LA PERTURBATION ENDOCRINIENNE : entre enjeux de recherche, enjeux de santé publique et enjeux de pratique quotidienne

Epidemiological and experimental data highlight
the fetal and early postnatal life as critical periods for the
effects of endocrine disrupting chemicals (EDCs), since exposure
to EDCs during these periods can predispose to disease
later in life. EDCs’ effects include disorders of the reproductive
system throughout life (abnormalities of sexual differentiation,
infertility or subfertility and some neoplasia)
and disorders of energy balance (obesity and metabolic syndrome).
They could also influence the development of the cerebral
cortex. However, the demonstration of the involvement of
a single EDC remains difficult in human since we are virtually
exposed to a mixture of several ubiquitous EDCs which are
variably persistent in the environment and the body and have
lifelong consequences. Moreover, since their dose-response
relationship can be non-monotonic, setting a threshold dose
for EDCs effects has become meaningless. Pregnant women,
newborns and young children appear to be mostly at risk.
However, the role of the physician remains difficult and raises
several questions: how can we formulate justified, applicable
and updated recommendations that are not counterproductive
or alarmist…in a society that has to take the necessary steps
to regulate production and protect the population?