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La Medicina del Lavoro - vol. 115 n° 6 -

La Medicina del Lavoro

"Background:PFASs, synthetic chemicals, can be encountered by humans through occupational or environmental exposure, and some reports suggest that they can disrupt endocrine and hormonal activities. In this comprehensive review and meta-analysis, we explored the connection between exposure to PFASs and the risks of breast and female genital cancers. Methods: We systematically reviewed the literature from IARC Monographs, ATSDR documents, and PubMed (as of January 2024) for cohort, case-control, and ecological studies on PFAS exposure and breast or female genital cancers. Four reviewers independently screened studies, and data extraction included study design, patient characteristics, and effect size measures. The quality of studies was assessed using the modified version of the Newcastle-Ottawa Scale (NOS). Forest plots of relative risks (RR) were constructed for breast and female genital cancer. Meta-analyses were conducted using random-effects models, stratified analyses, dose-response assessments, and publication bias evaluation. Results: The meta-analysis included 24 studies, comprising 10 cohort, 13 case-control, and one ecological study. The summary relative risk (RR) of breast cancer for PFOA exposure was 1.08 (95% CI = 0.97-1.20; n=21), and for PFOS was 1.00 (95% CI = 0.85-1.18; n=12). The RR for ovarian cancer and PFAS was 1.07 (95% CI = 1.04-1.09; n=12). The stratification by quality score, year of publication, and expo-sure source did not reveal any differences. However, analysis by geographical region (p=0.01) and study design (p=0.03) did show differences, particularly in terms of incidence. Stratified analyses of the dose-response relation-ship did not reveal a trend in the risk of breast cancer or female genital cancers, and no publication bias was found for either cancer type. No results were available for cervical and endometrial cancers. Conclusion: In summary, our results suggest an association between PFAS exposure and ovarian cancer and a possible effect on breast can-cer incidence in some specific groups. However, bias and confounding cannot be excluded and prevent conclusions regarding causality."

This work is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
"Background:PFASs, synthetic chemicals, can be encountered by humans through occupational or environmental exposure, and some reports suggest that they can disrupt endocrine and hormonal activities. In this comprehensive review and meta-analysis, we explored the connection between exposure to PFASs and the risks of breast and female genital cancers. Methods: We systematically reviewed the literature from IARC Monographs, ATSDR documents, and ...

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Andrology - vol. 4 n° 4 -

Andrology

"The developing brain is remarkably malleable as neural circuits are formed and these circuits are strongly dependent on hormones for their development. For those reasons, the brain is very vulnerable to the effects of endocrine-disrupting chemicals (EDCs) during critical periods of development. This review focuses on three ubiquitous endocrine disruptors that are known to disrupt the thyroid function and are associated with neurobehavioral deficits: polychlorinated biphenyls, polybrominated diphenyl ethers, and bisphenol A. The human and rodent data suggesting effects of those EDCs on memory, cognition, and social behavior are discussed. Their mechanisms of action go beyond relative hypothyroidism with effects on neurotransmitter release and calcium signaling."
"The developing brain is remarkably malleable as neural circuits are formed and these circuits are strongly dependent on hormones for their development. For those reasons, the brain is very vulnerable to the effects of endocrine-disrupting chemicals (EDCs) during critical periods of development. This review focuses on three ubiquitous endocrine disruptors that are known to disrupt the thyroid function and are associated with neurobehavioral ...

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Endocrine Reviews - vol. 33 n° 3 -

Endocrine Reviews

"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."
"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 ...

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Risk Analysis - vol. 24 n° 2 -

Risk Analysis

"This article provides a brief critical examination of a 2002 report jointly issued by the World Health Organization and the World Trade Organization on WTO law and public health. The author argues that the report is in many respects misleading as to the content of WTO law, as interpreted by the Appellate Body of the WTO, its final court. In particular, the WHO/WTO report systematically understates or underestimates the margins of regulatory autonomy that WTO member states have to make regulations that protect public health."
"This article provides a brief critical examination of a 2002 report jointly issued by the World Health Organization and the World Trade Organization on WTO law and public health. The author argues that the report is in many respects misleading as to the content of WTO law, as interpreted by the Appellate Body of the WTO, its final court. In particular, the WHO/WTO report systematically understates or underestimates the margins of regulatory ...

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Office for Official Publications of the European Communities

"The report examines how the concept of precaution has been applied – or not – by policy-makers over the past century when addressing a broad range of hazards linked to public health and the environment in Europe and North America. It should help to improve mutual understanding between Europe and the United States on the use of the precautionary principle in policy-making. The debate has been marked by disputes over the safety of synthetic hormones in beef and of genetically modified plants and foods. It also is about gathering information on the hazards raised by human economic activities and its use in taking action to protect better the environment and the health of the species and ecosystems that are dependent on it. The study aims to contribute to better and more accessible science-based information and more effective stakeholder participation in the governance of economic activity so as to help minimise environmental and health costs and maximise innovation."
"The report examines how the concept of precaution has been applied – or not – by policy-makers over the past century when addressing a broad range of hazards linked to public health and the environment in Europe and North America. It should help to improve mutual understanding between Europe and the United States on the use of the precautionary principle in policy-making. The debate has been marked by disputes over the safety of synthetic ...

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Risk Analysis - vol. 24 n° 2 -

Risk Analysis

"Risk analysis has been recognized and validated in World Trade Organization (WTO) decision processes. In recent years the precautionary principle has been proposed as an additional or alternative approach to standard risk assessment. The precautionary principle has also been advocated by some who see it as part of postmodern democracy in which more power is given to the public on health and safety matters relative to the judgments of technocrats. A more cynical view is that the precautionary principle is particularly championed by the European Community as a means to erect trade barriers. The WTO ruling against the European Community's trade barrier against beef from hormone-treated cattle seemed to support the use of risk assessment and appeared to reject the argument that the precautionary principle was a legitimate basis for trade barriers. However, a more recent WTO decision on asbestos contains language suggesting that the precautionary principle, in the form of taking into account public perception, may be acceptable as a basis for a trade barrier. This decision, if followed in future WTO trade disputes, such as for genetically modified foods, raises many issues central to the field of risk analysis. It is too early to tell whether the precautionary principle will become accepted in WTO decisions, either as a supplement or a substitute for standard risk assessment. But it would undermine the value of the precautionary principle if this principle were misused to justify unwarranted trade barriers."
"Risk analysis has been recognized and validated in World Trade Organization (WTO) decision processes. In recent years the precautionary principle has been proposed as an additional or alternative approach to standard risk assessment. The precautionary principle has also been advocated by some who see it as part of postmodern democracy in which more power is given to the public on health and safety matters relative to the judgments of t...

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Documents pour le médecin du travail - n° 92 -

Documents pour le médecin du travail

Ce dossier propose une revue de la littérature des différentes études publiées sur les effets des perturbateurs endocriniens lors d'expositions professionnelles.

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