The present document is a short summary of the current knowledge of the effects of endocrine disrupters on child health. The main focus is on congenital disorders, cryptorchidism and hypospadias, which have an endocrine connection, on thyroid hormone-related problems, and on puberty. There is ample evidence of endocrine disruption in wildlife, and the mechanisms of action of endocrine disrupters have been elucidated in experimental animals, but there is limited knowledge of the association of human disorders with exposure to endocrine disrupters. Accumulating data suggest that many adult diseases have fetal origins, but the causes have remained unexplained. Improving fetal and child health will influence the whole life of an individual and improve the wellbeing of our society.
Effects of human exposure to hormone-disrupting chemicals examined in landmark UN report
An assessment of the state of the science of endocrine disruptors prepared by a group of experts for the United Nations Environment Programme (UNEP) and WHO
This document provides the global status of scientific knowledge on exposure to and effects of endocrine disrupting chemicals (EDCs).
The work is based on the fact that endocrine systems are very similar across vertebrate species and that endocrine effects manifest themselves independently of species. The effects are endocrine system related and not necessarily species dependent. Effects shown in wildlife or experimental animals may also occur in humans if they are exposed to EDCs at a vulnerable time and at concentrations leading to alterations of endocrine regulation. Of special concern are effects on early development of both humans and wildlife, as these effects are often irreversible and may not become evident until later in life. The third and final chapter of this document discusses exposure of humans and wildlife to EDCs and potential EDCs.
Glyphosate – Need for a robust and credible scientific assessment of carcinogenicity
Organisations across Europe have called on the European Commission to adopt the precautionary principle and ban the use of glyphosate due to its potential to cause cancer.
The Commission has a responsibility to protect its citizens from the potential harm that pesticides can cause and given the scientific lack of consensus that glyphosate is not harmful and the recent WHO classification of glyphosate as a probable human carcinogen it is in the interests of the citizens of Europe that its use be stopped with immediate effect.
Read the letter which has been sent to the European Commissioner for Health and Food Safety: Glyphosate – Need for a robust and credible scientific assessment of carcinogenicity, pan-europe PDF. 29 October 2015.
World Health Assembly addresses antimicrobial resistance, immunization gaps and malnutrition
The World Health Assembly today agreed resolutions to tackle antimicrobial resistance; improve access to affordable vaccines and address over- and under-nutrition.
Tackling antimicrobial drug resistance
Delegates at the World Health Assembly endorsed a global action plan to tackle antimicrobial resistance – including antibiotic resistance, the most urgent drug resistance trend. Antimicrobial resistance is occurring everywhere in the world, compromising our ability to treat infectious diseases, as well as undermining many other advances in health and medicine.
The plan sets out 5 objectives:
improve awareness and understanding of antimicrobial resistance;
strengthen surveillance and research;
reduce the incidence of infection;
optimize the use of antimicrobial medicines;
ensure sustainable investment in countering antimicrobial resistance.
The resolution urges Member States to put the plan into action, adapting it to their national priorities and specific contexts and mobilizing additional resources for its implementation. Through adoption of the global plan, governments all committed to have in place, by May 2017, a national action plan on antimicrobial resistance that is aligned with the global action plan. It needs to cover the use of antimicrobial medicines in animal health and agriculture, as well as for human health. WHO will work with countries to support the development and implementation of their national plans, and will report progress to the Health Assembly in 2017.
The Assembly agreed a resolution to improve access to sustainable supplies of affordable vaccines – a key issue for low- and middle-income countries aiming to extend immunization to the entire population. In 2012, the Assembly endorsed the Global Vaccine Action Plan, a commitment to ensure that no one misses out on vital immunization by 2020. A report from WHO’s Strategic Advisory Group of Experts on immunization, warns, however, that progress towards the Action Plan’s targets is slow and patchy.
The resolution calls on WHO to coordinate efforts to address gaps in progress. It urges Member States to increase transparency around vaccine pricing and explore pooling the procurement of vaccines. It requests the WHO Secretariat to report on barriers that may undermine robust competition that can enable price reductions for new vaccines, and to address any other factors that might adversely affect the availability of vaccines. The resolution also highlighted that immunization is a highly cost-effective public health interventions, playing a major role in reducing child deaths and improving health. It recommends scaling up advocacy efforts to improve understanding of the value of vaccines and to allay fears leading to vaccine hesitancy.
