Endocrine disruptors, also called hormonally active agents, endocrine disrupting chemicals, or endocrine disrupting compounds, are chemicals that can interfere with the body's hormone systems. These chemicals may lead to health problems such as changes in sperm quality and fertility, issues with sex organs, endometriosis, early puberty, changes in nervous system or immune function, certain cancers, breathing difficulties, metabolic problems, diabetes, obesity, heart issues, growth problems, learning disabilities, and other challenges. These chemicals are found in many household and industrial products. They can affect how the body makes, releases, carries, uses, or removes natural hormones that help control development, behavior, fertility, and the body's balance.

Any system in the body that relies on hormones can be affected by hormone disruptors. These chemicals may be linked to learning disabilities, severe attention deficit disorder, and problems with brain development.

There is disagreement about endocrine disruptors. Some groups want regulators to quickly remove them from the market, while others believe more research is needed. Some chemicals have already been removed (for example, a drug called diethylstilbestrol), but it is unclear if all chemicals currently on the market harm humans or wildlife at the levels people and animals are exposed to. A 2012 report by the World Health Organization stated that even small amounts of these chemicals might cause harm to people.

History

The term "endocrine disruptor" was first introduced in 1991 during a meeting at the Wingspread Conference Center in Wisconsin. An early study on this topic was published in 1993 by Theo Colborn and others. This study explained that certain environmental chemicals can interfere with the development of the endocrine system, and that harm caused during development is often long-lasting. While some scientists have questioned the idea of endocrine disruption, meetings between 1992 and 1999 led to agreements among scientists about the risks of endocrine disruptors, especially for wildlife and humans.

The Endocrine Society released a scientific report that described how endocrine disruptors affect male and female reproduction, breast and prostate cancer, brain development, thyroid function, metabolism, obesity, and heart health. The report explained that studies in laboratories and on people support the idea that endocrine disruptors are a major public health concern. It also noted that proving endocrine disruptors cause diseases in humans is difficult and suggested following the precautionary principle, which means taking action to avoid harm even if some risks are not fully understood. Another report discussed policy issues related to endocrine disruptors.

Endocrine disrupting compounds include many types of chemicals, such as medicines, pesticides, chemicals used in plastics and consumer products, industrial waste, heavy metals, and some naturally occurring plant chemicals. Industrial chemicals like parabens, phenols, and phthalates are also strong endocrine disruptors. Some of these chemicals are widespread in the environment and can build up in living organisms over time. Others are persistent organic pollutants (POPs), which can travel long distances and have been found in nearly every part of the world, even near the North Pole. Some chemicals break down quickly in the environment or in the human body and remain only briefly. Health effects linked to endocrine disruptors include reproductive problems (such as reduced fertility, reproductive tract issues, and changes in the male-to-female sex ratio), hormone imbalances, early puberty, brain and behavior issues, weakened immune systems, and various cancers.

An example of the effects of endocrine disruptors is the drug diethylstilbestrol (DES), a type of estrogen not considered an environmental pollutant. Before it was banned in the 1970s, doctors gave DES to about five million pregnant women to prevent miscarriage. Later, it was found that DES caused reproductive system problems and vaginal cancer in children who took the drug. However, the doses of DES used were much higher than those from environmental exposure, so the connection to environmental risks is unclear.

Aquatic life exposed to endocrine disruptors in urban wastewater has shown lower serotonin levels and more female characteristics.

In 2013, the World Health Organization (WHO) and the United Nations Environment Programme published the most detailed study on endocrine disruptors to date. The report called for more research to better understand the links between endocrine disruptors and health risks for humans and animals. The team noted major gaps in knowledge and recommended:

• Testing: Known endocrine disruptors are only a small part of the problem. Better testing methods are needed to find other possible endocrine disruptors, their sources, and how people are exposed.
• Research: More scientific studies are needed to understand how mixtures of endocrine disruptors affect humans and wildlife, especially from industrial sources.
• Reporting: Many sources of endocrine disruptors are unknown because there is not enough information about chemicals in products and materials.
• Collaboration: Sharing data between scientists and countries can help fill knowledge gaps, especially in developing countries and emerging economies.

