These 15 endocrine disruptors are as scary as carcinogens in life, but no one cares?

*It is only for medical professionals to read for reference.
Endocrine disruptors are dangerous, so they should be managed like carcinogens! 1 What substance is an endocrine disruptor? In 1962, Carson described the effects of dichlorodiphenyltrichloroethane on human sexual development and reproductive system [1].

This seemingly incomprehensible chemical substance has a more widely known name as "DDT".

Less than ten years later, Herbst recorded a group of patients with vaginal adenocarcinoma who used diethylstilbestrol before delivery [2].

The famous saying of Paracelsus, a Swiss medical scientist, chemist, and father of toxicology during the Renaissance, "dose-determining toxicity" became widely known under the impetus of these events-people's awareness of endocrine-disrupting chemicals (EDC) began Germination.

Figure 1 Philippus Aureolus Theophrastus Bombastus von Hohenhein Paracelsus, the father of toxicology.
In fact, it is not only large doses of chemicals or synthetic chemicals that may affect the human endocrine system.

The U.
S.
Food and Drug Administration has determined that more than 1,800 chemical substances may at least affect estrogen, androgen or thyroxine-related pathways [3], and European screening also suggests that there are at least 575 chemical substances that may interfere with the human body.
The endocrine system [4].

Many of these substances exist naturally, and may have varying degrees of impact on the human body at different doses.

Figure 2 The dose-response of EDC to the human body may be non-linear.
According to the definition of the U.
S.
Environmental Protection Agency (EPA), EDC is "an exogenous substance that interferes with the synthesis, secretion, transportation, metabolism, binding, or elimination of natural hormones in the body.
" Substances, and these hormones play a role in the body’s homeostasis, reproduction and development process" [5]. EDC not only poses a threat to public health or global health, it can even endanger the health of the entire planet.

EDC can be found everywhere, including food, packaging materials, cosmetics, drinking water and consumer products.

These substances are related to a variety of non-communicable diseases, such as obesity, type 2 diabetes, thyroid diseases, neurodevelopmental diseases, hormone-related cancers, and reproductive system diseases.

Figure 3 The American Endocrine Society issued a statement related to EDC As early as 2009, the American Endocrine Society issued a statement [5] discussing the impact of EDC on human health, calling for the strengthening of related research and the development of corresponding preventive measures.

In 2015, this statement was updated to the second edition [6, 7], emphasizing that the newly added evidence further confirms the adverse effects of EDC on people’s endocrine health.
I hope that this information can help supervision and decision-making-but it is really managed.
Are you up? Figure 4 "Lancet Diabetes Endocrinol" published a series of articles related to EDC.
On July 22, 2020, five years later, "Lancet Diabetes Endocrinol" also participated in the discussion of EDC and published two series of articles [8, 9].
The evidence of human EDC exposure-related health risks was discussed and the corresponding supervision, decision-making and preventive measures were discussed.
In the review article [10] released at the same time, people are called to act quickly-to manage EDC like a carcinogen! 2 Status: Which chemicals can disrupt endocrine? EDC has an impact on a series of endocrine glands or organs with endocrine functions in the human body.
With the increase in the number of studies related to EDC exposure, people's understanding of EDC and its effects on human health continues to deepen.

In the series of articles published this time by "Lancet Diabetes Endocrinol", it first summarized the substances that have been proven to have or may have an effect on endocrine[8], and then discussed the relationship between EDC and the economic burden of disease, and called for the reduction of EDC.
Exposed regulations and policies are introduced [9]. Figure 5 The endocrine glands that may be affected The current report discloses 15 substances that may interfere with human endocrine.
For example, there is sufficient evidence that perfluoroalkyl substances are associated with obesity, impaired glucose tolerance, gestational diabetes, and birth weight loss in children and adults.
, Decreased semen quality, polycystic ovary syndrome, endometriosis and breast cancer; there is also evidence that BPA is related to adult diabetes, decreased semen quality and polycystic ovary syndrome; phthalates and premature delivery , Boy’s anogenital distance shortened, childhood obesity and impaired glucose tolerance are related; organophosphorus pesticides are related to decreased semen quality; occupational pesticide exposure is related to the risk of prostate cancer; prenatal exposure to bisphenol A, organophosphate pesticides and polybrominated pesticides Burning agents are related to children's cognitive deficits and attention deficit disorders.

