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      The Conflict between Regulatory Agencies over the 20,000-Fold Lowering of the Tolerable Daily Intake (TDI) for Bisphenol A (BPA) by the European Food Safety Authority (EFSA)

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      Environmental Health Perspectives
      Environmental Health Perspectives

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          Abstract

          Background:

          The European Food Safety Authority (EFSA) recommended lowering their estimated tolerable daily intake (TDI) for bisphenol A (BPA) 20,000-fold to 0.2  ng / kg  body weight  ( BW ) / day . BPA is an extensively studied high production volume endocrine disrupting chemical (EDC) associated with a vast array of diseases. Prior risk assessments of BPA by EFSA as well as the US Food and Drug Administration (FDA) have relied on industry-funded studies conducted under good laboratory practice protocols (GLP) requiring guideline end points and detailed record keeping, while also claiming to examine (but rejecting) thousands of published findings by academic scientists. Guideline protocols initially formalized in the mid-twentieth century are still used by many regulatory agencies. EFSA used a 21st century approach in its reassessment of BPA and conducted a transparent, but time-limited, systematic review that included both guideline and academic research. The German Federal Institute for Risk Assessment (BfR) opposed EFSA’s revision of the TDI for BPA.

          Objectives:

          We identify the flaws in the assumptions that the German BfR, as well as the FDA, have used to justify maintaining the TDI for BPA at levels above what a vast amount of academic research shows to cause harm. We argue that regulatory agencies need to incorporate 21st century science into chemical hazard identifications using the CLARITY-BPA (Consortium Linking Academic and Regulatory Insights on BPA Toxicity) nonguideline academic studies in a collaborative government–academic program model.

          Discussion:

          We strongly endorse EFSA’s revised TDI for BPA and support the European Commission’s (EC) apparent acceptance of this updated BPA risk assessment. We discuss challenges to current chemical risk assessment assumptions about EDCs that need to be addressed by regulatory agencies to, in our opinion, become truly protective of public health. Addressing these challenges will hopefully result in BPA, and eventually other structurally similar bisphenols (called regrettable substitutions) for which there are known adverse effects, being eliminated from all food-related and many other uses in the EU and elsewhere. https://doi.org/10.1289/EHP13812

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          EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine-Disrupting Chemicals.

          The Endocrine Society's first Scientific Statement in 2009 provided a wake-up call to the scientific community about how environmental endocrine-disrupting chemicals (EDCs) affect health and disease. Five years later, a substantially larger body of literature has solidified our understanding of plausible mechanisms underlying EDC actions and how exposures in animals and humans-especially during development-may lay the foundations for disease later in life. At this point in history, we have much stronger knowledge about how EDCs alter gene-environment interactions via physiological, cellular, molecular, and epigenetic changes, thereby producing effects in exposed individuals as well as their descendants. Causal links between exposure and manifestation of disease are substantiated by experimental animal models and are consistent with correlative epidemiological data in humans. There are several caveats because differences in how experimental animal work is conducted can lead to difficulties in drawing broad conclusions, and we must continue to be cautious about inferring causality in humans. In this second Scientific Statement, we reviewed the literature on a subset of topics for which the translational evidence is strongest: 1) obesity and diabetes; 2) female reproduction; 3) male reproduction; 4) hormone-sensitive cancers in females; 5) prostate; 6) thyroid; and 7) neurodevelopment and neuroendocrine systems. Our inclusion criteria for studies were those conducted predominantly in the past 5 years deemed to be of high quality based on appropriate negative and positive control groups or populations, adequate sample size and experimental design, and mammalian animal studies with exposure levels in a range that was relevant to humans. We also focused on studies using the developmental origins of health and disease model. No report was excluded based on a positive or negative effect of the EDC exposure. The bulk of the results across the board strengthen the evidence for endocrine health-related actions of EDCs. Based on this much more complete understanding of the endocrine principles by which EDCs act, including nonmonotonic dose-responses, low-dose effects, and developmental vulnerability, these findings can be much better translated to human health. Armed with this information, researchers, physicians, and other healthcare providers can guide regulators and policymakers as they make responsible decisions.
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            The Environment and Disease: Association or Causation?

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              Hormones and endocrine-disrupting chemicals: low-dose effects and nonmonotonic dose responses.

              For decades, studies of endocrine-disrupting chemicals (EDCs) have challenged traditional concepts in toxicology, in particular the dogma of "the dose makes the poison," because EDCs can have effects at low doses that are not predicted by effects at higher doses. Here, we review two major concepts in EDC studies: low dose and nonmonotonicity. Low-dose effects were defined by the National Toxicology Program as those that occur in the range of human exposures or effects observed at doses below those used for traditional toxicological studies. We review the mechanistic data for low-dose effects and use a weight-of-evidence approach to analyze five examples from the EDC literature. Additionally, we explore nonmonotonic dose-response curves, defined as a nonlinear relationship between dose and effect where the slope of the curve changes sign somewhere within the range of doses examined. We provide a detailed discussion of the mechanisms responsible for generating these phenomena, plus hundreds of examples from the cell culture, animal, and epidemiology literature. We illustrate that nonmonotonic responses and low-dose effects are remarkably common in studies of natural hormones and EDCs. Whether low doses of EDCs influence certain human disorders is no longer conjecture, because epidemiological studies show that environmental exposures to EDCs are associated with human diseases and disabilities. We conclude that when nonmonotonic dose-response curves occur, the effects of low doses cannot be predicted by the effects observed at high doses. Thus, fundamental changes in chemical testing and safety determination are needed to protect human health.
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                Author and article information