Last week, on the margins of the Health Assembly, the Secretariat brought together high-level representatives of 34 countries with low immunization coverage to discuss challenges and explore solutions to overcome them.
Rome Declaration on Nutrition and Framework for Action
Delegates approved a resolution endorsing the Rome Declaration on Nutrition and a Framework for Action which recommend a series of policies and programmes across the health, food and agriculture sectors to address malnutrition. Governments had previously agreed both documents at the Second International Conference on Nutrition (ICN2), organized by WHO and the Food and Agriculture Organization of the United Nations (FAO) in November 2014.
The Health Assembly called upon governments to implement commitments to make policy changes and investments aimed at ensuring all people have access to healthier and more sustainable diets. They requested that WHO report back on progress with implementation every 2 years. Delegates also referred to ongoing discussions in New York on a UN General Assembly resolution to welcome the Rome Declaration on Nutrition and a proposal to declare ‘ten years of sustained action in multiple sectors to improve nutrition’.
Indicators to measure nutrition among mothers, babies and young children
Member States agreed a set of indicators to monitor progress for global nutrition targets set in 2012 when the World Health Assembly endorsed a comprehensive implementation plan on maternal, infant and young child nutrition.
The plan listed 6 global targets to be achieved by 2025 on stunting (low height-for-age), wasting (low weight-for-height), overweight, low birth weight, anaemia, and breastfeeding. The decision called upon Member States to begin reporting on most indicators from 2016, and others from 2018. They recommended a review of the global nutrition monitoring framework in 2020.
68th session of the WHO World Health Assembly in Geneva on 18 May 2015
” The third issue that Germany would like to address during its G7 Presidency is resistance to antibiotics. We have obtained the advice of the National Academies of Sciences on this issue – and indeed on the subject of neglected tropical diseases. I think this is an issue of crucial importance for the entire human race – for people in developed and less developed countries alike. We must ensure that existing antibiotics remain effective, and that they are used only when medically necessary – not only when treating humans, but animals as well. To this end we want to agree on the strictest standards possible at the G7 meeting, in particular for industrialised countries.
Antibiotics have to be used restrictively, because once pathogens have become resistant to them, it is much, much harder to develop new treatments – in contrast to the situation for example with neglected tropical diseases. The pharmaceutical industry is an important partner in the fight against disease, but it can only provide new products through research and development. I have been told how difficult it is to develop new varieties of antibiotics to replace the old ones. We must therefore tread carefully if we are to make progress. We must pursue a “one health” approach for both humans and animals.
I am delighted that the World Health Assembly has undertaken to draw up the first global action plan to address the problem of antimicrobial resistance. Every country should have a plan of this sort. Only a few days ago the German Cabinet adopted its own antimicrobial resistance strategy. It will require close cooperation in the fields of human and veterinary medicine. ”
Sources and more information
Statement by Federal Chancellor Angela Merkel at the 68th session of the WHO World Health Assembly in Geneva on 18 May 2015, WHO Media centre, 18 May 2015.
The standard solution for iron deficiency – iron supplements or tablets – isn’t working in developing countries. Iron supplements tablets are neither affordable nor widely available, and because of the side-effects people don’t like taking them.
Dr Christopher Charles had a novel idea. Inspired by previous research which showed that cooking in cast iron pots increased the iron content of food, he decided to put a lump of iron into the cooking pot, made from melted-down metal.
If the iron fish is used every day in the correct way, Dr Charles says it should provide 75% of an adult’s daily recommended intake of iron – and even more of a child’s.
Trials on several hundred villagers in one province in Cambodia showed that nearly half of those who took part were no longer anaemic after 12 months…
What do you think of the Commission’s public consultation on endocrine disruptors? Are you happy with the process?
If we talk about the consultation itself, it’s a good thing. When talking about the whole process, we’re concerned because it’s too slow. It has already been delayed and the timeline for a definition of endocrine disruptors has not been respected. We are in an uncertain situation. It makes a lot of unclarity for the evaluators at the EFSA (the European Food Safety Authority) level, for the risk managers, the member states and of course also for our members. The sooner the criteria is established and validated, the better it will be.
