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<journal-id journal-id-type="publisher-id">Front. Environ. Sci.</journal-id>
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<journal-title>Frontiers in Environmental Science</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Environ. Sci.</abbrev-journal-title>
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<issn pub-type="epub">2296-665X</issn>
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<publisher-name>Frontiers Media S.A.</publisher-name>
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<article-id pub-id-type="publisher-id">1761496</article-id>
<article-id pub-id-type="doi">10.3389/fenvs.2026.1761496</article-id>
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<subject>Review</subject>
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<title-group>
<article-title>Drivers and potential effects of endocrine disruption in wild mammals: known facts and open questions</article-title>
<alt-title alt-title-type="left-running-head">Karaer and Snoj</alt-title>
<alt-title alt-title-type="right-running-head">
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fenvs.2026.1761496">10.3389/fenvs.2026.1761496</ext-link>
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<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Karaer</surname>
<given-names>Mina Cansu</given-names>
</name>
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<uri xlink:href="https://loop.frontiersin.org/people/2253003"/>
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<contrib contrib-type="author" corresp="yes">
<name>
<surname>Snoj</surname>
<given-names>Toma&#x17e;</given-names>
</name>
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<xref ref-type="corresp" rid="c001">&#x2a;</xref>
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<aff id="aff1">
<institution>Institute of Preclinical Sciences, Veterinary Faculty, University of Ljubljana</institution>, <city>Ljubljana</city>, <country country="SI">Slovenia</country>
</aff>
<author-notes>
<corresp id="c001">
<label>&#x2a;</label>Correspondence: Toma&#x17e; Snoj, <email xlink:href="mailto:tomaz.snoj@vf.uni-lj.si">tomaz.snoj@vf.uni-lj.si</email>
</corresp>
</author-notes>
<pub-date publication-format="electronic" date-type="pub" iso-8601-date="2026-03-04">
<day>04</day>
<month>03</month>
<year>2026</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2026</year>
</pub-date>
<volume>14</volume>
<elocation-id>1761496</elocation-id>
<history>
<date date-type="received">
<day>05</day>
<month>12</month>
<year>2025</year>
</date>
<date date-type="rev-recd">
<day>29</day>
<month>01</month>
<year>2026</year>
</date>
<date date-type="accepted">
<day>02</day>
<month>02</month>
<year>2026</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2026 Karaer and Snoj.</copyright-statement>
<copyright-year>2026</copyright-year>
<copyright-holder>Karaer and Snoj</copyright-holder>
<license>
<ali:license_ref start_date="2026-03-04">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract>
<p>Endocrine disruption has become a critical ecological problem, with environmental pollutants such as pesticides, industrial chemicals, and pharmaceutical residues playing crucial roles in altering endocrine regulation and disrupting key physiological processes. This overview addresses the mechanisms of endocrine disruption, focusing on how endocrine-disrupting chemicals (EDCs) interfere with hormone synthesis, receptor binding, and cellular signalling pathways, ultimately impacting animal reproductive function, development, and metabolism and thus affecting individuals, populations and ecosystems. We summarize the current state of knowledge on endocrine disruption and propose new research topics to clarify the effects of various substances with endocrine activity on organisms. Inter-species differences in sensitivity to EDCs, differences in receptor structure between species, observational studies on developmental disorders, effects of mixtures of EDCs, studies on epigenetic and transgenerational effects, and interactions between EDCs and other environmental stressors are presented as important topics for further research. Finally, we emphasize the need for collective action to protect biodiversity by curbing environmental pollution with EDCs.</p>
