Endocrine Disrupting Chemicals and Health in Europe: A Systematic Review and Meta-Analysis

Abstract

Background: Endocrine-disrupting chemicals (EDCs) are synthetic and natural compounds that interfere with hormonal regulation and are linked to obesity, diabetes, thyroid disorders, reproductive dysfunction, and hormone-sensitive cancers. Despite European regulatory measures, human exposure persists through food, consumer products, and the environment, raising significant public health concerns. Objectives: This systematic review and meta-analysis aimed to estimate the prevalence of EDC exposure in European populations and evaluate associations with major endocrine-related health outcomes. Methodology: A comprehensive search of PubMed, EMBASE, Web of Science, and Scopus identified observational studies published between January 2000 and July 2025. Eligible studies reported biomonitoring data on key EDCs (bisphenol A (BPA), phthalates, per- and polyfluoroalkyl substances (PFAS), dioxins, and organochlorine pesticides) and/or statistically assessed associations with endocrine outcomes. Data extraction and risk-of-bias assessment were conducted independently by two reviewers using the Newcastle-Ottawa Scale. Random-effects meta-analysis generated pooled prevalence estimates and effect sizes, with subgroup analyses by region, sex, age, and chemical class. Heterogeneity was quantified using I², and publication bias was assessed via funnel plots and Egger’s test. Results: Preliminary findings indicate widespread detection of PFAS and phthalates, particularly in Western and Northern Europe, with growing evidence of links to metabolic and reproductive outcomes. Conclusion: EDC exposure remains a significant and under-recognised public health issue in Europe. This review highlights the need for strengthened regulatory frameworks, ongoing surveillance, and further research to mitigate the long-term health risks associated with EDCs.