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Low Doses, Big Effects
Scientists Seek 'Fundamental Changes' in Testing,
Regulation of Hormone-Like Chemicals
By Marla Cone, Editor in Chief
Environmental Health News
March 15, 2012
http://www.environmentalhealthnews.org/ehs/news/2012/low-doses-big-effects

	Small doses can have big health effects. That is
	a main finding of a new report, three years in
	the making, published Wednesday by a team of 12
	scientists who study hormone-altering chemicals.
	Dozens of substances that can mimic or block
	hormones are found in the environment, the food
	supply and consumer products, including
	plastics, pesticides and cosmetics. One of the
	biggest controversies is whether the tiny doses
	that most people are exposed to are harmful.
	Researchers led by Tufts University's Laura
	Vandenberg concluded after examining hundreds of
	studies that health effects "are remarkably
	common" when people or animals are exposed to
	low doses. "Fundamental changes in chemical
	testing are needed to protect human health,"
	they wrote.

Small doses can have big health effects.

That is a main finding of a report, three years in the
making, published Wednesday by a team of 12 scientists
who study hormone-altering chemicals.

Dozens of substances that can mimic or block estrogen,
testosterone and other hormones are found in the
environment, the food supply and consumer products,
including plastics, pesticides and cosmetics. One of the
biggest, longest-lasting controversies about these
chemicals is whether the tiny doses that most people are
exposed to are harmful.

In the new report, researchers led by Tufts University's
Laura Vandenberg concluded after examining hundreds of
studies that health effects "are remarkably common" when
people or animals are exposed to low doses of endocrine-
disrupting compounds. As examples, they provide evidence
for several controversial chemicals, including bisphenol
A, found in polycarbonate plastic, canned foods and
paper receipts, and the pesticide atrazine, used in
large volumes mainly on corn.

The scientists concluded that scientific evidence
"clearly indicates that low doses cannot be ignored."
They cited evidence of a wide range of health effects in
people - from fetuses to aging adults - including links
to infertility, cardiovascular disease, obesity, cancer
and other disorders.

"Whether low doses of endocrine-disrupting compounds
influence human disorders is no longer conjecture, as
epidemiological studies show that environmental
exposures are associated with human diseases and
disabilities," they wrote.

They concluded that it is not, and so they urged
reforms. Some hormone-like chemicals have health effects
at low doses that do not occur at high doses.

"Current testing paradigms are missing important,
sensitive endpoints" for human health, they said. "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."

The report was published online Wednesday in the
scientific journal Endocrine Reviews. Authors include
scientists University of Missouri's Frederick vom Saal,
who has linked low doses of bisphenol A to a variety of
effects, Theo Colborn, who is credited with first
spreading the word about hormone-disrupting chemicals in
the late 1980s and University of California, Berkeley's
Tyrone Hayes, who has documented effects of atrazine on
frogs.

The senior author is Pete Myers, the founder of
Environmental Health News and chief scientist of
Environmental Health Sciences.

Linda Birnbaum, director of the National Institute of
Environmental Health Sciences, said in many cases,
industry is still asking "old questions" about chemical
safety even though "science has moved on." Birnbaum said
she agrees with their main finding: All chemicals that
can disrupt hormones should be tested in ultra-low doses
relevant to real human exposures, she said.

In many cases, chemical manufacturers still are asking
"old questions" when they test the safety of chemicals
even though "science has moved on," she said. "Some of
the testing paradigms have not advanced with the state
of the science." Birnbaum wrote an editorial on
Wednesday referencing the new report.

Nevertheless, for most toxicologists, Birnbaum said the
report does not offer a big shift from what they are
doing. The NIEHS already conducts low-dose testing of
chemicals, including looking for multi-generational
effects such as adult diseases that are triggered by
fetal exposures.

"Some people keep slamming the toxicologists. But you
can't paint everyone with the same brush," Birnbaum
said.

