Exposure to endocrine disruptors: discrepancies between awareness levels and cumulative chemical risk

Abstract

Introduction Endocrine disruptors are chemical compounds capable of interfering with hormonal homeostasis and are associated with reproductive, metabolic, neurodevelopmental, and oncological disorders. Population exposure is widespread and results from the interaction of dietary, occupational, and behavioral factors. Educational level regarding chemical risk may influence the adoption of protective behaviors and the reduction of cumulative exposure. Aim of the study To assess the level of knowledge and awareness regarding endocrine disruptors and to estimate cumulative chemical risk. Material and methods A descriptive cross-sectional study was conducted on a sample of 176 participants. Data were collected using a structured questionnaire, including socio-demographic variables, level of information, ability to identify substances with potential endocrine-disrupting effects, sources and pathways of exposure, and daily behaviors associated with risk. The mean age of participants was 42.9±11.2 years (95% CI: 41.4-44.4 years). Results Among the participants, 70% reported occupational exposure to at least two chemical substances (detergents, cosmetic products, paints/lacquers, pesticides, plastics). Exposure ranged from no substances reported (15%) to the simultaneous exposure to seven distinct categories in a single individual, indicating a relevant cumulative potential from an occupational perspective. In the domestic environment, frequent use of plastic containers for heating food was reported by 55% of participants, non-stick cookware by 60%, and cosmetic/personal care products by 65%. Consumption of preserved or plastic-packaged foods was reported by 50-55% of respondents. Preventive measures, such as washing fruits and vegetables and daily ventilation of the home, were reported by over 60% of participants, whereas domestic use of pesticides was reported by no more than 35%. Regarding knowledge level, 60% of participants reported having heard of endocrine disruptors, and 65% provided a correct or partially correct definition. Pesticides were the most frequently identified endocrine disruptors (88%), followed by nitrates (65%) and phthalates/BPA (42-46%). Cosmetic and personal care products were indicated as the main sources of exposure (73%), followed by plastics (65%) and canned foods (42%). The most frequently reported exposure pathways were dietary ingestion (92%), dermal absorption (69%), and inhalation (58%). Based on a composite exposure score derived from the questionnaire, participants were classified into three risk categories regarding endocrine disruptor exposure: low risk – 13.6%, moderate risk – 61.9%, and high risk – 24.5%. Conclusion The results highlight a discrepancy between the moderate level of awareness and the prevalence of cumulative exposure to endocrine disruptors. The predominance of moderate and high risk supports the need for integrated, evidence-based educational interventions aimed at translating knowledge into concrete preventive behaviors. Strengthening chemical risk literacy may constitute a key strategy to reduce the burden of endocrine disruptor-related diseases at the population level.