Endocrine Disruption

Sex and Gender-based Analysis of this topic

Definition
Endocrine disruption refers to one of the possible adverse health effects associated with exposure to a group of synthetic chemicals found in the environment. Endocrine disrupting chemicals (EDCs) can mimic or block natural hormones in wildlife and humans, interfering with how the endocrine system maintains and regulates itself and other biological systems of the body (e.g., central nervous, immune and metabolic systems, glands and organs) [1,2].
 
Exposure to minute concentrations of EDCs at crucial points in development, especially in utero and in early childhood, may lead to adverse health outcomes, including birth defects, learning disabilities, infertility, breast cancer and various other reproductive system cancers [1,3]. EDCs may affect biological systems at cellular, molecular and genetic levels, triggering the development of diseases and disorders that manifest long after exposure and that may be multi-generational [4]. 
 
EDCs are found in the air, soil, water and food and can accumulate in the fatty tissues of humans and wildlife and bioaccumulate (i.e., the accumulation of substances in an organism) up the food chain [1,4]. Some common EDCs are dioxin, polychlorinated biphenyls (PCBs), Bisphenol A, Phthalates, DDT; others come from sources such as fossil fuel combustion, cigarette smoke, plastics, paints, pharmaceuticals, personal care products, cleaning products, flame retardants and pesticides [4,5].
 
 
Sex Issues
Wildlife and laboratory animal studies as well as epidemiological studies of human populations indicate sex differences in the adverse health outcomes associated with EDCs [4]. For girls and women, evidence suggests that exposure to EDCs may cause spina bifida and congenital hip dislocation at birth, early puberty, polycystic ovarian syndrome (PCOS), uterine fibroids, endometriosis, impaired fertility or infertility, miscarriage, shorter gestation and lactation, breast cancer and cancers of the reproductive organs [6,7,8]. For boys and men, EDCs have also been linked with birth defects, impaired fertility and infertility, neurodevelopmental problems, and possibly cancer [3,9]. Many of these adverse health outcomes were first seen in association with in utero exposure to the drug diethylstilbestrol (DES), a synthetic estrogen originally prescribed to prevent miscarriage [10]. Studies of the effects of DES reinforce the relevance of animal studies to predict human health outcomes [4].
 
 
Gender Issues
Traditional gender roles in the family and the workplace are associated with different levels of exposure to EDCs [11,12]. Women continue to be the primary caregivers in families and are exposed to more EDCs from household cleaning products and other household contaminants, including contaminants brought into the home on the clothing and equipment of other family members (e.g., when family members work as miners, factory workers, or car mechanics) [8]. Women also use more cosmetics and other personal care products, many of which contain EDCs [13]. Workplaces that traditionally employ women are more likely to ignore or accept chemical hazards for their employees and non-traditional workplaces may not provide the necessary clean-up facilities for women [14]. Exposures to EDCs are significant health determinants for women and men themselves, as well as in their roles as parents or parents-to-be [15,16]. 
 
 
Diversity
EDCs are of greatest risk at specific stages of development or “windows of vulnerability” in the life cycle. However, other significant factors include race and ethnicity, geographic location and economic vulnerability. Incidences of cancer and levels of EDCs detected in body burden tests vary depending on race and ethnicity [8].  Living near an industrial area exposes residents to higher levels of many EDCs as demonstrated in the Aamjiwnaang First Nation near Sarnia, Ontario where the sex ratio of boys to girls in the community has declined significantly since the early 1990s [17,18]. Canada’s North is another area of concern due to the concentration of persistent organic pollutants (POPs) in colder climates [1,19]. Economic vulnerability is also a factor because people living in poverty or with low incomes are more likely to live in or near heavily polluted areas and may be unable to afford to buy organic food (i.e., to reduce exposure to pesticides). 
 
 
Critique
Full scientific certainty about the effects of EDCs is impossible due to the complexities of biological systems and the chemical interactions involved [1]. Much of the research on EDCs is carried out in the United States and internationally [20]. Canada-specific data are limited. For example, Canada does not currently have data from large-scale body burden testing [3]. 
 
Research on EDCs routinely includes sex disaggregated data; however, access to gender-based data on EDCs is limited. Initially, research on EDCs focused mainly on the developmental and reproductive system effects, but recent research broadens the areas of concern to include most other biological systems of the body and incorporates new protocols for the detection and evaluation of EDCs and combinations of EDCs [2]. Government policies and initiatives lag behind the research on EDCs and focus more on limiting the introduction of new EDCs or how individuals can avoid exposure rather than on phasing out or banning existing chemicals [21,22,23].
 
 
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health determinants > endocrine disruption