Large Effects from Small Exposures. I. Mechanisms for Endocrine-Disrupting Chemicals with Estrogenic Activity

• Published in: Environmental health perspectives Vol. 111; no. 8; pp. 994 - 1006
• Main Authors: Welshons, Wade V., Thayer, Kristina A., Judy, Barbara M., Taylor, Julia A., Curran, Edward M., Frederick S. vom Saal
• Format: Journal Article
• Language: English
• Published: United States National Institute of Environmental Health Sciences. National Institutes of Health. Department of Health, Education and Welfare 01.06.2003; National Institute of Environmental Health Sciences
• Subjects: Bisphenols; Cell growth; Cell lines; Chemical hazards; Dosage; Dose response relationship; Dose-Response Relationship, Drug; Endocrine System - drug effects; Environmental Exposure; Environmental Pollutants - toxicity; Estrogen receptors; Estrogens; Estrogens - toxicity; Hormones; Humans; Receptors; Receptors, Estrogen - drug effects; Receptors, Estrogen - physiology; Reproducibility of Results; Research Design; Reviews; Risk Assessment
• ISSN: 0091-6765; 1552-9924
• DOI: 10.1289/ehp.5494

Information concerning the fundamental mechanisms of action of both natural and environmental hormones, combined with information concerning endogenous hormone concentrations, reveals how endocrine-disrupting chemicals with estrogenic activity (EEDCs) can be active at concentrations far below those currently being tested in toxicological studies. Using only very high doses in toxicological studies of EEDCs thus can dramatically underestimate bioactivity. Specifically: a) The hormonal action mechanisms and the physiology of delivery of EEDCs predict with accuracy the low-dose ranges of biological activity, which have been missed by traditional toxicological testing. b) Toxicology assumes that it is valid to extrapolate linearly from high doses over a very wide dose range to predict responses at doses within the physiological range of receptor occupancy for an EEDC; however, because receptor-mediated responses saturate, this assumption is invalid. c) Furthermore, receptor-mediated responses can first increase and then decrease as dose increases, contradicting the assumption that dose-response relationships are monotonic. d) Exogenous estrogens modulate a system that is physiologically active and thus is already above threshold, contradicting the traditional toxicological assumption of thresholds for endocrine responses to EEDCs. These four fundamental issues are problematic for risk assessment methods used by regulatory agencies, because they challenge the traditional use of extrapolation from high-dose testing to predict responses at the much lower environmentally relevant doses. These doses are within the range of current exposures to numerous chemicals in wildlife and humans. These problems are exacerbated by the fact that the type of positive and negative controls appropriate to the study of endocrine responses are not part of traditional toxicological testing and are frequently omitted, or when present, have been misinterpreted.