Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
Independent Consultant, Frederick, MD, USA.
Nat Rev Endocrinol. 2023 Oct;19(10):600-614. doi: 10.1038/s41574-023-00872-x. Epub 2023 Aug 8.
Endocrine-disrupting chemicals (EDCs) are substances generated by human industrial activities that are detrimental to human health through their effects on the endocrine system. The global societal and economic burden posed by EDCs is substantial. Poorly defined or unenforced policies can increase human exposure to EDCs, thereby contributing to human disease, disability and economic damage. Researchers have shown that policies and interventions implemented at both individual and government levels have the potential to reduce exposure to EDCs. This Review describes a set of evidence-based policy actions to manage, minimize or even eliminate the widespread use of these chemicals and better protect human health and society. A number of specific challenges exist: defining, identifying and prioritizing EDCs; considering the non-linear or non-monotonic properties of EDCs; accounting for EDC exposure effects that are latent and do not appear until later in life; and updating testing paradigms to reflect 'real-world' mixtures of chemicals and cumulative exposure. A sound strategy also requires partnering with health-care providers to integrate strategies to prevent EDC exposure in clinical care. Critical next steps include addressing EDCs within global policy frameworks by integrating EDC exposure prevention into emerging climate policy.
内分泌干扰化学品(EDCs)是人类工业活动产生的物质,它们通过对内分泌系统的影响对人类健康造成危害。EDCs 给全球社会和经济带来了巨大负担。政策界定不明确或执行不力会增加人类接触 EDC 的机会,从而导致人类疾病、残疾和经济损失。研究人员表明,在个人和政府层面实施的政策和干预措施有可能减少 EDC 的接触。本综述描述了一套基于证据的政策行动,以管理、最小化甚至消除这些化学物质的广泛使用,更好地保护人类健康和社会。目前存在一些具体的挑战:定义、识别和优先考虑 EDC;考虑 EDC 的非线性或非单调特性;考虑到 EDC 暴露的潜在影响,这些影响直到生命后期才会显现;以及更新测试范例,以反映“现实世界”中化学物质的混合物和累积暴露。一个健全的策略还需要与医疗保健提供者合作,将预防 EDC 暴露的策略整合到临床护理中。下一步的关键步骤包括通过将 EDC 暴露预防纳入新兴的气候政策,在全球政策框架内解决 EDC 问题。