title: A systematic review on the effects of environmental exposure to some organohalogens and phthalates on early puberty.
abstract: BACKGROUND
  Early puberty is a common worldwide problem. Different parameters as genetics, metabolic diseases, obesity, as well as environmental factors may affect the age of puberty. This systematic review aims to survey the related literature on the effects of environmental pollutants and especially organohalogens and phthalates on early puberty.
  
  
  METHODS
  A systematic review of papers published in the English language was completed in January 2014. Studies on the associations of organohalogens and phthalates with the puberty time were included. A literature search was conducted in EMBASE, PubMed, Scopus, ISI Web of Science, and Cochrane Library from 1995 to January 2014; moreover manual search through references of relevant manuscripts was considered. The literature search identified 212 papers, of which 13 papers fulfilled the inclusion criteria of the current study. Two reviewers independently identified relevant papers for potential inclusion and assessed the methodological quality.
  
  
  RESULTS
  This review included 6572 participants in nine countries from three continents (Europe, North America, and Asia). Different studies determined the effects of pollutants on maturation signs and pubertal stages and confirmed the association of organohalogens and phthalates with early puberty.
  
  
  CONCLUSIONS
  Based on the studied literature, environmental pollutants surround and accumulate in human societies and their adverse health effects are well documented. It can be concluded that organohalogens and phthalates are disturbing the normal process of puberty timing; especially their influence on early maturation in girls should be underscored.
authors.affiliation: Department of Environmental Health Engineering, Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Parinaz
authors.initials: P
authors.lastname: Poursafa
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Ataei
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
keywords: Early puberty; organohalogens; phthalates; systematic review