Fig.
6 EDC may cause obesity, diabetes, and cardiovascular disease.
Fig.
7 EDC may affect the ovaries.
Fig.
8 EDC may affect the biosynthesis of estrogen.
Fig.
9 EDC may affect the uterus, vagina and anterior pituitary gland.
Fig.
10 EDC may also affect the breast.
Fig.
11 EDC The effect on the breast is related to the timing of exposure.
Figure 12 EDC may affect the hypothalamic-pituitary-thyroid axis.
Figure 13 Many EDCs are similar in structure to thyroxine.
Figure 14 EDC may affect the hypothalamic-pituitary-adrenal axis and hypothalamic-pituitary-gonad axis.
Birth result: The growth of the fetus and the length of pregnancy have a major impact on the future health of the child, especially low birth weight and premature delivery.

More and more EDC has been proven to shorten the length of pregnancy, change the growth environment in the uterus, and interfere with the metabolic process.

The relationship between perfluoroalkyl substances and lower birth weight, phthalates and premature birth, and phthalates and shorter anogenital distances in boys is worth noting.

Neural development: Prenatal exposure to EDC will at least affect fetal neurodevelopment through interfering with thyroxine and sex hormones.

Prenatal exposure to polybrominated diphenyl ethers and organophosphorus pesticides is related to lower children’s IQ.
Polybrominated diphenyl ethers, bisphenol A, organophosphate pesticides and pyrethroids may cause behavioral problems in offspring.
Organophosphorus pesticides and pyrethroids Ester pesticides are also associated with autism spectrum disorders. Obesity and metabolic diseases: EDC destroys metabolic signal transduction pathways such as peroxisome proliferator activated receptors, estrogen receptors and thyroid hormone receptors, induces the expression of "thrifty phenotype" and increases future cardiovascular metabolism Disease risk.

Prenatal exposure to BPA is associated with childhood obesity, and perfluoroalkyl substances and phthalates may also increase the risk of childhood obesity.

Exposure to these substances in adulthood may increase the risk of gestational diabetes, impaired glucose tolerance, type 2 diabetes, and obesity.

Male reproductive system: Prenatal exposure to EDC may cause testicular hypoplasia, including hypospadias, cryptorchidism, testicular cancer, prostate cancer, low testosterone levels and poor semen quality.

The link between polybrominated diphenyl ethers and cryptorchidism, phthalates and low testosterone levels is worth noting.

In addition, occupational exposure to pesticides is related to prostate cancer, and bisphenol A, perfluoroalkyl substances, phthalates and organophosphorus pesticides are related to the deterioration of semen quality.

Female reproductive system: Female exposure to EDC can cause ovarian hypoplasia.
At the same time, polycystic ovary syndrome, endometriosis, uterine fibroids and genital cancer may all be related to EDC exposure.

Bisphenol A and perfluoroalkyl substances can increase the risk of polycystic ovary syndrome; phthalates can increase the risk of endometriosis, and it is also very likely to be mixed; breast cancer may be Caused by organophosphate pesticides and perfluoroalkyl substances.

Professor Leonardo Trasande, the corresponding author of the series of articles in Figure 15, although there is so much evidence, his actions have not kept up.

The corresponding author of the two articles [8, 9], Professor Leonardo Trasande from the Department of Pediatrics, New York University School of Medicine, pointed out in the second article that although these harmful chemicals may cause illness and disability, they are currently disrupting endocrine chemicals.
It is not regulated as a dangerous substance by legislation.
Although Europe and the United States have certain concerns about this, it is necessary to truly prevent endocrine-disrupting chemical substances from causing harm to human health.
International cooperation is required to actively identify the hazards and carry out follow-up supervision. 3 Call: Take action to protect everyone's health! In a review article published at the same time [10], the Lancet editorial department first reviewed a piece of history in the last century.