However, the scientists who wrote the report said that
low-dose science "has been disregarded or considered
insignificant by many." They seemed to aim much of their
findings at the National Toxicology Program and the U.S.
Food and Drug Administration. The FDA in 2008 discounted
low-dose studies when it concluded that bisphenol A
(BPA) in consumer products was safe. Two years later,
the agency shifted its opinion, stating that they now
will more closely examine studies showing low-dose
effects. The National Toxicology Program in 2008 found
that BPA poses "some risks" to human health but rejected
other risks because studies were inconsistent.

Several of the report's authors have been criticized by
some other scientists and industry representatives
because they have become outspoken advocates for
testing, regulating and replacing endocrine-disrupting
compounds. The scientists, however, say they feel
compelled to speak out because regulatory agencies are
slow to act and they are concerned about the health of
people, especially infants and children, and wildlife.

Industry representatives say that just because people
are exposed to traces of chemicals capable of altering
hormones doesn't mean there are any harmful effects.
They say that the studies are often contradictory or
inconclusive.

"Based on the evidence, it is concluded that these 'low
dose' effects have yet to be established [and] that the
studies purported to support these cannot be validly
extrapolated to humans," Kamrin, a toxicologist, wrote
in the International Journal of Toxicology in 2007.

But vom Saal and other scientists have said that tests
that do not find low-dose effects of chemicals such as
BPA are often industry-funded, and they often have
tested the wrong animals or the wrong doses, or don't
expose the animals during the most vulnerable time of
fetal growth.

Endocrinologists have long known that infinitesimal
amounts of estrogen, testosterone, thyroid hormones and
other natural hormones can have big health effects,
particularly on fetuses. It comes as no surprise to them
that manmade substances with hormonal properties might
have big effects, too.

"There truly are no safe doses for chemicals that act
like hormones, because the endocrine system is designed
to act at very low levels," Vandenberg, a postdoctoral
fellow at Tufts University's Levin Lab Center for
Regenerative and Developmental Biology, told
Environmental Health News.

But many toxicologists subscribe to "the dose makes the
poison" conventional wisdom. In other words, it takes a
certain size dose of something to be toxic. They also
are accustomed to seeing an effect from chemicals called
"monotonic," which means the responses of an animal or
person go up or down with the dose.

The scientists in the new review said neither of those
applies to hormone-like chemicals.

"Accepting these phenomena should lead to paradigm
shifts in toxicological studies, and will likely also
have lasting effects on regulatory science," they wrote.

In the report, the scientists were concerned that
government has determined "safe" levels for "a
significant number of endocrine-disrupting compounds"
that have never been tested at low levels. They urged
"greatly expanded and generalized safety testing."

Vandenberg said that there may be no effect or a totally
different effect at a high dose of a hormonal substance,
while a lower dose may trigger a disease.

The breast cancer drug tamoxifen "provides an excellent
example for how high-dose testing cannot be used to
predict the effects of low doses," according to the
report. At low doses, it stimulates breast cancer
growth. At higher ones, it inhibits it.

"Imagine taking 100 individuals that are representative
of the American population and lining them up in order
of exposure to an EDC [endocrine-disrupting compound] so
that the person on the far left has the least exposure
and the person on the far right has the most. For many
toxic chemicals, individuals with the highest levels of
exposure, at the right end of the line, have the highest
incidence of disease. But for some EDCs, studies suggest
that people in the middle of the line have the highest
risk," Vandenberg said. She compared hormones, which
bind to receptors in the body to trigger functions such
as growth of the brain or reproductive organs, to keys
in a lock.

"The more keys that are in the locks, the more of an
effect that is seen. But at some point, the locks are
overwhelmed and stop responding to the keys. Thus, in
the lower range, more keys equals more of an effect, but
in the higher range, more keys equals less of an
effect," she said.

Vandenberg predicted the report "will start
conversations among academic, regulatory and industry
scientists about how risk assessments for EDCs can be
improved."

"The question is no longer whether these phenomena
exist, but how to move forward and deal with them."

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