</abstract>
<kwd-group>
<kwd>ecosystems</kwd>
<kwd>endocrine disruption</kwd>
<kwd>endocrine-disrupting chemicals</kwd>
<kwd>metabolic disorders</kwd>
<kwd>reproductive disorders</kwd>
<kwd>wild mammals</kwd>
</kwd-group>
<funding-group>
<funding-statement>The author(s) declared that financial support was received for this work and/or its publication. This work was supported by Slovenian Research and Innovative Agency grant No. P4-0053.</funding-statement>
</funding-group>
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<fig-count count="2"/>
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<ref-count count="174"/>
<page-count count="20"/>
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<custom-meta-group>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Toxicology, Pollution and the Environment</meta-value>
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</front>
<body>
<sec sec-type="intro" id="s1">
<label>1</label>
<title>Introduction</title>
<p>
<italic>I cannot have control over what I am unable to name.</italic>
</p>
<p>
<italic>Jorge Bucay.</italic>
</p>
<p>Since the Industrial Revolution and especially after World War II, the environment has been heavily polluted with industrial waste and products, vehicle exhaust and numerous human-made chemicals used in agriculture, animal husbandry and aquaculture. Although the acute and chronic toxicity of various pollutants was known previously, a question arose in the late 1950s as whether certain compounds used in livestock farming could interact with the human endocrine system (<xref ref-type="bibr" rid="B50">Gassner et al., 1958</xref>). In 1960s and 1970s, ecologists observed several poorly understood phenomena. Egg hatching failure was reported in some bird populations inhabiting North American lakes, reproductive disorders were observed in domesticated minks, and premature births were reported in sea lions (<xref ref-type="bibr" rid="B51">Gilbertson and Reynolds, 1972</xref>; <xref ref-type="bibr" rid="B8">Aulerich et al., 1973</xref>; <xref ref-type="bibr" rid="B28">DeLong et al., 1973</xref>). Furthermore, endocrine disruption has been intensively studied since the early 1990s, revealing that these pollutants can have unpredictable and widespread effects on both human and animal health (<xref ref-type="bibr" rid="B129">Schug et al., 2016</xref>). Some pioneering studies set the stage for research into endocrine disruption and deserve mention. In 1992, <xref ref-type="bibr" rid="B16">Carlsen et al. (1992)</xref> reported a decline in semen quality in humans over the prior 50 years and connected these results with increased pollution in the period studied. One year later, <xref ref-type="bibr" rid="B135">Sharpe and Sakkbeak (1993)</xref> listed several compounds with oestrogenic activity and linked them to human reproductive and developmental disorders. In the same year, <xref ref-type="bibr" rid="B21">Colborn et al. (1993)</xref> reviewed studies that described endocrine-disrupting effects in several wildlife species and started to use the term <italic>endocrine-disrupting chemicals</italic> (EDCs) (even though &#x201c;wildlife&#x201d; refers to undomesticated animals and uncultivated plant species, in this article we use the term only for undomesticated animals). In addition, <xref ref-type="bibr" rid="B55">Guillette et al. (1994)</xref> reported a population decline and feminization of male alligators in a contaminated lake in Florida. Furthermore, an increased incidence of some developmental disorders such as hypospadias and cryptorchidism was observed in human newborns (<xref ref-type="bibr" rid="B111">Paulozzi, 1999</xref>). These studies raise questions about the broader effects of EDCs on wildlife and humans. In the following years, research focused on the identification of EDCs, their potency, and their interactions with the regulatory mechanisms in animal and human bodies. These aspects, with a particular focus on wild mammals, are also addressed in the present paper. The historical insight into the research of endocrine disruption is well documented in the review by <xref ref-type="bibr" rid="B129">Schug et al. (2016)</xref>.</p>
