European Union data revealed that Women are facing a
potential risk of several reproductive disorders being exposed common chemicals
in the household and incurring huge public health cost.
Endocrine-disrupting compounds (EDCs) act
as covert bombers of environmental toxins on human body. They are ubiquitous in
our environment, entering our bodies without our knowledge-plastic linings in
cans, water bottles, toys and most recently in the thermal paper used in
cash register and gas pump
receipts.
The recent study led by
Patricia Hunt,
PhD, at Washington
State University
was published online March 22, 2016 in the
Journal of Clinical
Endocrinology & Metabolism. The
researchers found that exposure to controversial chemicals, like
phthalates and diphenyldichlorethene (DDE), increase a woman’s likelihood of
developing endometriosis and fibroids, causing reproductive health problems and
incurring a whopping sum of
estimated €1.4
billion ($1.5 billion) a year in health care expenditures and lost earning
potential to European Union.
Senior author Leonardo Trasande, MD, MPP, associate
professor of pediatrics, environmental medicine & population health at NYU Langone Medical Center, New York, opines that this is just the tip
of the iceberg of the entire female reproductive disease burden due to EDC.
Hunt and her colleagues identified other chemicals namely
dioxins and polychlorinated biphenyls (PCBs), among others -- but decided to
focus on phthalates and diphenyldichlorethene (DDE) as most robust set of data
existed for these chemicals.
DDE is a breakdown product of the insecticide DDT that,
although banned in the United States
in 1972 and in Europe starting in the 1970s
still lingers in the environment and enters our body through food. The main
exposure to phthalates is through eating food and drink stored in plastic
containers that have phthalates.
In both cases, the epidemiological evidence was low and
toxicological evidence was moderate but of all the total cases 20%–39% cases were attributed to these chemicals.
The researchers determined that
145,000 cases of endometriosis among women aged 20 to 44 years and 56,700 cases
of uterine fibroids in Europe could be
attributed to exposure to endocrine-disrupting chemicals.
In women 15-54 of age, the exposure to DDE was measured in
12 studies by taking a sample of cord blood. They then adapted an
Intergovernmental Panel on Climate Change (IPCC) model for determining the
probability of causation. The women were separated into groups according to
degree of exposure, with the lowest level used as the base and than the odds
ratio for developing fibroid was calculated.
The process for phthalate attributable endometriosis was
similar, but the investigators relied on data from a large biomonitoring study
called as DEMOnstration of a study to COordinate and Perform Human
biomonitoring on a European Scale (DEMOCOPHES). Human biomonitoring (HBM)
involves collecting samples from human volunteers – blood, hair, saliva or
urine – and measuring the levels of indicators of chemicals uptake (known as
biomarkers) that are of interest.
The authors further added that "Although it is highly
appropriate to focus on these extremely important uterine tract health
deficits, [polycystic ovary syndrome], infertility, and pregnancy complications
also affect a considerable number of women, have major cost implications, and
are increasingly linked to EDC exposures." For instance, phthalate
exposure has a 40% to 69% likelihood of causing 618,000 additional assisted
reproductive technology procedures each year, and a 20% to 69% likelihood of
causing 42,400 new cases of childhood obesity each year.
The director of the National Institute of Environmental
Health Sciences and the National Toxicology Program Linda S. Birnbaum said
“Some of these chemicals, including PCBs and dioxins, have already been
restricted through a treaty called the Stockholm Convention on Persistent
Organic Pollutants, which went into effect in 2004.”
The current study is important because it focused on
chemicals that have not been restricted, and in the case of DDE -- which
persists in the environment -- are not able to be restricted.
"This study is kind of a wake-up to say endocrine
disruptors impact the female reproductive system, and we have some evidence
they are associated with an increase in endometriosis and fibroids and it costs
a lot of money," Birnbaum said.
Not all researchers are convinced by the methodology. They
say that to imply causation based on current data is highly speculative because
most of the data is based on observational study and trials is human are hard
to do.
Even with all the questions that remain, and few regulations
in place, "there are safe and simple steps that families and women can
take to reduce exposure to endocrine-disrupting chemicals," Trasande said.
"They can eat organic, reduce canned food consumption,
which reduces exposure to BPA, and avoid packaged or highly processed food,
which is a major route for phthalates to enter food. They can also open windows
to allow chemical dust, which accumulates on the carpet and electronics, to
circulate out of homes."
Although the study had several limitations: it focused on
adult EDC exposure only; it relies on assumption of causation; and it focuses only
on two reproductive disorders and two EDCs, it does draws attention on urgent
need of further research , government
regulations and public awareness on the issue of toxic chemicals in the
environment.
References:
http://press.endocrine.org/doi/10.1210/jc.2015-2873
http://saferchemicals.org/health-report/chemicals-and-our-health/reproduction/
http://www.aboutlawsuits.com/endocrine-disruptor-women-study-97423/
https://www.endocrine.org/news-room/current-press-releases/womens-health-endocrine-disruptors-diabetes-research-will-be-in-spotlight-at-endo-2016