Endocrine system

The endocrine system is found in many types of animals. It is made up of glands that release hormones and receptors that detect and respond to these hormones. Hormones move through the body in the blood and act as chemical messengers. They attach to cells that have matching receptors on or inside their surfaces. This process is similar to how a key fits into a lock. The endocrine system controls changes in the body through slow processes, using hormones to send messages. Hormones are released in response to changes in the environment and to manage growth, development, and reproduction. The changes caused by the endocrine system are chemical, altering the inside and outside of cells to create long-term effects in the body. These systems work together to keep the body functioning properly throughout its life. Hormones like estrogens, androgens, and thyroid hormones are controlled by feedback systems, which help limit how sensitive the glands are to these hormones.

Hormones work in very small amounts (measured in parts per billion). Exposure to low doses of chemicals that act like hormones, such as bisphenol A, can disrupt the endocrine system. These chemicals can attach to receptors involved in other hormone-related processes. Since the body already has active levels of its own hormones, even small amounts of outside chemicals can interfere with the endocrine system’s normal function. This means that endocrine disruptors can cause harm at much lower doses than chemicals that cause direct toxicity, using a different method of action.

The timing of exposure is important. Many key stages of development happen in the womb, where the fertilized egg divides and forms all the structures of a baby, including the brain. Disrupting hormone communication in the womb can lead to major changes in both the body’s structure and brain development. Depending on the stage of development, hormone interference can cause effects that cannot be reversed, even if adults are exposed to the same dose for the same time. Studies on animals have found specific times during pregnancy and shortly after birth when exposure to hormone-interfering chemicals can cause lasting problems in adulthood. Early disruption of thyroid function may lead to abnormal sexual development, motor delays, and learning difficulties in both boys and girls.

Research on cells, lab animals, wildlife, and humans accidentally exposed to chemicals shows that these substances can affect reproduction, development, growth, and behavior. While it is unclear whether these effects happen in humans, the science behind them is solid, and the possibility of harm is real. Studies have focused on chemicals that mimic estrogen, testosterone, or thyroid hormones, but less is known about how they interact with other hormones.

Exposure to endocrine-disrupting chemicals has also been linked to changes in the immune system. Since immune activity is controlled by hormones, disrupting hormone signals can affect how the body produces immune cells and responds to infections. These changes are connected to weaker immune responses and increased inflammation, which can raise the risk of autoimmune diseases. Early-life exposure is especially concerning because it can lead to long-term changes in immune function.

The relationship between chemical exposure and health effects is complex. It is difficult to prove that a specific chemical causes a particular health issue, and adults exposed to these chemicals may not show symptoms. However, fetuses and embryos, whose growth is highly controlled by the endocrine system, are more vulnerable. Exposure before birth can cause lasting health or reproductive problems. In some cases, early exposure may lead to permanent changes and adult diseases.

Some scientists are concerned that exposure to endocrine disruptors during pregnancy or early life may be linked to neurodevelopmental disorders, such as lower intelligence, ADHD, or autism. Certain cancers and reproductive issues in women are connected to exposure to a chemical called diethylstilbestrol (DES) during pregnancy.

In a 2005 study, phthalates found in the urine of pregnant women were linked to small but specific changes in the genitalia of their male infants, such as a shorter distance between the anus and genitals, incomplete testicle descent, and smaller scrotums and penises. Some experts questioned the study’s findings, but later research confirmed that the anogenital distance (AGD) is a sign of fetal exposure to male hormones. Studies now show a connection between AGD and the risk of prostate cancer.

Effects on intrinsic hormones

Toxicology research shows that some endocrine disruptors target the specific hormone function that controls how hormones manage the creation or breakdown of natural hormones. Because endocrine disruptors can copy or block natural hormones, these chemicals can cause effects by interacting with nuclear receptors, the aryl hydrocarbon receptor, or membrane-bound receptors.

U-shaped dose-response curve

Most harmful substances, including those that interfere with hormones, are said to follow a U-shaped pattern when their effects are studied. This means that very small amounts and very large amounts of these substances can cause more harm than amounts in the middle range.

Studies have shown that some chemicals, even at levels similar to those found in the environment, can affect animals. For example, a chemical called BDE-47, which is used in flame retardants, has been found to harm the reproductive system and thyroid gland of female rats when exposed to doses similar to those humans may encounter.

In some amphibians, very small amounts of hormone-interfering substances may work together to cause stronger effects. However, it is not certain whether these combined effects happen through the hormone system.

