Topic 2.4 Pharmaceuticals and personal care products: A source of endocrine disruption in the environment?*

A wide variety of chemicals are used in pharmaceuticals. Most of these are already under thorough control for endocrine activity. The main causal agents recognized for endocrine disruption from sewage are substances used in medicine (sex hormones, glucocorticoids, and others), natural substances (estrone and 17β-estradiol), and synthetic estrogens (e.g., 17α-ethinylestradiol). Similar substances are used in anabolic agents (growth hormones) in livestock production in some countries. Although the estimated use of anabolic agents in livestock production is approximately one order of magnitude below the natural release of estrogens from farm animals, their possible significance remains unanswered. At present, no other medical substances are recognized as endocrine disruptors in the environment. However, candidates may be identified on the basis of simple assumptions regarding their use and activity: (1) Nonestrogenic steroids may react with environmental endocrine receptors or metabolize on their way to the environment and thus form endocrine disruptors. (2) Many high-volume drugs released to the environment have not yet been tested for their endocrine properties, and some of these are known to interact with the human endocrine system. (3) Compared to medicinal substances, personal care products and additives in drugs are used in high amounts; from this group, parabens, siloxanes, and other substances are suspected of causing endocrine disruption in the environment.