Perspective on Health Effects of Endocrine Disruptors with a Focus on Data Gaps.

Screening for endocrine disrupting properties at the molecular and cellular level is developing rapidly, but can epidemiology bridge the gap to human health impact? Reviews by the World Health Organization and the United States Endocrine Society listed diseases which may be related to endocrine disrupting chemicals (EDCs). Much of the evidence relating these diseases to EDCs is from animal and epidemiological studies, many with significant weaknesses. What human health data sources are available? Some examples are provided from Nordic countries, Denmark, France, Switzerland, and the United States. Health register shortcomings are noted, including diagnostic criteria and "signal-to-noise" ratio (high background incidence rates). Issues with exposure assessment (human biomonitoring), data governance (FAIR principles), legislative hurdles, and patient consent are also illustrated. For all the above reasons, it is clear why generating reliable long-term data for human diseases putatively associated with EDCs has not yet been achieved and thus why it is difficult to bridge the gap between molecular/cellular/animal toxicity data and human health risks of EDCs. This will require international cooperation, sustained support, and public acceptance.