A group called the Learning and Developmental Disabilities Initiative stated that the effects of hormone-interfering substances at very low doses cannot be predicted by studying their effects at high doses. This idea challenges the usual rule in toxicology that "the amount of a substance determines its harm." These unusual patterns are called non-monotonic dose response curves.

It has been reported that certain substances, such as tamoxifen and some phthalates, can cause different and harmful effects on the body at low doses compared to what happens at high doses.

Routes of exposure

Food is a major way people come into contact with pollutants. Diet is believed to be responsible for up to 90% of the amount of PCBs and DDT found in a person's body. A study of 32 common food items from three grocery stores in Dallas, Texas, found that fish and other animal products were contaminated with PBDE. These chemicals dissolve in fat, so they likely build up in the fatty tissue of animals humans eat. Some believe eating fish is a major source of environmental pollutants. Wild and farmed salmon from around the world have been found to contain many man-made organic compounds. While pesticides are found in many foods, phthalates can also enter crops, vegetables, and fruits through contaminated soil and plastic covers used in greenhouses.

Endocrine disruptors can cause changes in the body's hormones. Children and infants are more likely to be affected by these chemicals. Phthalates (PAEs) are used to make plastics last longer and can be found in water bottles and during dairy production. Drinking water from plastic bottles is one way people are exposed to endocrine disruptors. However, there is not a large risk for humans. Phytoestrogens are naturally occurring endocrine disruptors found in food. Soybeans contain a type of phytoestrogen called Geinstein. Studies in Turkey found that battery eggs contained PAEs, and free-range eggs had DDT, a banned pesticide.

Indoor air has become a major source of pollutant exposure due to more household products with pollutants and less ventilation. People living in homes with wood floors treated in the 1960s with PCB-based finishes have higher levels of these chemicals in their bodies than the general population. A study of house dust and dryer lint from 16 homes found high levels of all 22 PBDE types tested. Recent research suggests that house dust, not food, may be the main source of PBDE in the body. One study estimated that eating house dust accounts for up to 82% of the PBDE found in humans.

Contaminated house dust is a primary source of lead in young children's bodies. Babies and toddlers may eat more house dust than adults, leading to higher pollutant levels in their systems.

Consumer products are another way people are exposed to endocrine disruptors. A comparison of 42 household cleaning and personal care products with 43 "chemical-free" products found 55 different chemicals. Parabens, linked to reproductive issues, were found in seven "chemical-free" products, including three sunscreens that did not list them on labels. Vinyl items like shower curtains contain more than 10% DEHP, a chemical linked to asthma in children. Using multiple products increases the risk of exposure to these chemicals.

A study of Old Order Mennonite women during pregnancy found they had lower levels of endocrine disruptors than the general population. Mennonites eat mostly fresh, unprocessed food, avoid pesticides, and use few cosmetics. One woman who used hairspray and perfume had high levels of a phthalate, while others had levels too low to detect. Three women who were in a car or truck within 48 hours of testing had higher levels of another phthalate found in car interiors.

Recent research has focused on clothing as a source of endocrine disruptors. Greenpeace found phthalates in 33 of 35 printed clothing items in 2013, including high levels in a t-shirt and baby clothing. PFCs were found in swimwear and waterproof clothing, and NPEs were common in many items. A 2014 study found high phthalate levels in athletic gear, with some items containing up to 15% phthalates. A 2019 study found all 15 phthalates tested in preschoolers' clothing, with risks increasing when children wore certain combinations of clothes.

A review of 120 studies from 2014 to 2023 found that screen-printing ink, vinyl patches, and synthetic leather may contain 30–60% phthalates. Waterproof items like infant mattress covers also had high levels. Manufacturers often replace heavily regulated chemicals like DEHP with newer ones that are not as strictly controlled.

Additives in plastics can leak into the environment after plastic items are thrown away. These chemicals enter the environment through plastics in oceans, landfills, and products like food containers, toys, and personal care items. They can pollute soil, air, and water.

Types

All people come into contact with chemicals that can act like estrogen in their daily lives. These hormone-disrupting chemicals are found in small amounts in thousands of products. Common chemicals found in people include DDT, polychlorinated biphenyls (PCBs), bisphenol A (BPA), polybrominated diphenyl ethers (PBDEs), and many types of phthalates. Almost all plastic products, even those labeled as BPA-free, have been found to release hormone-disrupting chemicals. A 2011 study showed that some BPA-free products released more hormone-active chemicals than products containing BPA. Other hormone-disrupting chemicals include phytoestrogens, which are plant-based compounds that mimic estrogen.

