Public Health Services, Israel Ministry of Health, Jerusalem, Israel.
Isr J Health Policy Res. 2012 Aug 28;1(1):34. doi: 10.1186/2045-4015-1-34.
Nearly two decades ago, researchers first reported that endocrine disrupting chemicals in the environment were affecting reproductive health in the general population. The purpose of this article is to examine the evidence of adverse reproductive health trends in Israel and to explore implications for environmental health policy in Israel. We reviewed studies and data in Israel regarding trends in reproductive health indices, specifically: breast and testis cancer, hypospadias, sperm quality, male factor infertility, and age at menarche. The data provide some evidence of adverse reproductive trends in the Israeli population: an increase in testicular cancer from 1990 to 2007, a decrease in age at menarche from 1986 to 2000, an increase in the prevalence of male factor infertility, and some evidence of decreasing sperm counts. However, we note that much of the evidence is limited.The policy implications of reported adverse reproductive health trends possibly related to environmental exposure have been radically different in Europe and the United States. In Europe, such reports led the Parliament of the European Community to adopt a resolution on endocrine disruptors, which emphasizes the application of the Precautionary Principle. U.S. Environmental Protection Agency policy is focused on screening chemicals for endocrine disrupting properties and does not specifically refer to the Precautionary Principle. To date, there has been no formal governmental policy or strategy in Israel regarding endocrine disrupting chemicals. Environmental health policy on endocrine disruptors requires integrating evidence on human reproductive health trends, evidence on adverse reproductive outcomes in wildlife and experimental systems, and data from biomonitoring studies. Despite gaps in evidence and current data, we support a precautionary approach to regulating potential endocrine disrupting chemicals and reducing public exposures, especially in sensitive groups such as children and pregnant women.
近二十年前，研究人员首次报告称，环境中的内分泌干扰化学物质正在影响普通人群的生殖健康。本文旨在检查以色列不良生殖健康趋势的证据，并探讨其对以色列环境健康政策的影响。我们回顾了以色列关于生殖健康指标趋势的研究和数据，特别是：乳腺癌和睾丸癌、尿道下裂、精子质量、男性因素不孕以及初潮年龄。这些数据提供了一些以色列人群生殖不良趋势的证据：睾丸癌从 1990 年到 2007 年增加，初潮年龄从 1986 年到 2000 年下降，男性因素不孕的患病率增加，以及精子数量减少的一些证据。然而，我们注意到，大部分证据都很有限。与环境暴露可能相关的不良生殖健康趋势的报告对欧洲和美国的政策影响截然不同。在欧洲，此类报告促使欧洲共同体议会通过了一项关于内分泌干扰物的决议，该决议强调了预防原则的应用。美国环境保护署的政策侧重于筛选具有内分泌干扰特性的化学品，并未特别提及预防原则。迄今为止，以色列尚未制定关于内分泌干扰化学物质的正式政府政策或战略。内分泌干扰物的环境健康政策需要整合人类生殖健康趋势的证据、野生动物和实验系统中不良生殖结果的证据以及生物监测研究的数据。尽管证据和现有数据存在差距，但我们支持采取预防措施来监管潜在的内分泌干扰化学物质，并减少公众暴露，特别是在儿童和孕妇等敏感群体中。