Contrary to what some NGOs think, we have not worked to slowdown the process.
You would prefer stringent criteria adopted fast rather than the opposite?
No. Since the current regulation was adopted, we have been fighting hard against the so-called hazard criteria. Until now, all our products were risk-based evaluated. That means that every technology including natural products can come under the label ‘hazard’. Based on the use, crops and the amount, there is an exposure which is big or low and if we combine the hazard with the exposure, then the risk manager can say that we can put the product on the market based on this. Europe is the only place in the world where we have this approach now.
Does this also include minimum residue levels for pesticides?
Yes, and this issue will become hotter this year due to the TTIP (Transatlantic Trade and Investment Partnership) negotiations. Endocrine disruptors and TTIP can be linked due to the residue levels. We don’t want them to be linked too much, but some people want them to be linked.
People from the Commission?
No, the new Commission in fact has a new way of looking at things. Our understanding is that they prefer to check and be sure that the current regulation is working. If it’s not working, they want to make it work before they consider new regulation.
Before the new Commission took office we thought that the current regulation, which really hasn’t been working yet, would be revised as soon as possible. Now, if the Commission says it’s better to really make the current regulation work, then that’s a fine idea.
But the public consultation is taking place to update the regulation, right?
The consultation is specific to endocrine disruptors. The problem with it is that it’s not a general public consultation. In fact, you do need a little bit of knowledge about the file. This is more for experts. This topic really is the hot topic of the coming months and we have of course been contributing to the consultation. As one of many important stakeholders in this debate, we take the issue of endocrine disruptors seriously. We welcome a vigorous, informative and reasonable public dialogue to fully consider the consequences of the criteria for endocrine disruption.
These criteria will be used to regulate endocrine disruptors in sector-specific chemicals legislation, such as for general chemicals, biocides and pesticides. The application of these criteria could have significant consequences for consumers, agriculture and trade. That’s why the public consultation is so vital to the process.
Our position is that the EU’s criteria should evaluate endocrine active substances based on risk assessment, considering both hazard and exposure, and that the final criteria should clearly distinguish those substances that are of high regulatory concern from those that are not.
The number of active substances available for the industry to use has consistently been reduced due to regulation…
Not only because of the regulation, but also because of us. In the 1990s, we had around 1,000 substances available on the European market. Today, the number is 250 because regarding 60-70% of the substances, we have decided not to maintain them as we knew they would be technically outdated and we would have better solutions for the farmers. Then we had 80 substances where we were trying to renew them, but this was not accepted due to risk concerns. At the same time, on top of the 250 substances, 150 new substances have been developed.
So we have 400 substances now, and they are generally safer. They represent less risk and really answer our needs as consumers and citizens. With the new regulation on endocrine disruptors, our guess is that between 50 to 60 substances can again disappear, knowing that all the current 400 will have to go through the screening again.
Have you identified those 50-60 substances?
Yes, and among those potential ones, there are ones which are bringing technical solutions that are very useful for the farmers and we don’t really have alternative solutions available yet. This could result in substances disappearing from the market so that, for example, wheat production, which is an important crop in Europe, can be negatively impacted.
We want an approach that is really pragmatic, based on use.
The 50-60 substances that you think could be taken off the market… Is this something the industry is already taking for granted and already phasing out? Do you agree that the risk may too high for some of them?
Today, based on the knowledge available and on the current risk-benefit analysis, which has been done, there’s no obvious reason. We potentially have some insecticides which have been largely used, with a lot of benefits, which could disappear.
We have been bringing new families, new benefits, more targeted and environmental-friendly products to the market. Of course we can always do more. This is what our research and development teams are working on. But for a product, we need more than ten years before bringing them to the market. We cannot make those changes in a split second.
The number of products reaching the market is declining because companies are not taking risks when there are so many discussions on criteria profile to continue to push for them being on the market.
The concern is still about the products in the pipeline or those already on the market. It’s more and more complicated to find new product families. If we rely too much on the same product families, the risk of resistance will be increased, and then the farmers won’t be able to control the problem.
