A Global Perspective
on Endocrine Disruption, with Comments on the US Experience.
Robert Kavlock,
National Health and Environmental Effects Research Laboratory, USEPA
The last two decades
have witnessed a growing concern for chemicals that have the potential
to adversely affect the normal functioning of the endocrine system. The
International Programme on Chemical Safety (IPCS) of the World Health
Organization has recently reviewed the current state-of-the-science on
this controversial topic from a global perspective. After analysis of
more than 1500 peer reviewed research papers covering the range of modes
of action by which hormonal function can be altered, reports of adverse
outcomes in humans and wildlife populations, and exposure sources and
pathways, the IPCS noted that although the evidence that human health
has been adversely affected is weak, there is sufficient evidence to conclude
that adverse effects have occurred via this mechanism in some wildlife
species. A unique feature of the assessment is the development of a framework
for evaluating diverse data sets utilizing objective criteria to evaluate
the extent to which causality between an exposure to an endocrine disrupting
chemical (EDC) and a particular health outcome has been established. The
framework begins with a clear statement of hypothesis regarding some health
outcome (e.g., endometriosis) and some stressor (e.g., dioxins and PCBs).
The available data is then evaluated along five dimensions: temporality,
strength of the association, consistency of the observations, biological
plausibility of the effect, and evidence for recovery following diminution
of the stressor. Based on the overall strength of the evidence, an assessment
is made regarding the validity of the hypothesis and, separately, the
likelihood that an endocrine effect caused by the stressor was involved
in the etiology. A number of examples using the framework were provided.
The review concluded that studying endocrine disruption must remain a
global priority and identified a number of research needs, including improved
coordination and international cooperation, and monitoring and effects
studies in potentially vulnerable populations.
At the US Environmental
Protection Agency (EPA), attention is focused on validating a battery
of screening tests for the identification of chemicals with endocrine
disrupting potential. The outlined screening approach includes a number
of in vitro (ligand binding and transcriptional activation) and in vivo
(uterotrophic, Hershberger, female pubertal development, fish reproduction
and amphibian metamorphosis) assays. Collectively, the battery is intended
to efficiently identify chemicals with potential to alter estrogenic,
androgenic and/or thyroid hormone function and which should be put through
a subsequent tier of more definitive testing. These assays are being standardized
and evaluated using a core set of chemicals in multiple laboratories in
order to judge their relevance, reliability and sensitivity to detecting
endocrine disruption. Using a number of criteria (e.g., production volumes,
environmental persistence, known health effects, and quantitative structure-activity
relationships for ligand binding), the first 200 chemicals to be submitted
for screening will be proposed by the EPA in December 2002. In the meantime,
EPA regards endocrine disruption as a mode of action and uses this information
where possible in its risk assessment and risk management decisions. One
of the more contentious issues relates to shape of the dose-response curve
for endocrine disruptor modes of action. Recently, EPA issued an interim
policy that given the current state-of-the-science, it is premature to
require testing for substances for low-dose effects within the screening
program. The EPA is also beginning to develop risk management options
in the event that the screening and testing programs identifies chemicals
of concern. Elements of the risk management evaluation process will be
discussed.
[This is an abstract of a presentation and does not represent EPA policy].
presentation