<p>Building decades of research demonstrating the widespread and multi-level impacts of EDCs, recent studies have increasingly focused on epigenetic mechanisms by which these chemicals influence gene expression and developmental programming (<xref ref-type="bibr" rid="B63">Herr&#xe1;ez et al., 2023</xref>). Attention has also shifted towards transgenerational effects, revealing that EDC exposure can affect not only directly exposed individuals but also subsequent generations (<xref ref-type="bibr" rid="B31">Dias et al., 2025</xref>). Beyond classical reproductive outcomes, current research investigates broader health impacts, including metabolic, neurological, and cancer-related effects (<xref ref-type="bibr" rid="B2">Ahn and Jeung, 2023</xref>). Methodologically, there is a move towards integrative approaches, addressing mixture effects, and long-term environmental monitoring (<xref ref-type="bibr" rid="B12">Boahen et al., 2025</xref>). There is also a growing emphasis on translating scientific findings into policy and mitigation strategies, highlighting the need to link mechanistic understanding with actionable interventions to reduce environmental and human exposure to EDCs (<xref ref-type="bibr" rid="B64">Hilz and Gore, 2023</xref>).</p>
<p>EDCs are defined by Endocrine Society as <italic>an exogenous chemical, or mixture of chemicals, that can interfere with any aspect of hormone action</italic> (<xref ref-type="bibr" rid="B170">Zoeller et al., 2012</xref>; <xref ref-type="bibr" rid="B129">Schug et al., 2016</xref>). These xenobiotics are mainly of anthropogenic origin and occur in various forms. Many substances, including pesticides and their metabolites, plasticizers, various industrial pollutants, pharmaceutical residues and cosmetic ingredients, are on the list of EDCs (<xref ref-type="bibr" rid="B153">The ED Lists, 2022</xref>). Owing to their widespread presence and strong persistence in the environment, EDCs can affect a wide range of organisms. For example, wild animals are exposed to a mixture of different EDCs, even if the ecosystem to which they belong is not directly contaminated by the nearest industrial plants, traffic, agricultural land or landfills. From the point of origin or deposition, EDCs can spread widely in the environment via the atmosphere and water. Importantly, EDCs, even when generated on land, not only have serious impacts on terrestrial ecosystems but also cause damage to the aquatic environment (<xref ref-type="bibr" rid="B152">Teng et al., 2012</xref>; <xref ref-type="bibr" rid="B73">Johnson et al., 2013</xref>; <xref ref-type="bibr" rid="B95">McKinney et al., 2015</xref>; <xref ref-type="bibr" rid="B13">Brown et al., 2018</xref>; <xref ref-type="bibr" rid="B14">Butnariu, 2022</xref>).</p>
<p>Wild mammals play vital roles in ecosystems and contribute not only to ecosystem stability and biodiversity but also to key ecological processes such as nutrient cycling, seed dispersal, and trophic regulation (<xref ref-type="bibr" rid="B176">Lacher et al., 2019</xref>). By controlling prey populations, influencing vegetation dynamics, and serving as prey for higher predators, wild mammals help maintain ecological balance and resilience (<xref ref-type="bibr" rid="B141">Sinclair, 2003</xref>). They are also linked to human nutrition: some species have served as ancestors of domesticated animals, while others have traditionally been hunted as game, highlighting their dual ecological and socio-economic importance (<xref ref-type="bibr" rid="B171">Bennett et al., 2007</xref>). Endocrine disruption in these species can affect metabolism, reproduction, behaviours, and development, including fetal growth, and may decrease fertility through reduced sperm counts or disrupted oestrous cycle (<xref ref-type="bibr" rid="B21">Colborn et al., 1993</xref>; <xref ref-type="bibr" rid="B55">Guillette et al., 1994</xref>; <xref ref-type="bibr" rid="B156">Tyler et al., 1998</xref>; <xref ref-type="bibr" rid="B90">Lister and Van Der Kraak, 2001</xref>; <xref ref-type="bibr" rid="B145">Snoj et al., 2013</xref>; <xref ref-type="bibr" rid="B53">Graceli et al., 2020</xref>) and thus affect population dynamics, food web and ecosystems. As many EDCs have a long half-life, they tend to accumulate in soil and subsequently in plants, thereby exposing herbivores, and even more carnivores and scavengers to these compounds through the food web. This process, where the contaminant concentration increases at progressively higher levels of the food web, is known as biomagnification and is characteristic of both terrestrial and aquatic environments (<xref ref-type="fig" rid="F1">Figure 1</xref>).