To: Stephen Hahn, MD.

From: Nicholas Burney, PA-S

Date: January 20, 2020

Statement of Issue #2: Endocrine Disrupting Compounds (EDCs) have become widely dispersed in our water and food. Compounds such as Bisphenol A (BPA), Polychlorinated Biphenyl (PCB) phthalates, and other pharmaceuticals can cause complications with normal hormone function. This can lead to abnormal onset of puberty, fertility problems, and low birth weight and neurological issues if exposed prenatally. The number of suspected EDCs is over 1,419 as of 2017, and it is continuing to increase. Because these compounds can be found in commonly used products like plastics, canned foods, and our drinking water, these are universal concerns that could potentially affect a large number of people. The estimated cost on the health care system from exposure to EDCs is over $340 billion as of 2016, over 2% of GDP.

The effects of chronic exposure to EDCs can be unpredictable. Humans are continuously exposed to EDC’s in their air supply, food, and water without their knowledge. Long-term exposure can be linked to chronic diseases like Type II Diabetes, metabolic syndrome, and cardiovascular diseases. By refusing to tackle the issue of these compounds, we can indirectly be worsening the prevalence and incidence of these diseases in the public and contributing to a higher strain on the healthcare system.

EDCs can disrupt fertility in a multitude of ways. The EDCs can accumulate in lipids and fat tissue, and since women on average have a higher percentage of fat tissue, they have an increased burden of EDC’s on their endocrine systems. This bioaccumulation is associated with reduced sex hormone production, shortened menstrual cycles, and uterine fibroids which can all affect pregnancy chances. Mothers can also pass EDC’s through their breast milk to their infants, causing problems with the normal developmental cycle.

EDC exposure comes from a variety of sources. Household materials such as furniture and electronics can contain Brominated Flame Retardants (BFRs) that may eventually leach out into household dust and food. Similarly, phthalates and BPA can leach out of plastic containers of food or water when microwaved. Atrazine, one of the most commonly used pesticides, often contaminates drinking water as well as wildlife that we consume, and has been shown to cause complete feminization and chemical castration in these animals. Parabens and benzones in skin creams and sunscreens can absorb through the skin and are associated with breast cancer formation.

Policy Options:

Given the sheer amount of chemicals being introduced into our systems, policies should be put in place to restrict the use of many current compounds and prevent new compounds from being used unless proven to be both safe with continuous exposure, and also does not accumulate in biological tissues.

Advantages: Can promote more natural and environmentally sustainable packaging for food items, can allow focus on mitigation and cleanup of current problem without worrying about new additions, could be following precedent set by European Food Safety Authority which has strict criteria for potential food additives

Disadvantages: Companies may have to invest in alternatives or spend time and money on research for new additives which can drive up costs for goods, more must be done to combat the current ubiquity of EDCs that affect the environment and food

I would also recommend that every food additive and chemical additive be assigned a catalogue number that can be easily found in a database that states its function as an additive, and contains data about its effects on the human body. Concurrently, each additive should be clearly labeled on all food items as well as common household items.

Advantages: Would promote more awareness and knowledge about the potential harms of EDCs, would allow easier reference for potential harms, could help avoid consuming EDCs and create culture where companies are incentivized to avoid them, can prevent new incidences of exposure from happening

Disadvantages: Would require a very large revamp of the food labeling system that would be time and cost intensive, may face a large pushback from companies that do not want to comply, could create confusion among population with introduction of new system, would not affect EDCs present in the atmosphere or in naturally occurring things like groundwater

Thirdly, I would suggest that funding be given to help offset the healthcare costs for those that have been affected by exposure to EDCs. More screening tests should also be developed to determine how much of the most common and biologically active EDCs are present in a person. This can help determine if any chronic diseases they may have can be attributable to endocrine disruptors.

Advantages: Would help drive down healthcare costs by those seriously affected and with chronic disease, would allow the gathering of important biological data to establish more known effects

Disadvantages: Proving that exposure to certain compounds was the root cause of a disease may be very difficult, would increase healthcare spending by the government, screenings may take a long time to implement and test for accuracy and precision

Policy Recommendation: Chronic diseases are on the rise, and they can be caused by over a thousand different chemicals and additives that are affecting nearly American in the country. Billions of dollars are spent per year to treat the disorders associated with endocrine disruptor exposure. National reform is necessary in order to stop the usage of these pernicious chemicals, by heavily restricting their use and reducing their presence in the environment. It is also necessary to catalogue them and educate the population about their potentially devastating effects. Compensation should also be given to those that have been victimized by unintentional exposure, and adequate screening tests should be developed for those that are at risk in order to minimize future exposures. These steps are necessary in order to prevent Americans from experiencing worsening health outcomes.

Sources:

1. Tursi, Antonio et al. “Removal of Endocrine Disrupting Chemicals from Water: Adsorption of Bisphenol-A by Biobased Hydrophobic Functionalized Cellulose.” International journal of environmental research and public health vol. 15,11 2419. 31 Oct. 2018, doi:10.3390/ijerph15112419
2. https://www.ncbi.nlm.nih.gov/pubmed/27765541
3. Schug, Thaddeus T et al. “Minireview: Endocrine Disruptors: Past Lessons and Future Directions.” Molecular endocrinology (Baltimore, Md.) vol. 30,8 (2016): 833-47. doi:10.1210/me.2016-1096
4. Lee, Duk Hee. “Evidence of the Possible Harm of Endocrine-Disrupting Chemicals in Humans: Ongoing Debates and Key Issues.” Endocrinology and metabolism (Seoul, Korea) vol. 33,1 (2018): 44-52. doi:10.3803/EnM.2018.33.1.44
5. Petrakis, Demetrios et al. “Endocrine Disruptors Leading to Obesity and Related Diseases.” International journal of environmental research and public health vol. 14,10 1282. 24 Oct. 2017, doi:10.3390/ijerph14101282
6. Rattan, Saniya et al. “Exposure to endocrine disruptors during adulthood: consequences for female fertility.” The Journal of endocrinology vol. 233,3 (2017): R109-R129. doi:10.1530/JOE-17-0023
7. Almberg, Kirsten S et al. “Atrazine Contamination of Drinking Water and Adverse Birth Outcomes in Community Water Systems with Elevated Atrazine in Ohio, 2006⁻2008.” International journal of environmental research and public health vol. 15,9 1889. 31 Aug. 2018, doi:10.3390/ijerph15091889
8. https://www.endocrine.org/topics/edc/what-edcs-are/common-edcs
9. Engeli, Roger T et al. “Interference of Paraben Compounds with Estrogen Metabolism by Inhibition of 17β-Hydroxysteroid Dehydrogenases.” International journal of molecular sciences vol. 18,9 2007. 19 Sep. 2017, doi:10.3390/ijms18092007
10. https://www.epa.gov/endocrine-disruption/endocrine-disruptor-screening-program-edsp-policies-and-procedures