I’m guessing you are trying to meet with Commissioner Frans Timmermans, the First Vice-President responsible for Better Regulation. Are you telling the Commission to drop this legislation?
No. We have looked at impact assessments from the beginning so that we remain consistent. What we just want is an acceleration of the process. We don’t know yet what the outcome will be.
What will be the desirable outcome from your point of view?
The desirable outcome for us would be that before taking the decision to exclude a substance, they go through a risk-benefit analysis which is not the case today from the current regulation. If you have classified a substance as an endocrine disruptor, whatever the criteria is, because they are still being discussed, then it will be dropped.
Do you think the Commission is listening to this argument?
With the new Commission, I don’t know. But there were different opinions in the previous different Commission units.
The new Commission has a new approach which is more centralised, which could help making your point, no?
We have not yet had the opportunity to really… We have had a meeting in one of the cabinets, but it was more like an introductory meeting.
Impact assessments are being reviewed at the Commission with a more systematic cost-benefit analysis being considered. You must see this as going in the right direction, no?
In principle, of course it goes in the right direction. This is for the future. But for today and for the endocrine disruptors, the fight has already been quite emotional that I can’t imagine that this impact assessment will continue to the end and then stop.
On the other hand, we’re not interested in stopping it because that would keep it in the grey area. We are really happy that the public consultation will close on Friday.
The impact assessment, I believe, has already started and some input will be used from the public consultation to make the final proposal of the criteria which will be discussed by the Council and Parliament. The only concern we have is the planning, because we don’t expect the criteria to be agreed by the Commission, Parliament and Council before the end of 2016. It’s not going to be tomorrow. In the meantime, the debate will continue. – 16/01/2015.
” What does HEAL think of the concept of the Commission’s endocrine disruptors consultation?
The consultation is only one part of a larger impact assessment process, which has been introduced to delay action on endocrine-disrupting chemicals to protect public health.
HEAL believes it to be strange to hold a public consultation, and even an impact assessment, on the scientific criteria for the identification of endocrine disruptors when the Commission has spent years obtaining scientific work and advice on this subject: for example, the Kortenkamp report contracted by the Commission; the two-year long Expert Advisory Group on endocrine disrupting chemicals, which included member state experts, NGO experts and industry experts, and which resulted in a report by the EU’s own Joint Research Centre; and even the European Food Safety Authority’s (EFSA) opinion.
The fact that we are having an impact assessment at all is already testament to the influence the pesticides and chemicals industry have on the Commission.
It was already democratically agreed by 28 member states in 2009 and 2011 through the Parliament and the Council to remove these endocrine-disrupting pesticides and biocides, because of the risks of diseases and environmental problems generated by these products, which are widely dispersed and end up in our food, air, water and bodies. The laws agreed foresee exemptions to these bans when, for example, there is a serious danger to plant health.
So a broad agreement has been reached, but it seems the pesticides and chemical industries deliberately ignore it and keep fighting the same old battle.
What are your views on endocrine disruptors? Have you made your views heard during the consultation?
Endocrine disruptors are one of the biggest public health threats of this and possibly the next centuries, maybe on par with global climate destabilisation. The World Health Organization (WHO) and UNEP say they are a global threat to health and the environment that needs to be resolved as soon as possible.
We believe that systematically reducing exposures to endocrine-disrupting chemicals provides a massive opportunity to prevent many chronic diseases, such as hormonal cancers (of breast, prostate, and testicles), diabetes and obesity, learning disabilities and attention deficit disorder, and fertility problems. So it’s imperative that all endocrine-disrupting chemicals are properly identified. To this end, we believe the WHO definition, in combination with three categories that rank the endocrine disrupting chemicals according to the strength of the scientific evidence, is the single best way to proceed. It’s the same way that we identify chemicals that cause cancer, gene mutations or that are toxic to reproduction.
