Influence of exposure to endocrine disruptors and other environmental chemicals on breast development in girls: A systematic review of human studies

Abstract

Background: Age at thelarche has decreased over recent decades. This change in female puberty timing may be influenced by exposure to endocrine disrupting chemicals (EDCs) during critical periods of development.

Objective: To review the scientific literature for evidence on the association of exposure to EDCs and other environmental chemicals with the timing of thelarche in girls.

Methods: A systematic search for original peer-reviewed articles published up to July 2023 was conducted in three databases (Medline/PubMed, Scopus, and Web of Science), following the PECO strategy and PRISMA guidelines. The quality of evidence and reporting and the risk of bias were evaluated using GRADE, STROBE, and ROBINS-E tools.

Results: Out of 3094 articles retrieved in the search, 67 met the review inclusion criteria. Data from 10 out of the 14 studies offering high-quality suggest that in utero and/or childhood exposure to certain synthetic and natural chemicals is associated with earlier breast development in girls; 8 of these 10 studies described a relationship with exposure to organohalogenated compounds in utero and to phthalates in childhood.

Conclusions: This systematic review provides the first overview of available human data on the association of EDCs/environmental chemicals with the timing of thelarche. Further high-quality research is urgently needed to fully elucidate the influence of this exposure on breast development timing in girls.

Keywords: Breast development; Endocrine disrupting chemicals; Environmental chemicals; Onset of puberty; Thelarche.