</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Conceptual illustration of biomagnification of endocrine-disrupting chemicals (EDCs) within a food web. Low concentrations of EDCs present in environmental compartments and primary producers (e.g., plants) become progressively concentrated in herbivores and are further amplified in carnivores and higher trophic levels. This schematic highlights how even low environmental levels of EDCs can result in substantial exposure in top consumers through trophic transfer.</p>
</caption>
<graphic xlink:href="fenvs-14-1761496-g001.tif">
<alt-text content-type="machine-generated">Pencil drawing illustrating environmental pollution with a factory emitting smoke, agricultural fields with a tractor, a pipe discharging waste into a river, and fish in the water covered in red spots, suggesting contamination impacts on aquatic life.</alt-text>
</graphic>
</fig>
<p>In light of mention facts, this overview explores the multifaceted drivers of endocrine disruption in wild mammals, with a particular focus on key anthropogenic and environmental factors contributing to hormonal imbalances. By elucidating these dynamics, we aim to improve understanding of the long-term implications for the health of wild mammals, identify gaps in current knowledge, and support the development of effective strategies to mitigate the harmful effects of EDCs. Ultimately, these goals will contribute to environmental sustainability and the preservation of biodiversity in the long term.</p>
</sec>
<sec id="s2">
<label>2</label>
<title>Mechanisms of endocrine disruption</title>
<p>In animals and humans, the endocrine system includes hormones acting as signalling molecules, hormone receptors in target cells and genes and enzymes involved in hormone synthesis and metabolism. Once released, hormones bind to specific receptors, triggering specific responses within target cells. Proper endocrine function relies on precise homeostatic regulation. However, endocrine homeostasis can be disrupted by both internal and external factors (<xref ref-type="bibr" rid="B11">Bartkowiak-Wieczorek et al., 2024</xref>). Among external factors, EDCs represent a major class of xenobiotics capable of interfering with hormonal signalling, synthesis, metabolism, and receptor binding, thereby leading to endocrine dysfunction.</p>
<p>EDCs can affect the endocrine system at every step of endocrine activity, as shown in <xref ref-type="fig" rid="F2">Figure 2</xref>. For example, these substances can affect the transcription of genes encoding peptide and protein hormones or enzymes involved in the synthesis of thyroid, steroid or other hormones. EDCs can also bind to hormone receptors as agonists or antagonists, interfering with endocrine signalling and disrupting the proper activity of endocrine axes and feedback loops; induce conformational changes in the tertiary structure of receptors; or affect the recruitment of cofactors, which are critical for ligand&#x2012;receptor transcriptional regulation and the modulation of target gene expression (<xref ref-type="bibr" rid="B34">Djordjevic et al., 2020</xref>; <xref ref-type="bibr" rid="B93">Marlatt et al., 2022</xref>). Some EDCs can induce or suppress enzymatic activity involved in hormone metabolism by interacting with regulatory receptors or directly inhibiting metabolic enzymes including cytochrome P450 and key steroidogenic enzymes (<xref ref-type="bibr" rid="B96">Mikamo et al., 2003</xref>). These mechanisms can alter hormone degradation and the clearance rate thereby significantly affecting the half-life and bioavailability of endogenous hormones (<xref ref-type="bibr" rid="B10">Balaguer et al., 2019</xref>). In addition, some EDCs have pleiotropic effects and can interact with several steps of endocrine activity (hormone synthesis and distribution, receptor binding, and hormone metabolism) and influence several endocrine signalling pathways (<xref ref-type="bibr" rid="B133">Shanle and Xu, 2011</xref>). EDCs also have