions, among other things, can influence reef resilience to this global-scale threat. Without a doubt, a variety of compounds present in the mixture of chemical pollution entering our environments are a contributing cause of ecological decline. An emerging target of possible concern has been ultraviolet (UV) filters, which notably comprise the “active” ingredients in sunscreens. This collection of slightly over a dozen diverse compounds can be carried into the water on human skin when used to protect the skin from injury from the sun’s ultraviolet radiation. In addition, these compounds can enter waterways with the wide array of other chemicals in our wastewater. It was to better understand the potential risk of UV filters on our already threatened aquatic environments, and the potential consequence to human health should sunscreen usage or composition be modified, that the National Academies was tasked by Congress and funded by the U.S. Environmental Protection Agency (EPA) to undertake this consensus study. Addressing environmental and human health issues increasingly involves holistic thinking and approaches that integrate human and ecological considerations. All consensus panels of the National Academies are comprised of teams of scientists representing the scope of expertise needed to address complex questions and the range of differing perspectives when alternative approaches to those questions have been articulated. The demands of this task stretched the typical bounds of even that norm: On the one hand, we needed experts in the many disciplines pertinent to environmental assessment in aquatic environments of all types. On the other hand, we needed expertise in dermatology, cancer prevention, behavioral science, and human epidemiology. We were challenged in our work by the COVID-19 pandemic, which precluded the face-to-face interactions that most readily facilitate such diverse groups to coalesce around the statement of task, and fully realize the potential of team science. Using our first sessions to fact-find with invited guests from around the world—perhaps the one advantage of Zoom!—to present both evidence and perspectives, we tiptoed our way into the water. We were then faced with integrating several workstreams into a coherent narrative with all of its supporting data. While challenging, our work showed that this was possible, with concerted effort to reach a shared understanding. Especially important to achieving our goals were ongoing and indepth exchanges concerning the applicability, strengths, and limitations of the underlying science relevant to the task. In the end, we have met the challenge set forth by the statement of task, and are pleased to present it to EPA and to the public. Of course, this would have been impossible without the incredible efforts of our staff team—led by Emily Twigg and Vanessa Constant—as well as the support of the staff and leadership of the National Academies, more broadly. We are worn out after this 18-month journey, but also proud to present the pages that follow, with the hope—indeed, expectation—that they will accelerate the effort to meet the dual goals: safety to the environment and protecting humans from the noxious effects of the sun. Charles A. Menzie, Chair Mark R. Cullen, Vice-Chair Committee on Environmental Impact of Currently Marketed Sunscreens and Potential Human Impacts of Changes in Sunscreen Usage 2 See https://www.nationalacademies.org/our-work/interventions-to-increase-the-resilience-of-coral-reefs. Prepublication Copy xiii

