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If CEPA was indeed protecting public health, we would expect declining diseases associated with anthropogenic exposures, rather than the opposite.
Yes, today children are exposed to lower levels of tobacco smoke, some old pesticides, and lead in drinking water, gasoline exhaust and paint. Unfortunately, endocrine-related obesity and metabolic syndrome, disorders of early development and sexual differentiation, and cancers in hormone-sensitive tissues (e.g., breast, prostate, thyroid) have not been prevented. This is as groups of chemicals (e.g., phthalates, bisphenols, flame retardants and some pesticides) remain in commerce, in water, food and products, in homes, schools and the workplace, and in the environment, for decades before being restricted or banned.
Endocrine disruption does not follow a classic dose-response, and can be perpetuated under risk-based management. Endocrine disrupting chemicals (EDCs) require actions based on their innate hazard. With many thousands of EDCs, classes of similar chemicals require group actions.
Single-chemical regulation does not work, and Canadian-led research highlights how aggregate effects of low dose mixtures of chemicals can cause cancer.1 This explains today’s increasing health conditions associated with altered signalling in hormone-driven endocrine systems. Examples include: disorders of sexual development and reproduction; obesity, metabolism and diabetes; neurological development and function; and some cancers. As well, intergenerational effects occur even when the genetic code is not mutated; rather, epigenetic changes that affect expression and suppression of particular genes, can alter susceptibility to dysfunction and disease. Higher prevalence is seen in racialized2 and more highly exposed populations.
Examples of adverse trends in public health linked to toxicants include:
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2. Waldron I. Environmental Racism in Canada. The Canadian Encyclopedia; 2022 https://www.thecanadianencyclopedia.ca/en/article/environmental-racism-in-canada
3. Androutsopoulos VP, Hernandez AF, Liesivuori J, Tsatsakis AM. A mechanistic overview of health associated effects of low levels of organochlorine and organophosphorous pesticides. Toxicology. 2013;307:89–94. http://www.sciencedirect.com/science/article/pii/S0300483X12003502
4. Diamanti-Kandarakis E, Bourguignon JP, Giudice LC, Hauser R, Prins GS, Soto AM, et al. Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement. Endocr Rev. 2009;30(4):293–342. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726844/
5. Gore AC, Chappell VA, Fenton SE, Flaws JA, Nadal A, Prins GS, et al. EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocrine Reviews. 2015 Dec;36(6):E1–150.
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7. National Academies of Sciences E. Environmental Chemicals, the Human Microbiome, and Health Risk: A Research Strategy. 2017 https://www.nap.edu/catalog/24960/environmental-chemicals-the-human-microbiome-and-health-risk-a-research
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13. Teixeira D, Pestana D, Santos C, Correia-Sá L, Marques C, Norberto S, et al. Inflammatory and Cardiometabolic Risk on Obesity: Role of Environmental Xenoestrogens. J Clin Endocrinol Metab. 2015;100(5):1792–801.
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