Rapidly advancing evidence documents that a broad array of synthetic chemicals found ubiquitously in the environment contribute to disease and disability across the lifespan. Although the early literature focused on early life exposures, endocrine-disrupting chemicals (EDCs) are now understood to contribute substantially to chronic disease in adulthood, especially metabolic, cardiovascular, and reproductive consequences as well as endocrine cancers. The contribution to mortality is substantial, with over 90,000 deaths annually and at least $39 billion/year in lost economic productivity in the United States (US) due to exposure to certain phthalates that are used as plasticizers in food packaging. Importantly, exposures are disproportionately high in low-income and minoritized populations, driving disparities in these conditions. Though non-Hispanic Blacks and Mexican Americans comprise 12.6% and 13.5% of the US population, they bear 16.5% and 14.6% of the disease burden due to EDCs, respectively. Many of these exposures can be modified through safe and simple behavioral changes supported by proactive government action to both limit known hazardous exposures and to proactively screen new industrial chemicals prior to their use. Routine healthcare maintenance should include guidance to reduce EDC exposures, and a recent report by the Institute of Medicine suggests that testing be conducted, particularly in populations heavily exposed to perfluoroalkyl substances—chemicals used in nonstick coatings as well as oil- and water-resistant clothing.

中文翻译：

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内分泌干​​扰化学物质：对健康影响的主流认识以及对执业内科医生的影响

快速推进的证据表明，环境中普遍存在的多种合成化学物质会导致整个生命周期的疾病和残疾。尽管早期文献主要关注生命早期的暴露，但现在人们认为内分泌干扰化学物质 (EDC) 会导致成年期的慢性疾病，特别是代谢、心血管和生殖后果以及内分泌癌症。由于接触食品包装中用作增塑剂的某些邻苯二甲酸盐，导致美国每年有超过 90,000 人死亡，每年至少造成 390 亿美元的经济生产力损失。重要的是，低收入和少数族裔人群的暴露程度异常高，从而导致了这些条件的差异。尽管非西班牙裔黑人和墨西哥裔美国人分别占美国人口的 12.6% 和 13.5%，但他们分别承担了 EDC 造成的疾病负担的 16.5% 和 14.6%。其中许多暴露可以通过政府积极行动支持的安全和简单的行为改变来改变，以限制已知的危险暴露并在使用前主动筛查新的工业化学品。日常医疗保健维护应包括减少 EDC 接触的指导，医学研究所最近的一份报告建议进行测试，特别是在严重接触全氟烷基物质（不粘涂层以及防油和防水服装中使用的化学物质）的人群中。