Lamb James C, Boffetta Paolo, Foster Warren G, Goodman Julie E, Hentz Karyn L, Rhomberg Lorenz R, Staveley Jane, Swaen Gerard, Van Der Kraak Glen, Williams Amy L
Exponent, 1800 Diagonal Road, Suite #500, Alexandria, VA 22314, USA.
The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, 17 East 102 Street Floor West Tower, 5th Floor Room 5-142, New York, NY 10029, USA.
Regul Toxicol Pharmacol. 2014 Jun;69(1):22-40. doi: 10.1016/j.yrtph.2014.02.002. Epub 2014 Feb 13.
Early in 2013, the World Health Organization (WHO) released a 2012 update to the 2002 State of the Science of Endocrine Disrupting Chemicals. Several significant concerns have been identified that raise questions about conclusions reached in this report regarding endocrine disruption. First, the report is not a state-of-the-science review and does not follow the 2002 WHO recommended weight-of-evidence approach. Second, endocrine disruption is often presumed to occur based on exposure or a potential mechanism despite a lack of evidence to show that chemicals are causally established as endocrine disruptors. Additionally, causation is often inferred by the presentation of a series of unrelated facts, which collectively do not demonstrate causation. Third, trends in disease incidence or prevalence are discussed without regard to known causes or risk factors; endocrine disruption is implicated as the reason for such trends in the absence of evidence. Fourth, dose and potency are ignored for most chemicals discussed. Finally, controversial topics (i.e., low dose effects, non-monotonic dose response) are presented in a one-sided manner and these topics are important to understanding endocrine disruption. Overall, the 2012 report does not provide a balanced perspective, nor does it accurately reflect the state of the science on endocrine disruption.
2013年初,世界卫生组织(WHO)发布了《2002年内分泌干扰化学物科学现状》的2012年更新版。已发现了几个重大问题,这些问题对该报告中有关内分泌干扰的结论提出了质疑。首先,该报告并非科学现状综述,也未遵循2002年WHO推荐的证据权重方法。其次,尽管缺乏证据表明化学物被因果性地确定为内分泌干扰物,但往往基于暴露或潜在机制就假定发生了内分泌干扰。此外,因果关系常常是通过呈现一系列不相关的事实来推断的,而这些事实总体上并未证明因果关系。第三,在讨论疾病发病率或患病率趋势时,未考虑已知病因或风险因素;在没有证据的情况下,将内分泌干扰归咎于此类趋势的原因。第四,对于所讨论的大多数化学物,剂量和效力都被忽略了。最后,有争议的话题(即低剂量效应、非单调剂量反应)以片面的方式呈现,而这些话题对于理解内分泌干扰很重要。总体而言,2012年报告没有提供一个平衡的观点,也没有准确反映内分泌干扰的科学现状。