Xenoestrogens are a type of chemical that imitates estrogen. Synthetic xenoestrogens include industrial chemicals like PCBs, BPA, and phthalates, which can affect living organisms.

Alkylphenols are a type of xenoestrogen. The European Union has limited the use of certain alkylphenols, like nonylphenol, because they are considered harmful, long-lasting, and can build up in the environment. In the United States, the Environmental Protection Agency (EPA) has taken a slower approach to ensure actions are based on scientific evidence.

Long-chain alkylphenols are used in making detergents, fuels, lubricants, polymers, and phenolic resins. They are also used in fragrances, rubber products, and fire retardants. These chemicals are found in tires, adhesives, coatings, and other materials. They have been used in industry for over 40 years.

Some alkylphenols are byproducts of nonionic detergents. Nonylphenol is considered a weak hormone-disruptor because it can mimic estrogen.

Bisphenol A (BPA) is found in plastic bottles, food containers, dental materials, and the linings of metal cans. It is also present in receipt paper used in stores, as the paper is coated with BPA-containing clay for printing.

BPA is known to disrupt hormones. Studies on animals have shown that exposure to low levels of BPA can increase the risk of diabetes, breast and prostate cancers, lower sperm counts, reproductive issues, early puberty, obesity, and neurological problems. In the United States, studies found that urinary BPA levels in healthy women were not linked to pregnancy timing, but other research suggests BPA exposure may reduce ovarian function. Women undergoing in vitro fertilization (IVF) often have high BPA levels in their urine. Studies also found higher BPA levels in women who experienced miscarriages compared to those who had successful pregnancies. These findings suggest BPA may affect early stages of conception. Some studies show differences in BPA effects based on race or ethnicity, but all women in these studies had lower BPA levels. Early life stages appear most sensitive to BPA’s effects, and prenatal exposure has been linked to later health and developmental issues. Regulatory agencies have set safety limits for BPA, but these limits are being reviewed due to new research. A 2011 study found BPA in 96% of pregnant women in the U.S. In 2010, the World Health Organization recommended no new restrictions on BPA, stating that public health measures were premature.

In 2008, the U.S. Food and Drug Administration (FDA) reviewed BPA and concluded it was safe. However, the FDA’s advisory board later said the assessment had flaws and did not prove BPA was safe for infants. In 2010, the FDA expressed concern about BPA’s effects on the brains and behavior of fetuses, infants, and young children. In 2012, the FDA banned BPA in baby bottles, but the Environmental Working Group called the ban “cosmetic,” arguing that BPA should be banned from food and infant formula cans. The Natural Resources Defense Council said the ban was not enough and called for a complete ban on BPA in all food packaging. A FDA representative stated the ban was not based on safety concerns and that BPA is safe for food-contact products.

A program by the National Institute of Environmental Health Sciences, the National Toxicology Program, and the FDA (named CLARITY-BPA) found no harmful effects from long-term BPA exposure in rats. The FDA still considers current BPA uses safe for consumers.

The Environmental Protection Agency has set a reference dose for BPA at 50 micrograms per kilogram of body weight per day for mammals. Studies have shown that even lower doses can affect reproductive systems in both males and females.

Bisphenol S (BPS) and Bisphenol F (BPF) are similar to BPA. They are found in thermal receipts, plastics, and household dust. Traces of BPS have also been found in personal care products. BPS is used in place of BPA in BPA-free items, but studies show BPS and BPF can disrupt hormones just like BPA.

Dichlorodiphenyltrichloroethane (DDT) was first used as a pesticide in 1936 to protect crops from Colorado potato beetles. Its use expanded after World War II to control diseases like malaria, typhus, dysentery, and typhoid fever by targeting insects that spread these illnesses. Before the war, pyrethrum, a natural insecticide from Japan, was used, but Japan stopped exporting it, leading to the search for alternatives. DDT was used by soldiers to prevent typhus outbreaks.

After the war, DDT was approved for general use and became widespread in agriculture to increase crop yields and reduce malaria. However, most countries later banned its agricultural use due to environmental harm, while its use against malaria-carrying insects is still allowed under the Stockholm Convention on Persistent Organic Pollutants.

As early as 1946, scientists noticed harmful effects of DDT on birds, insects, fish, and marine life. The most well-known example was the decline of bird populations, such as eagles, due to DDT’s impact on their ability to lay strong eggshells.

