title: Causal inference considerations for endocrine disruptor research in children's health.
abstract: Substantial population exposure to endocrine disrupting chemicals, combined with available biomarkers and public concern, has resulted in an explosion of human health effects research. At the same time, remarkable shifts in the regulations governing the composition of some consumer products that contain endocrine disruptors (EDs) has occurred. However, important questions remain as to the weight of evidence linking EDs to human health end points. In this review, we critically examine the literature linking ED exposures to child neurodevelopment, focusing in particular on two model exposures to demonstrate issues related to bioaccumulative [e.g., polychlorinated biphenyls (PCBs)] and rapidly metabolized (e.g., phthalates) compounds, respectively. Issues of study design, confounding, and exposure measurement are considered. Given widespread exposure to these compounds, the potential public health consequences of even small effects on human health are substantial. Therefore, advancing our understanding of any impact calls for careful attention to the principles of causal inference.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, USA. Stephanie.Engel@unc.edu
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Engel
authors.forename: Mary S
authors.initials: MS
authors.lastname: Wolff
mesh_terms: D035843:Biomedical Research / Q000592:standards*; D015984:Causality; D002648:Child; D002657:Child Development; D002669:Child Welfare; D052244:Endocrine Disruptors / Q000009:adverse effects*; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans
chemical_list: D052244:Endocrine Disruptors