Epidemiological approaches to the effects of endocrine disrupting chemicals on human health

We reviewed recent reports on endocrine disrupting chemicals (EDCs) and hav e outlined various problems inherent in them. The specific behavioral objec tives of this review were to understand the findings in the reports and to criticize and evaluate them in an academically appropriate manner. Since mo st of the human studies adopted epidemiological methods, it seems indispens able for those interested in EDC problems to understand this discipline. In accordance with the categories of epidemiological studies, we reviewed the so-called Skak-kebaek report (descriptive epidemiology), dioxins discharge d by incineration facilities and neonatal mortality rate (ecological study) , dioxins in breast milk and thyroxine in infants (cross-sectional study), dioxins and breast cancer (case-control study) and the Seveso report (cohor t study). We discuss several issues underlying the epidemiological problems found in studies on EDCs, for example, difficulty in risk assessment on th e individual level and the presence of bias. To address these issues, we em phasize the usefulness of surveys of accidental or industrial-exposure case s. In our concluding remark, we stress the large contribution of epidemiolo gists to public health and the need for debates with opponents because they share our interest in the effects of EDCs.