Required reading for endocrinologists? Some key points from the Endocrine Society’s first Scientific Statement

July 23, 2009 at 8:21 am | Posted in Briefing | Leave a comment
Prostate cancer - one of many diseases linked to EDCs. Picture by National Institutes of Health.

Prostate cancer - one of many diseases linked to EDCs. Picture by National Institutes of Health.

Last month, the Endocrine Society published its first Scientific Statement on endocrine disrupting chemicals (EDCs). [Endocrine Reviews 30(4):293-342, Diamanti-Kandarakis E et al. – download here].

The importance of the Statement cannot be understated: this is a leading medical/scientific body publishing a definitive statement about what we know about the risks posed by EDCs and how best to limit and manage them.

Endocrine disruptors have been making the news recently, particularly in the form of the plastic packaging and food tin lining additive bisphenol-A (BPA), which interferes with oestrogen pathways in the body. There are, however, many other EDCs out there – unregulated, biologically active at extremely low concentrations, with unknown health consequences.

Some of the key points to understand about EDCs are outlined below. From the Society’s own summary of its report, the emphasis on complexity of EDC interactions in the body is very striking:

An endocrine-disrupting substance is a compound, either natural or synthetic, which through environmental or inappropriate developmental exposures alters the hormonal and homeostatic systems that enable the organism to communicate with and respond to its environment.

Issues key to understanding the mechanisms of action and consequences of exposure to endocrine disrupting chemicals include age at exposure, latency from exposure, the mixture of chemicals, dose-response dynamics, and long-term latent effects. […]

The evidence for adverse reproductive outcomes (infertility, cancers, malformations) from exposure to endocrine disrupting chemicals is strong, and there is mounting evidence for effects on other endocrine systems, including thyroid, neuroendocrine, obesity and metabolism, and insulin and glucose homeostasis.

Michael Lerner, vice-chair of the Collaborative on Health and the Environment (CHE) and President of Commonweal, a health and environmental research institute, recently highlighted 13 points in the report which he considers of particular importance. Six of these are as follows (the full list is available on request):

Note: Michael highlighted the important sections via email to the CHE listservs. CHE is an excellent source of information and discussion. For more information about signing up, go here.

Chapter 3. Relevance to medicine. “The field of endocrine disruption has particular pertinence to endocrinologists…The properties of these substances are particulary well suited for study by endocrinologists.” (page 4)

Chapter 6. Impacts of EDCs on female reproduction. These include polycystic ovarian syndrome, aneuploidy, POF, reproductive tract anomalies, uterine fibroids, endometriosis, and ectopic gestation. A treasure-trove of the best science condensed into five pages (pages 8-13).

Chapter 8. Male reproductive and developmental health. The focus is on disrupted reproductive function, manifest as reduced semen quality and infertility, altered fetal development, including hypospadias and cryptorchidism, and testicular germ cell cancer. Pthalates, PCBs, dioxins, and pesticides are each discussed as they impact semen quality. (pages 16-19)

Chapter 9. Prostate cancer and benign prostatic hyperplasia. Pesticides, environmental estrogens including DES, BPA, PCBs, , UV filters in sunscreens, cadmium, arsenic, vinclozin, DDT/DDE, are each discussed, with a note box with recommendations for prostate cancer research. (pages 19-22)

Chapter 12. Environmental chemical, obesity and metabolism. A wide-ranging and important section which uses DES in rodent studies as a poster-child and illustrates non-linear dose/response curves for EDCs with an important cautionary section on phytoestrogens like genistein in soy. At low levels these inhibit lipogenesis but at high levels they promote it. (page 33)

Chapter 13. Recommendations for the future. The need to link basic research to clinical practice, EDCs and the public, the need for a robust program of prevention using the precautionary principle for guidance, a call to TES to lobby for regulation seeking to decrease human exposure to EDCs, and this final statement:

Our chemical policies at the local, state and national levels, as well as globally, need to be formulated, financed and implemented to ensure the best public health.

H&E maintains a news and science feed for endocrine disruptors, which you can view here at del.icio.us or monitor using this RSS feed.

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