Regulation of Endocrine-Disrupting Chemicals Insufficient to Safeguard Public Health

The following article, “The Metabolically Healthy but Obese Phenotype Is Associated With Lower Plasma Levels of Persistent Organic Pollutants as Compared With the Metabolically Abnormal Obese Phenotype” (JCEM 2014;99:E1061–E1066) is one of many new studies that links endocrine-disrupting chemicals (EDCs) to disease. The study reports that obese patients with higher blood levels of persistent organic pollutants (POPs) had significantly greater insulin resistance and worse measures of cardiovascular disease compared with obese patients with lower blood levels of POPs. POPs are toxic man-made chemicals used in agricultural, industrial, and manufacturing processes. The study authors suggest that POPs may contribute to the development of insulin resistance and cardiometabolic disease in obese patients. The good news is that POPs have been strictly regulated since the Stockholm Convention in 2004. The bad news is that these chemicals are still omnipresent and are even found in Arctic locations thousands of miles from known sources. Furthermore, there are many other chemicals with endocrine-disrupting effects that are underregulated or not regulated at all. In the United States, federal agencies including the Food and Drug Administration and the Environmental Protection Agency are responsible for identifying and regulating potentially hazardous chemicals. In the European Union (E.U.), the task falls largely to the European Commission, but with the added complexity of implementation at the national level. The Organisation for Economic Cooperation and Development provides a bridge between the U.S. and E.U. systems, establishing protocols that are agreed upon by all participating parties. In all these efforts, however, endocrinologists are woefully underrepresented, if they participate at all, in the processes of assessing and developing policies. As a result, established policies do not take into account critical endocrine principles. Through scientific publications, education, and awareness-raising efforts, the Endocrine Society is working to change this. Many well-designed, heavily reviewed, National Institutes of Health-funded studies show that exposure to even low doses of EDCs can have adverse effects during critical life periods when organisms may be most vulnerable, yet current regulations often disregard these findings. The Endocrine Society asserts that regulatory decisions on the use of EDCs should be made based on the best available science, and the Society has been joined in this call by other major health organizations. Endocrinologists have a valuable and unique insight into the impact of EDCs, and those actively engaged in the development of new knowledge in relevant disciplines should be involved in evaluating the weight of evidence of EDC studies as well as in the design and interpretation of studies that inform the regulation of EDCs. To this end, the Endocrine Society continues to call on policymakers to enhance screening programs for EDCs by incorporating well-defined and accepted principles of endocrinology. Furthermore, the Society urges policymakers to make sure endocrinologists have a seat at the table when determining effective chemical screening and regulatory measures. The Society is increasing knowledge and understanding of EDCs through publication of its 2009 Scientific Statement and 2012 Statement of Principles, EDC programming at ENDO, and ongoing advocacy efforts in the United States and abroad.