Contents SUMMARY ......................................................................................................................................................... 1 1 INTRODUCTION ................................................................................................................................... 12 Study Task and Approach, 14 Ecological Risk Assessment, 17 Regulation of Sunscreens in the United States, 18 Data Quality Assessment in Decision Making, 20 2 INTRODUCTION TO SUNSCREENS AND THEIR UV FILTERS ................................................. 22 Physical and Chemical Profiles, 22 Modes of Action for Skin Protection, 25 UV Filters in Sunscreen Formulations, 26 Inventory and Uses of UV Filters, 31 Findings and Knowledge Gaps, 37 3 PROBLEM FORMULATION: SOURCES, SETTINGS, AND ECOLOGICAL RECEPTORS .............................................................................................................. 38 Problem Formulation, 38 Sources and Inputs of UV Filters into the Environment, 39 Environmental Settings and Routes of UV Filter Exposure, 61 Ecological Receptors and Ecosystem Services, 66 Findings and Knowledge Gaps, 68 4 FATE, TRANSPORT, AND POTENTIAL EXPOSURE IN THE ENVIRONMENT ...................... 70 Fate Characteristics of UV Filters, 71 Physical Factors and Spatial Relationships, 84 Estimated and Measured Concentrations in Water and Sediments, 85 Analytical Chemistry Considerations, 98 Findings and Knowledge Gaps, 102 5 BIOACCUMULATION AND MEASURED CONCENTRATIONS OF UV FILTERS IN BIOTA ............................................................................................................................. 105 How Bioaccumulation Information Is Used in Risk Assessment, 105 Bioaccumulation of UV Filters, 105 Exposure Beyond Aquatic Ecosystems, 121 Findings and Knowledge Gaps, 122 6 REVIEW OF STUDIES ON THE EFFECTS OF UV FILTERS IN AQUATIC ENVIRONMENTS ................................................................................................................................ 123 How Effects Information Is Used in Ecological Risk Assessments, 123 Acute Toxicity QSAR Overview, 125 Committee Approach to Toxicity Data Relevance and Reliability for ERA, 127 Investigations on the Toxicity of Organic UV Filters to Aquatic Organisms, 129 Investigations on the Toxicity of Inorganic UV Filters to Aquatic Organisms, 135 Syntheses of UV Filter Toxicity Data, 139 Studies Informing Mode(s) of Action, 149 Potential for Effects on Threatened and Endangered Species, 151 Community and Ecosystem Effects, 154 Prepublication Copy xv

Contents Effects of UV Filters in the Context of Multiple Stressors, 157 Findings and Knowledge Gaps, 161 7 SUNSCREEN, PREVENTIVE HEALTH BEHAVIORS, AND IMPLICATIONS OF CHANGES IN SUNSCREEN USE FOR PUBLIC HEALTH .................................................... 163 Ultraviolet Radiation and Skin Damage, 163 Sunscreen Efficacy, Safety, and Use, 167 Correlates of Sunscreen Use and Changes in Sunscreen Use, 176 Potential Changes to Sunscreen Use and the Human Health Consequences, 180 Findings and Knowledge Gaps, 182 8 CONCLUSIONS AND RECOMMENDATIONS ............................................................................... 184 Summary of Information on Each UV Filter, 184 Conclusions, 192 Recommendations, 194 Managing Human and Environmental Health, 195 APPENDIXES A Committee Member Biographies .................................................................................................................. 197 B UV Filter Usage ............................................................................................................................................ 203 C UV Filter Water and Sediment Occurrence Data .......................................................................................... 211 D Supplementary Information for Bioaccumulation......................................................................................... 250 E UV Filter Toxicity Data ................................................................................................................................ 273 F Studies on Behavioral and Physiological Endpoints on Select Organic UV Filters ...................................... 317 G Acronyms, Abbreviations, and Units ............................................................................................................ 340 REFERENCES ............................................................................................................................................... 343 xvi Prepublication Copy

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Regular use of sunscreens has been shown to reduce the risk of sunburn and skin cancer, and slow photoaging of skin. Sunscreens can rinse off into water where people are swimming or wading, and can also enter bodies of water through wastewater such as from bathing or showering. As a result, the ultraviolet (UV) filters - the active ingredients in sunscreens that reduce the amount of UV radiation on skin - have been detected in the water, sediment, and animal tissues in aquatic environments. Because the impact of these filters on aquatic ecosystems is not fully understood, assessment is needed to better understand their environmental impacts.

This report calls on the U.S. Environmental Protection Agency to conduct an ecological risk assessment of UV filters to characterize the possible risks to aquatic ecosystems and the species that live in them. EPA should focus on environments more likely to be exposed such as those with heavy recreational use, or where wastewater and urban runoff enter the water. The risk assessment should cover a broad range of species and biological effects and could consider potential interacting effects among UV filters and with other environmental stresses such as climate change. In addition, the report describes the role of sunscreens in preventing skin cancer and what is known about how human health could be affected by potential changes in usage. While the need for a risk assessment is urgent, research is needed to advance understanding of both risks to the environment from UV filters and impacts to human health from changing sunscreen availability and usage.

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