From July 26 to 28, 1991, 21 experts from various fields discussed the impact of industrial and agricultural chemicals on the endocrine system in Wisconsin, USA.
At this meeting, the concept of endocrine disruptors was first put forward.

Suddenly looking back more than thirty years, we have to lament the vicious eyes of those experts at that time.

In daily life, ordinary people can also start from all aspects of their lives to avoid exposure to EDC.

The Hormone Health Network of the Endocrine Society (The Hormone Health Network of the Endocrine Society) under the American Endocrine Society puts forward the following recommendations: Food and water: First find out whether the fish caught is edible; remove the fat from the fish and cook it.
Reduce possible fat intake during the process; thoroughly wash fruits and vegetables; do not use microwave heating plastic food containers or fill hot water; do not use plastic containers labeled #3, #6 and #7; reduce the consumption of canned and processed foods; May use glass, porcelain or stainless steel containers; try to eat at home and choose more fresh ingredients; consider using a water purifier; buy organic food as much as possible; use ceramic coated pots instead of old non-stick pots; change your diet.

Exercise and activities: Check the air quality before going out for exercise.
Do not go out for exercise when the pollution level is high; avoid exercising in crowded areas; stay away from busy roads.

Personal care: avoid products containing phthalates; choose products labeled as "phthalate-free", "bisphenol A-free" and "paraben-free"; avoid Essence, choose cosmetics that are "no synthetic fragrances" or "scented only with essential oils"; wash your hands before preparing food and eating; avoid contact with receipts and thermal paper.

Family life: If there is a well in the home, pay attention to whether there is oil film or odor; safely discard fluorescent lights and altered building materials; try not to get close to burning wood or garbage; repair lawns manually or electrically, and do not use gasoline-powered equipment; prohibit indoors Smoking, smoking in public places is prohibited; clean the floor regularly and remove the dust in the home; a variety of trees, filter out the gas and particulate matter in the air.

Parenting: Avoid second-hand plastic toys; use "BPA-free" baby formula bottles and toys.

Transportation: Choose short-term transportation methods and transportation routes; encourage school buses to reduce emissions and reduce idling to protect children.

EDC induces a series of endocrine-related diseases by imitating, blocking or interfering with normal hormones in the body, such as obesity, type 2 diabetes and thyroid disease.

In recent decades, the rapid increase in the incidence of these diseases cannot be fully explained by genetic factors.
In addition to the changes in people's living habits, the role of EDC in the environment cannot be ignored. As the review article [10] said, it is time to act in the face of these endocrine-disrupting chemicals! As a leader in the field of children’s environmental health, Professor Leonardo Trasande also proposed that it is necessary to establish an organization similar to the International Agency for Research on Cancer, overcome the current regulatory inertia, and promote the formulation of relevant global regulations-endocrine disruptors are harmful and should be carcinogenic.
Manage it like a thing! Reference source: [1] Carson R.
Silent spring.
Boston: Houghton Mifflin Company, 1962.
[2] Herbst AL, Ulfelder H, Poskanzer DC.
Adenocarcinoma of the vagina.
Association of maternal stilbestrol therapy with tumor appearance in young women.
N Engl J Med.
1971;284(15):878-881.
doi:10.
1056/NEJM197104222841604.
[3] Ding D, Xu L, Fang H, et al.
The EDKB: an established knowledge base for endocrine disrupting chemicals.
BMC Bioinformatics .
2010;11 Suppl 6(Suppl 6):S5.
Published 2010 Oct 7.
doi:10.
1186/1471-2105-11-S6-S5.
[4] European Commission.
Endocrine Disruptors.
2015.
Avaliable via https://ec .
europa.
eu/environment/chemicals/endocrine/documents/index_en.
htm#SubThemes5 on 2020-08-0.
[5] Diamanti-Kandarakis E, Bourguignon JP,