tissue-specific effects depending on tissue receptor expression and the expression of intracellular kinases (<xref ref-type="bibr" rid="B57">Guvvala et al., 2020</xref>). Kinases play a role in the endocrine system by mediating hormone signal transduction, regulating metabolism, controlling transcription, and influencing cellular growth and differentiation (<xref ref-type="bibr" rid="B123">Robinson-White and Stratakis, 2002</xref>). When EDCs bind to cell receptors, they either activate or block the receptor, leading to phosphorylation of intracellular kinases. Subsequently, transcription factors and metabolic enzymes are activated or inactivated, resulting in tissue-specific responses (<xref ref-type="bibr" rid="B84">Lee et al., 2013</xref>). The expression of kinases determines the cell&#x2019;s response to EDCs; active kinases produce strong effects, while low kinase expression leads to weaker responses. These effects depend on the type and density of hormone receptors in the tissue as well as the expression and activity of intracellular kinases (<xref ref-type="bibr" rid="B123">Robinson-White and Stratakis, 2002</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Schematic overview of the sources, mechanisms, and biological effects of endocrine-disrupting chemicals (EDCs). The figure illustrates major environmental sources of EDCs and their mechanisms of action. As shown, EDCs can interfere with endocrine regulation at multiple levels, resulting in a wide range of adverse outcomes.</p>
</caption>
<graphic xlink:href="fenvs-14-1761496-g002.tif">
<alt-text content-type="machine-generated">Infographic showing sources of endocrine-disrupting chemicals (EDCs) including industrial, agricultural, pharmaceutical, and natural origins on the left, mechanisms of EDC action such as altered hormone synthesis, hormone transport disruption, receptor interaction, and epigenetic effects in the center, and effects like reproductive disorders, population changes, ecosystem impact, cancer, immune and metabolic disorders, behavioral changes, developmental damage, and gonadal anomalies on the right with corresponding illustrations.</alt-text>
</graphic>
</fig>
<p>In general, the impact of EDCs on the mammalian organism results from the following mechanisms.<list list-type="bullet">
<list-item>
<p>Stimulation of endogenous hormone biosynthesis (e.g., EDC-induced upregulation of aromatase (CYP19) expression leading to increased oestrogen synthesis; atrazine indirectly enhancing aromatase activity).</p>
</list-item>
<list-item>
<p>Inhibition of endogenous hormone biosynthesis (e.g., phthalates inhibiting key steroidogenic enzymes in Leydig cells, resulting in reduced testosterone synthesis).</p>
</list-item>
<list-item>
<p>Binding to circulating hormone-binding proteins (e.g., isoflavones such as genistein and daidzein, compete with endogenous hormones for sex hormone binding globulin (SHBG), thereby altering hormone bioavailability).</p>
</list-item>
<list-item>
<p>Stimulation or inhibition of hormone-binding protein synthesis or degradation (e.g., PCBs, dioxins, BPA, vinclozolin, DDT induce changes in SHBG or transport protein expression, affecting free hormone levels).</p>
</list-item>
<list-item>
<p>Binding to a hormone receptor leading to activation of its signaling pathway (e.g., bisphenol A (BPA) binding to oestrogen receptors (ER&#x3b1;/ER&#x3b2;), thereby activating oestrogen-responsive transcriptional programs, or to the G protein&#x2013;coupled oestrogen receptor (GPER), triggering rapid non-genomic signalling; dioxins binding to the aryl hydrocarbon receptor (AhR) and modulating the expression of hormone-responsive genes through receptor crosstalk; organochlorine pesticides such as DDT/DDE acting as oestrogen receptor agonists).</p>
</list-item>
<list-item>
<p>Binding to a hormone receptor leading to inhibition of its signaling pathway (e.g., PCBs antagonizing thyroid hormone receptor activity; DDT/DDE acting as androgen receptor antagonists).</p>
</list-item>
<list-item>
