PEPS'PE Study: Prioritization of Health Effects to Be Monitored Under the Endocrine Disruptor Surveillance Program. Results

Santé publique France plans to expand its monitoring of health indicators related to endocrine disruptors (EDs) beyond the monitoring of reproductive health that has been underway since 2015. This work is now part of the National Strategy on Endocrine Disruptors No. 2, the National Health and Environment Plan No. 4, and the recommendations of the World Health Organization, as well as a context of increasingly high expectations from public authorities and civil society regarding the agency’s role on the subject of EDs. This is why Santé publique France has undertaken a prioritization of health effects linked to EDs in order to identify the health outcomes to be included in the agency’s surveillance strategy. Health effects were prioritized according to two criteria: (1) the strength of the evidence and (2) the epidemiological and societal value of implementing surveillance of the health effect. In the absence of a commonly accepted method for assessing the strength of evidence regarding the association between exposure to PEs and the occurrence of a health effect, a prioritization method was developed, combining available literature data with the results of a consultation with a broad panel of international experts and French stakeholders involved in the field of PEs. During this external consultation, consensus was sought using a Delphi method. This work therefore follows an epidemiological and population-based approach. The aim is to monitor changes in a health indicator in the general population due to its suspected link with exposure to PEs, but not to characterize the health effect of a specific PE product (or group of products). The proposed methodology aimed to find the best balance between scientific robustness, operational feasibility, and clarity for all stakeholders. This report presents the results of the prioritization of health indicators in the context of exposure to PE. Fifty-nine conditions or health effects suspected of being linked to exposure to PE were subjected to this prioritization. Twenty-one of these were assessed as priorities for monitoring due to their link to PE. Among them were reproductive health disorders already being monitored by the agency (cryptorchidism, precocious puberty, testicular cancer, impaired sperm quality, endometriosis, etc.), as well as effects not yet monitored for their link to EDCs (infertility, ovarian cancer, endometrial cancer…), metabolic disorders (overweight and obesity, cardiovascular diseases, type 2 diabetes, metabolic syndrome), and neurodevelopmental disorders in children (behavioral disorders, intellectual disability, attention-deficit disorders). Santé publique France will analyze, for an upcoming report, the feasibility of establishing surveillance for the identified priority effects. The analysis will determine whether reliable indicators tailored to the topic of EDCs already exist or can be tracked over time and across regions using an integrated surveillance approach.

Author(s): Peyronnet Alexia, Naud Jérôme, Caudeville Julien

Publishing year: 2023

Pages: 74 p.

Collection: Studies and Surveys

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