Ringvold S, Røttingen J A
Norges Naturvernforbund, Oslo.
Tidsskr Nor Laegeforen. 1997 Jan 10;117(1):66-70.
Lately, a theory on possible oestrogenic effects of environmental contaminants like PCB, dioxin and some pesticides, has caused much concern. The "oestrogen theory" states that persistent, bioaccumulating chemicals affect foetal development by acting like oestrogens. This results in permanent changes, of the reproductive organs in particular, and leads to reduced reproductive success. The theory is based to a large degree on reports on animals from the Great Lakes region in North America, alligators from Florida and fish from rivers in Great Britain. Now that a decline in human semen quality over the last 50 years has been reported, the question has been raised as to whether this too may be a result of environmental oestrogens. The higher incidence of other diseases like hypospadia, cryptorchidism and testicular cancer also indicates that something may be affecting the reproductive health of the male. Whether the higher incidence of endometriosis and breast cancer can be explained by the hypothesis is questioned. That several environmental contaminants have oestrogenic effects, has been documented. Recent studies have shown that the contaminants have more general endocrine-disrupting effects, thereby indicating that the oestrogen model is too simple. It is a dilemma for environmental medicine whether the present knowledge gives sufficient reason to apply precautionary principle and demand specific regulations.
最近，一种关于多氯联苯、二恶英和某些农药等环境污染物可能具有雌激素效应的理论引发了诸多关注。“雌激素理论”认为，持久性、生物累积性化学物质通过类似雌激素的作用影响胎儿发育。这会导致永久性变化，尤其是生殖器官的变化，并导致生殖成功率降低。该理论在很大程度上基于来自北美五大湖地区的动物、佛罗里达的短吻鳄以及英国河流中的鱼类的报告。鉴于有报道称过去50年人类精液质量有所下降，人们提出了这是否也可能是环境雌激素所致的问题。尿道下裂、隐睾症和睾丸癌等其他疾病发病率的上升也表明，可能有某种因素正在影响男性的生殖健康。子宫内膜异位症和乳腺癌发病率的上升是否能用该假说来解释也受到质疑。已有文献证明几种环境污染物具有雌激素效应。最近的研究表明，这些污染物具有更广泛的内分泌干扰作用，从而表明雌激素模型过于简单。对于环境医学来说，目前的知识是否足以成为应用预防原则并要求制定具体法规的充分理由，这是一个两难问题。