Temporal trends of body burden

Since DDT and PCB were banned, the average amounts of these chemicals in the human body have decreased. After being banned in 1972, the amount of PCB in the body in 2009 was one-hundredth of the amount found in the early 1980s. However, studies of breast milk samples from Europe show that PBDE levels are increasing. An analysis of PBDE levels in breast milk from Europe, Canada, and the US found that North American women have 40 times more PBDE than Swedish women. In North America, PBDE levels are increasing by about twice every two to six years.

Some scientists believe that the gradual decrease in average body temperature since the start of the industrial revolution may be linked to problems with thyroid hormone signals.

Animal models

Scientists use animals to study how chemicals called endocrine disruptors affect the body’s systems, such as metabolism, reproduction, and brain function. Common animals used for these studies include mice, fish eggs, and frogs.

Genetically modified mice are used to understand how genes influence health. For example, some mice are created from a group of eight original mouse strains. These strains include wild mice (with many different genes) and mice bred in labs. Each type of mouse helps scientists test how endocrine-disrupting chemicals affect the body.

A group of mice called CC has 83 inbred strains that were developed from the eight original strains over many generations. Another group, called DO mice, shares the same genes as CC mice but has one key difference: every DO mouse is unique. This makes DO mice useful for studying how genes work together, but they cannot be reproduced in the same way as CC mice.

Scientists use special techniques, like CRISPR, to insert genes from other organisms into mice to create transgenic lines. These mice help study how chemicals affect the body. However, creating these mice takes a long time and is expensive.

Gene knockout lines are used to study how certain body processes work when affected by endocrine-disrupting chemicals. Scientists also use animals like prairie and pine voles, which form long-term social bonds, to study how chemicals might affect human social behaviors.

Fish, such as zebrafish, are used because their endocrine systems are similar to those of mammals. Zebrafish embryos are clear, small, and have simple ways of being affected by chemicals. They also share many genes with humans, with about 80% of human genes found in zebrafish. Scientists can use zebrafish genomes and special transgenic lines to study how chemicals impact the body.

Directions of research

Research on endocrine disruptors faces five challenges that require special study methods and detailed plans:

• The separation of space means that although disruptors may work through hormone receptors, their effects can also happen in other ways, such as by changing how hormones move in the body, how they are broken down, or how hormone feedback systems operate (called allostatic load).
• The separation of time means that harmful effects might occur during early development (like in an embryo or fetus), but the results could appear many years later or even affect future generations.
• The separation of substance means that when disruptors are combined, they can create effects that are different from what happens when each disruptor is used alone. These effects might be stronger or weaker depending on how the disruptors interact.
• The separation of dose means that the relationship between the amount of a disruptor and its effects is not always straightforward. Sometimes, small or medium amounts can cause more harm than large amounts.
• The separation of sex means that the effects of disruptors might differ depending on whether the embryo or fetus is female or male.

Legal approach

In the United States, many laws help regulate chemicals that can disrupt the endocrine system. These laws include the Toxic Substances Control Act, the Food Quality Protection Act, the Food, Drug and Cosmetic Act, the Clean Water Act, the Safe Drinking Water Act, and the Clean Air Act.

Congress has worked to improve how chemicals and drugs are tested and regulated. The Food Quality Protection Act of 1996 and the Safe Drinking Water Act of 1996 required the Environmental Protection Agency (EPA) to begin addressing endocrine disruption. This included creating a program to screen and test chemical substances.

In 1998, the EPA started the Endocrine Disruptor Screening Program. This program aimed to test more than 85,000 chemicals used in the United States. The Food Quality Protection Act required the EPA to test pesticides for effects similar to estrogen in humans. It also allowed the EPA to test other chemicals and endocrine effects. Based on advice from experts, the program expanded to include testing for male hormones, the thyroid system, and effects on fish and wildlife.

The program prioritizes chemicals based on their uses, production volume, structure, and toxicity. Initial screening uses lab tests, such as checking if a chemical interacts with estrogen or androgen receptors. Additional testing uses animals, like observing tadpole development or uterine growth in young rodents. Full testing includes studies on mammals (such as rats) and other species (like frogs, fish, birds, and invertebrates). Animal testing is important for scientific accuracy but has faced opposition from groups concerned about animal welfare. Testing on humans would also be needed to confirm effects, but this is also controversial.