                Journal
                Environ Health Perspect
                Environ Health Perspect
                EHP
                Environmental Health Perspectives
                Environmental Health Perspectives
                0091-6765
                1552-9924
                9 April 2024
                April 2024
                : 132
                : 4
                : 045001
                Affiliations
                [ 1 ]Division of Biological Sciences, University of Missouri-Columbia , Columbia, Missouri, USA
                [ 2 ]Department of Medical and Molecular Genetics, King’s College London School of Medicine , London, UK
                [ 3 ]Department of Biological Sciences, North Carolina State University , Raleigh, North Carolina, USA
                [ 4 ]Department of Environmental Science (ACES), Stockholm University , Stockholm, Sweden
                [ 5 ]Scientist Emeritus and Former Director, National Toxicology Program (NTP), National Institute of Environmental Health Sciences (NIEHS) , Research Triangle Park, North Carolina, USA
                [ 6 ]Scholar in Residence, Duke University , Durham, North Carolina, USA
                [ 7 ]Integrative Rheumatology Associates , Princeton, New Jersey, USA
                [ 8 ]Department of Chemistry, Carnegie Mellon University , Pittsburgh, Pennsylvania, USA
                [ 9 ]Comparative Physiology Laboratory, Natural History Museum , Paris, France
                [ 10 ]Environmental Medicine Education International , Mancos, Colorado, USA
                [ 11 ]Department of Comparative Biosciences, University of Illinois Urbana—Champaign , Urbana-Champaign, Illinois, USA
                [ 12 ]ToxAlim (Research Centre in Food Toxicology), University of Toulouse , Toulouse, France
                [ 13 ]California Pacific Medical Center Research Institute , San Francisco, California, USA
                [ 14 ]Division of Pharmacology and Toxicology, University of Texas at Austin , Austin, Texas, USA
                [ 15 ]Healthy Environment and Endocrine Disruptor Strategies , Raleigh, North Carolina, USA
                [ 16 ]School of Molecular Biosciences, Center for Reproductive Biology, Washington State University , Pullman, Washington, USA
                [ 17 ]Graduate School of Nanobioscience, Yokohama City University , Yokohama, Japan
                [ 18 ]Institute of Environmental Health Sciences, Wayne State University , Detroit, Michigan, USA
                [ 19 ]Department of Pharmacology, Wayne State University , Detroit, Michigan, USA
                [ 20 ]Centre for Pollution Research and Policy, Brunel University London , Uxbridge, UK
                [ 21 ]Food Packaging Forum Foundation , Zurich, Switzerland
                [ 22 ]Environmental Health Sciences , Charlottesville, Virginia, USA
                [ 23 ]Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE) and CIBERDEM, Miguel Hernandez University of Elche , Elche, Alicante, Spain
                [ 24 ]Scientist Emeritus, NTP, NIEHS , Research Triangle Park, North Carolina, USA
                [ 25 ]Department of Pediatrics, Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan, USA
                [ 26 ]Department of Molecular and Integrative Physiology, University of Michigan , Ann Arbor, Michigan, USA
                [ 27 ]Department of Environmental Health Sciences, University of Michigan , Ann Arbor, Michigan, USA
                [ 28 ]Unit of Neuroscience, Department of Medicine and Surgery, University of Parma , Parma, Italy
                [ 29 ]PalmaMD , Miami, Florida, USA
                [ 30 ]Unit of Evolutionary and Functional Biology, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma , Parma, Italy
                [ 31 ]Department of Urology, University of Illinois at Chicago , Chicago, Illinois, USA
                [ 32 ]Biomedical Sciences, Thompson Center for Autism and Neurobehavioral Disorders, University of Missouri—Columbia , Columbia, Missouri, USA
                [ 33 ]MU Institute of Data Science and Informatics, University of Missouri—Columbia , Columbia, Missouri, USA
                [ 34 ]Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen , Copenhagen, Denmark
                [ 35 ]Department of Immunology, Tufts University School of Medicine , Boston, Massachusetts, USA
                [ 36 ]Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai , New York, New York, USA
                [ 37 ]Royal Veterinary College, University of London , London, UK
                [ 38 ]NTHERES, INRAE, ENVT, Université de Toulouse , Toulouse, France
                [ 39 ]Department of Community, Environment & Policy, University of Arizona , Tucson, Arizona, USA
                [ 40 ]Department of Biomedical Sciences, University of Missouri—Columbia , Columbia, Missouri, USA
                [ 41 ]Department of Biology, University of Massachusetts , Amherst, Massachusetts, USA
                Author notes
                Address correspondence to Frederick S. vom Saal, Division of Biological Sciences, 105 Lefevre Hall, University of Missouri—Columbia, Columbia, MO 65211 USA. Telephone: (573) 356-9621. Email: vomsaalf@ 123456missouri.edu
                Author information
                https://orcid.org/0000-0002-0488-3264
                Article
                EHP13812
                10.1289/EHP13812
                11003459
                38592230
                e4b5a4b1-e593-4512-8d38-627b6951cd65

                EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted.

                History
                : 13 August 2023
                : 05 March 2024
                : 05 March 2024
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