With respect to the different regulatory approaches in the consultation, HEAL does not think that making post-jure changes to the democratically agreed existing pesticides and biocides laws, which already allow for exceptions in case of need, is acceptable. Firstly, because the changes being considered would not be subject to a fully democratic legislative process, the way the pesticides and biocides laws were decided, and secondly because either of the two options (B or C) would essentially build a different escape hatch for hormone disrupting pesticides and biocides, which we had already, as a society, agreed must be phased out – unless they qualify for the already agreed exemptions built into the laws!
We have made our views known on the criteria, and insofar as the slanted format of the consultation allowed it, on the importance of the societal, environmental and health benefits that would come from properly identifying endocrine disrupting chemicals and proceeding with their phase out as agreed in the 2009 and 2011 laws.
HEAL and many other NGOs in the endocrine-disrupting chemicals-free Europe coalition, known as “EDC-Free Europe”, have facilitated the voices of a large number of citizens across Europe on this. So far over 18,000 people have also asked for use the three categories with the WHO definition, and for no change in the existing laws and exemptions.
What do you expect will come out of the Commission’s consultation?
We hope that the Commission will not be able to deny the political significance of (so far) over 18,000 people who have used our online platform to say it’s time to stop hormone disrupting chemicals from contaminating our environment and harming our health.
In the past, industry has greatly exaggerated the costs to their business, using models that are too static and limited. The agricultural industry has miscalculated the impact on farming yields by using bogus baselines, ignored or underestimated the benefits of adaptation, and so on. This has been detailed in the new report Predicted costs by industry in the face of new environmental regulations.
The Commission should conclude that we must systematically reduce our exposures to endocrine disrupting chemicals and phase out their uses – something which will help prevent cancer, diabetes, obesity and infertility and can be an enormous catalyst for innovation and improvement because it will stimulate safer, healthier products and environments.
How many endocrine disrupting substances are a priority to you?
All those that are contaminating our bodies, our babies before birth, our breast milk and our environment.
HEAL supported and participated in the WWF human biomonitoring of three generations in Europe in 2005, and they found an average of at least 73 synthetic chemicals in the bodies of those tested. In the US, biomonitoring has found an average of 200 chemicals and contaminants already in newborns. Not all may be endocrine-disrupting chemicals, even though they are still hazardous and may interact with endocrine-disrupting chemicals to exert cocktail effects.
Commission First Vice-President Frans Timmermans is also in charge of ‘better regulation’ and cutting red tape. Do you fear that regulation on endocrine disruptors could be one of the areas that he would consider scrapping?
Junker and Timmermans have stressed many times that they want the Commission to make a fresh start and bring the EU closer to citizens again.
Protection against exposure to endocrine disruptors is a key issue for people all over Europe. Consider for example the thousands of people in Germany using an app to detect endocrine disrupting chemicals in consumer products, the pregnant women in Denmark who consult a guide on endocrine-disrupting chemicals and how to avoid them, and the huge numbers of others throughout Europe who feel it necessary to empty food from plastic packaging before heating or microwaving.
The Parliament has made it abundantly clear they’re expecting the EU to act to reduce harm from endocrine disrupting chemicals. in December, nine EU member states – including Denmark, Germany, France and others – launched an initiative to urge the Commission to act. Several member states are frontrunners in adopting laws to phase out endocrine-disrupting chemicals in products.
Surely Timmermans doesn’t want to ignore all these concerns?
In addition, a recent assessment on cutting red tape in Europe by the High Level Group on Administrative Burdens found that environmental regulation accounts for less than 1% of the total administrative burden, with regulations in the areas of taxation/customs and annual accounts having a much higher toll.
We therefore hope that Timmermans will share our view that regulation on endocrine-disrupting chemicals is not only crucial to protect public health but also can actually be a driver for innovation towards less harmful chemicals. After all, he is also in charge of sustainable development in the EU. ” – 16/01/2015.
Effects of human exposure to hormone-disrupting chemicals examined in landmark UN report
19 FEBRUARY 2013 News Release Many synthetic chemicals, untested for their disrupting effects on the hormone system, could have significant health implications according to the State of the Science of Endocrine Disrupting Chemicals, a new report by the United Nations Environment Programme (UNEP) and WHO.
The joint study calls for more research to understand fully the associations between endocrine disrupting chemicals (EDCs)—found in many household and industrial products—and specific diseases and disorders. The report notes that with more comprehensive assessments and better testing methods, potential disease risks could be reduced, with substantial savings to public health.