After missing several deadlines, the EPA began testing suspected endocrine disruptors in early 2007, 11 years after the program was announced. When the final testing plan was shared, some people criticized its design. Critics claimed the process was influenced by chemical companies. In 2005, the EPA asked experts to review the program. They concluded that the program’s goals and scientific questions were appropriate, though the review happened before the final testing plan was announced. The EPA continues to struggle with creating a reliable and efficient testing program.

By 2016, the EPA had completed estrogen screening for 1,800 chemicals.

In 2013, the European Union planned to ban certain pesticides containing endocrine-disrupting chemicals. However, U.S. trade negotiators pushed the EU to abandon this plan, arguing that regulations should be based on risk assessments. On the same day, a European official asked for the ban to be removed.

The European Commission had planned to set rules by December 2013 to identify endocrine-disrupting chemicals in products like disinfectants, pesticides, and toiletries. These chemicals are linked to health issues such as cancer, birth defects, and developmental problems. The process was delayed, leading Sweden to threaten legal action in 2014, blaming pressure from the chemical industry.

Sweden’s environment minister noted that hormone-disrupting chemicals are a growing problem, with examples like fish showing both male and female traits and reports linking these chemicals to health issues in children. Denmark also called for action.

In 2014, a report by the Nordic Council of Ministers estimated that endocrine-disrupting chemicals may cost European health systems between 59 million and 1.18 billion euros annually. The report stated that these costs represented only a small portion of the total health impacts caused by such chemicals.

In 2020, the European Union released a plan to shift the chemical industry toward safer practices, reducing reliance on harmful chemicals like xenohormones.

Environmental and human body cleanup

There is evidence that when a pollutant is no longer used or is limited in use, the amount of that pollutant in the human body decreases. Large monitoring programs have helped identify the most common pollutants found in people. The first step to reduce the amount of these pollutants in the body is to stop making them or reduce their use.

The second step is to raise awareness and label foods that may contain high levels of pollutants. This method has worked before, such as when pregnant and nursing women are advised not to eat certain seafood that contains high levels of mercury.

The hardest part of this issue is finding ways to remove these chemicals from the environment and deciding where to focus cleanup efforts. Even pollutants that are no longer produced can remain in the environment and build up in the food chain. Understanding how these chemicals move through ecosystems is important for finding ways to remove them. Global efforts have labeled the most common persistent organic pollutants (POPs) found in the environment, such as those from insecticides. The twelve main POPs have been grouped together to make information easier for the public. This has helped countries work together to test and reduce the use of these chemicals. By reducing these chemicals in the environment, the spread of POPs into food sources that supply the U.S. population can be limited.

Many long-lasting chemicals, such as PCBs, DDT, and PBDEs, build up in river and ocean sediments. The EPA uses several methods, as described in their Green Remediation program, to clean up heavily polluted areas. Naturally occurring microbes that break down PCBs are used in some cleanup processes.

There are many examples of successful cleanup projects at large polluted sites. A 10-acre (40,000 m²) landfill in Austin, Texas, once filled with illegal chemicals, was cleaned and turned into a wetland and educational park in one year. A U.S. uranium enrichment site contaminated with uranium and PCBs was cleaned using advanced equipment to locate pollutants in the soil. At a polluted wetland, soil and water were cleaned of VOCs, PCBs, and lead. Native plants were planted to help filter the environment, and a community program was started to monitor pollution levels. These examples show that large cleanup projects can be completed quickly and successfully.

Studies show that certain pollutants, like bisphenol A (BPA), some PCBs, and phthalates, are removed from the body through sweat. Recent scientific methods have been developed to help the body eliminate pollutants faster. For example, techniques using enzymes like laccase and peroxidase can break down BPA into less harmful substances. Another method uses highly reactive chemicals to break down BPA.

Economic effects

Human exposure to certain chemicals may cause health problems, such as lower intelligence, adult obesity, female reproductive issues, and male reproductive issues. These problems can lead to less work, health problems, or early death in some people. A study found that in the European Union, the cost of these health effects might be about twice as much as the costs from mercury and lead pollution.

In the last 5 years, the cost to society from health problems linked to these chemicals was estimated at about €163 billion each year in the EU and $340 billion each year in the USA. These numbers might be lower than the real cost because many health problems caused by these chemicals are not fully measured.