<p>Interactions with components of hormone signaling pathways downstream of a receptor (e.g., phthalates such as di(2-ethylhexyl) phthalate (DEHP) modulating peroxisome proliferator-activated receptor gamma (PPAR&#x3b3;)-dependent signalling and downstream kinases, including adenosine monophosphate-activated protein kinase (AMPK) and extracellular signal-regulated kinase (ERK); aryl hydrocarbon receptor (AhR)-mediated crosstalk with oestrogen and thyroid hormone signalling pathways; BPA influencing non-genomic signalling cascades such as the Ras/ERK/AKT pathway; atrazine affecting cyclic adenosine monophosphate (cAMP)/phosphodiesterase 4 (PDE4)-dependent signalling; glyphosate-based formulations interfering with intracellular signal transduction; organophosphates altering neuroendocrine and metabolic signalling downstream of classical hormone receptors).</p>
</list-item>
<list-item>
<p>Stimulation of hormone receptor expression (e.g., bisphenols, isoflavones, or DDT exposure upregulating oestrogen receptor expression in certain tissues; phthalates upregulate PPAR&#x3b3; expression).</p>
</list-item>
<list-item>
<p>Inhibition of hormone receptor expression (e.g., dioxins and PCBs downregulate oestrogene and glucocorticoid receptors; vinclozolin and DDE downregulate androgen receptor).</p>
</list-item>
</list>
</p>
<p>These mechanisms are not mutually exclusive; many EDCs can act through multiple pathways simultaneously, and their effects can vary across tissues and species depending on receptor expression, kinase activity, and metabolic context (<xref ref-type="bibr" rid="B22">Combarnous and Nguyen, 2019</xref>).</p>
<p>There is extensive data on the acceptable daily intake of EDCs. <xref ref-type="table" rid="T1">Table 1</xref> presents data on the prevention of chronic toxicity caused by certain xenobiotics as reported in some publications and documents from global organizations. Generally, to protect against chronic toxicity, levels below maximum residue limits (MRLs) are considered acceptable for public health. However, EDCs can disrupt endocrine homeostasis at concentrations much lower than the MRLs (<xref ref-type="bibr" rid="B157">Vandenberg et al., 2012</xref>). In addition, wildlife feed is uncontrolled, and other non-oral routes of exposure to EDCs can also occur. In some environments, many different xenobiotics may be present, causing unpredictable toxic and endocrine-disrupting effects.</p>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Tolerable exposure and mechanism of endocrine-disrupting effects of certain EDCs.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="center">Industrial byproducts and contaminants</th>
<th align="center">Recommended dietary exposure</th>
<th align="center">Endocrine disruptive effect</th>
<th align="center">References</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="center">Dioxins (2,3,7,8-tetrachlorodibenzodioxin)</td>
<td align="center">1&#xa0;pg/kg&#xa0;bw/d</td>
<td rowspan="2" align="center">Decreasing in 17&#x3b2;-estradiol and progesterone levels</td>
<td rowspan="2" align="center">
<xref ref-type="bibr" rid="B147">Stellman et al. (2003)</xref>; <xref ref-type="bibr" rid="B88">Li et al. (2006)</xref>
</td>
</tr>
<tr>
<td align="center">(NOAEL, depends on species)</td>
</tr>
<tr>
<td rowspan="2" align="center">PCBs</td>
<td align="center">0.04&#xa0;mg/kg&#xa0;bw/d</td>
<td rowspan="2" align="center">Interaction with thyroid receptors as agonists or antagonists. Impact on leydig cell homeostasis. Impact on estrogens and testosterone secretion and sex hormone binding globulin (SHBG) concentration</td>
<td rowspan="2" align="center">WHO JECFA, n.d, <xref ref-type="bibr" rid="B34">Djordjevic et al. (2020)</xref>
</td>
</tr>
<tr>
<td align="center">(NOAEL, monkey)</td>
</tr>
<tr>
<td rowspan="2" align="center">Phthalates</td>
<td align="center">50&#xa0;&#x3bc;g/kg&#xa0;bw/d</td>
<td rowspan="2" align="center">Reduction of testosterone concentration in fetuses, affect HPG axis in several levels resulting in developmental disorders in males, affect follicular development</td>
<td rowspan="2" align="center">
<xref ref-type="bibr" rid="B159">Wang and Qian (2021)</xref>; <xref ref-type="bibr" rid="B44">Food Packaging Forum (2019)</xref>; <xref ref-type="bibr" rid="B65">Hlisn&#xed;kov&#xe1; et al. (2020)</xref>
</td>
</tr>
<tr>
<td align="center">(Tolerable daily intake for several phthalate esters, humans)</td>
</tr>
<tr>
<td rowspan="2" align="center">Bisphenol A</td>
<td align="center">0.2&#xa0;ng/kg&#xa0;bw/d</td>