Some substances can alter the hormonal system
Human health depends on a well-functioning endocrine system to regulate the release of certain hormones that are essential for functions such as metabolism, growth and development, sleep and mood. Some substances known as endocrine disruptors can alter the function(s) of this hormonal system increasing the risk of adverse health effects. Some EDCs occur naturally, while synthetic varieties can be found in pesticides, electronics, personal care products and cosmetics. They can also be found as additives or contaminants in food.
The UN study, which is the most comprehensive report on EDCs to date, highlights some associations between exposure to EDCs and health problems including the potential for such chemicals to contribute to the development of non-descended testes in young males, breast cancer in women, prostate cancer in men, developmental effects on the nervous system in children, attention deficit /hyperactivity in children and thyroid cancer.
Human exposure can occur in a number of ways
EDCs can enter the environment mainly through industrial and urban discharges, agricultural run-off and the burning and release of waste. Human exposure can occur via the ingestion of food, dust and water, inhalation of gases and particles in the air, and skin contact.
“Chemical products are increasingly part of modern life and support many national economies, but the unsound management of chemicals challenges the achievement of key development goals, and sustainable development for all,” said UN Under Secretary-General and UNEP Executive Director Achim Steiner.
“Investing in new testing methods and research can enhance understanding of the costs of exposure to EDCs, and assist in reducing risks, maximizing benefits and spotlighting more intelligent options and alternatives that reflect a transition to a green economy,” added Mr Steiner.
More research is needed
In addition to chemical exposure, other environmental and non-genetic factors such as age and nutrition could be among the reasons for any observed increases in disease and disorders. But pinpointing exact causes and effects is extremely difficult due to wide gaps in knowledge.
“We urgently need more research to obtain a fuller picture of the health and environment impacts of endocrine disruptors,” said Dr Maria Neira, WHO’s Director for Public Health and Environment. “The latest science shows that communities across the globe are being exposed to EDCs, and their associated risks. WHO will work with partners to establish research priorities to investigate links to EDCs and human health impacts in order to mitigate the risks. We all have a responsibility to protect future generations.”
The report also raises similar concerns on the impact of EDCs on wildlife. In Alaska in the United States, exposure to such chemicals may contribute to reproductive defects, infertility and antler malformation in some deer populations. Population declines in species of otters and sea lions may also be partially due to their exposure to diverse mixtures of PCBs, the insecticide DDT, other persistent organic pollutants, and metals such as mercury. Meanwhile, bans and restrictions on the use of EDCs have been associated with the recovery of wildlife populations and a reduction in health problems.
The study makes a number of recommendations to improve global knowledge of these chemicals, reduce potential disease risks, and cut related costs. These include:
Testing: known EDCs are only the ‘tip of the iceberg’ and more comprehensive testing methods are required to identify other possible endocrine disruptors, their sources, and routes of exposure.
Research: more scientific evidence is needed to identify the effects of mixtures of EDCs on humans and wildlife (mainly from industrial by-products) to which humans and wildlife are increasingly exposed.
Reporting: many sources of EDCs are not known because of insufficient reporting and information on chemicals in products, materials and goods.
Collaboration: more data sharing between scientists and between countries can fill gaps in data, primarily in developing countries and emerging economies.
“Research has made great strides in the last ten years showing endocrine disruption to be far more extensive and complicated than realized a decade ago,” said Professor Åke Bergman of Stockholm University and Chief Editor of the report. “As science continues to advance, it is time for both management of endocrine disrupting chemicals and further research on exposure and effects of these chemicals in wildlife and humans.”
Sources and more information
Effects of human exposure to hormone-disrupting chemicals examined in landmark UN report, who, 20130219.
UN, WHO panel calls hormone-disrupting chemicals a global threat
Rising exposure to chemicals that disrupt and mimic hormones – endocrine disruptors – may present a significant threat to human health, especially that of children in the womb, and to wildlife populations, a new global study of the effect of man-made substances in the environment has concluded. Study produced for the World Health Organisation (WHO) and the United Nations Environment Programme (UNEP).