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 So-called endocrine disrupting chemicals upset the body’s hormone
balance. They can have adverse developmental, reproductive,
neurological, and immune effects in both humans and wildlife,
according to the National Institute of Environmental Health
Sciences.
Exposure to these chemicals - found in plastic bottles, metal food
cans, detergents, flame retardants and cosmetics - has been tied to
a wide array of diseases, including autism, diabetes and obesity,
said senior author Dr. Leonardo Trasande of the New York University
School of Medicine in New York City.
Trasande and colleagues looked at the cost of exposure to endocrine
disrupting chemicals in terms of two diseases of the uterus:
endometriosis and uterine fibroids.
In endometriosis, which affects up to one in 10 women, abnormal
growth of uterine tissue causes pain and disability.
Uterine fibroids, most common for women in their 40s and 50s, are
benign tumors that can cause heavy and painful periods and pain
during sex.
The researchers combined data from 12 European studies that measured
diphenyldichloroethene (DDE) exposure in women with fibroids. They
also looked at adult phthalate exposure and endometriosis.
To estimate women’s levels of these chemicals, they used findings
from two earlier studies in Europe – one that analyzed DDE levels in
women ages 15 to 54, and another that looked at urinary phthalate
concentrations in women ages 20 to 24.
Their cost estimates for treating fibroids came from national
databases in England, Germany and France. The data on costs of
treating endometriosis came from Belgium.
They attributed 56,000 cases of fibroids to DDE exposure among
European women in 2010, amounting to 163 million euros in economic
and healthcare costs, or US$185 million.
For endometriosis, the additional 145,000 cases attributed to
phthalates may have cost 1.25 billion euros or $1.42 billion U.S.,
the researchers reported in the Journal of Clinical Endocrinology
and Metabolism.
The strength of the evidence used to develop these estimates was
low, however, and the toxicological evidence linking the chemicals
to each outcome was only moderate.
Babies in the womb are particularly vulnerable to endocrine
disrupting chemicals, although that was not part of this analysis,
said Dr. Niels E. Skakkebaek, who studies these chemicals at the
University of Copenhagen in Denmark.
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Policymakers should be doing more to remove the chemicals from
circulation, he told Reuters Health by email.
“There’s still a substantial amount of uncertainly but ultimately
this provides some context for active policymaking in the EU,”
Trasande told Reuters Health by phone.
“The analysis was based in Europe but so far as we know for data
from the CDC, exposure is similar if not greater in the U.S. . . .
and costs are likely to be on the same order of magnitude or even
greater,” he said.
The results support ongoing efforts to update the Toxic Substances
Control Act of 1976, which addresses the production, importation,
use, and disposal of specific chemicals in the U.S., but it severely
outdated, Trasande said.
“Future research is clearly needed to understand the effects of
these chemicals,” he said.
“It is extremely difficult to avoid exposure,” said Elizabeth E.
Hatch, professor of epidemiology at Boston University School of
Public Health, who was not part of the new analysis.
One can limit exposure by trying to eat mostly organic or locally
grown food, by not eating canned foods, and by limiting use of
cosmetics or lotions or looking for products that are less harmful,
Hatch told Reuters Health by email.
The research team did not estimate the expense of replacing
endocrine disrupting chemicals with safer alternatives, but other
studies have suggested it would be on the order of billions of
dollars, so the net cost of making changes would be small, Trasande
said.
SOURCE: http://bit.ly/1PFzW3k Journal of Clinical Endocrinology and
Metabolism, online March 22, 2016.
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