<td rowspan="2" align="center">Estrogenic activity, mimics endogenous estrogens, disruption of the feedback loop: reproductive disorders infertility (changes in sperm parameters, estrus cycle), developmental disorders, occurrence of hormone related cancers</td>
<td rowspan="2" align="center">
<xref ref-type="bibr" rid="B131">Science Media Centre Espa&#xf1;a (2023)</xref>; <xref ref-type="bibr" rid="B105">Ohore and Zhang (2019)</xref>
</td>
</tr>
<tr>
<td align="center">(Tolerable daily intake)</td>
</tr>
<tr>
<td align="center">DDT and related compounds</td>
<td align="center">5&#x2013;30&#xa0;ng/kg&#xa0;bw/d</td>
<td align="center">Weak estrogenic agonist disrupts estrogen homeostasis which results in reproductive disorders in both sexes and failures in fetal development. Affects thyroid, androgen and renin-angiotensin function</td>
<td align="center">
<xref ref-type="bibr" rid="B75">Kabir et al. (2015)</xref>; <xref ref-type="bibr" rid="B110">Patisaul and Adewale (2009)</xref>; <xref ref-type="bibr" rid="B157">Vandenberg et al. (2012)</xref>
</td>
</tr>
<tr>
<td align="center">Atrazine</td>
<td align="center">0.3&#xa0;&#x3bc;g/kg&#xa0;bw/d</td>
<td align="center">It impacts FSH and LH concentration which is further reflected in the steroidogenesis of sex hormones. It mainly disturbs male reproduction</td>
<td align="center">
<xref ref-type="bibr" rid="B174">Health Canada (1993)</xref>; <xref ref-type="bibr" rid="B56">Guimar&#xe3;es-Ervilha et al. (2025)</xref>
</td>
</tr>
<tr>
<td align="center">Glyphosat</td>
<td align="center">0.1&#xa0;mg/kg&#xa0;bw/d</td>
<td align="center">Disruption of steroidogenesis, leading in reduced concentration of glucocorticoids and sex hormones. Controversal disruptive effect on hypothalamic-pituitary-peripheric glands axes resulting in downregulation of ACTH and upregulation of FSH and LH levels</td>
<td align="center">
<xref ref-type="bibr" rid="B38">EFSA, 2015</xref>; <xref ref-type="bibr" rid="B27">de Ara&#xfa;jo-Ramos et al., 2021</xref>
</td>
</tr>
<tr>
<td align="center">Organophosphates (dichlorvos, chlorpyriphos)</td>
<td align="center">0.004&#xa0;mg/kg&#xa0;bw/d</td>
<td align="center">Antiandrogenic action; organophosphates can affect male fertility and development. Similar effects are reported for carbamates</td>
<td align="center">
<xref ref-type="bibr" rid="B68">International Agency for Research on Cancer (1991)</xref>; <xref ref-type="bibr" rid="B78">Kitamura et al. (2006)</xref>; <xref ref-type="bibr" rid="B157">Vandenberg et al. (2012)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="center">Pyrethroids</td>
<td align="center">0.1&#x2013;1.0&#xa0;mg/kg bw/d</td>
<td rowspan="2" align="center">Interaction with androgen receptor leading to male reproductive disorders</td>
<td rowspan="2" align="center">
<xref ref-type="bibr" rid="B39">EFSA (2022)</xref>; <xref ref-type="bibr" rid="B136">Sheikh and Beg (2021)</xref>
</td>
</tr>
<tr>
<td align="center">(Tolerable daily intake); depends on pyrethroid compound</td>
</tr>
</tbody>
</table>
</table-wrap>
<p>Under physiological conditions, endocrine system homeostasis is maintained by very low concentrations (nmol or pmol) of hormones. Therefore, even a small amount of exogenous compounds can affect endocrine homeostasis. In addition, the dose-response effect of EDCs is not fully understood. It has been reported that low doses of EDCs can affect the endocrine system more than high doses. This is most likely because low doses up-regulate hormone receptors and thus provide a more intensive effect, while high doses cause receptor downregulation (<xref ref-type="bibr" rid="B157">Vandenberg et al., 2012</xref>).</p>
<p>However, we believe that exposure to high doses of EDCs can cause other subchronic, subacute, or acute toxic effects (such as cytotoxicity and oxidative stress resulting in nephrotoxic, hepatotoxic, haematotoxic, neurotoxic, etc .,&#x2026; effects) which alter animals&#x2019; health, welfare, and behaviour and therefore mask or modify their impact on the endocrine system. Endocrine effects occur after a longer period and cannot be observed in animals with other, more evident health disturbances. In addition, developing foetuses appear to be more susceptible to the action of EDCs than adults (<xref ref-type="bibr" rid="B93">Marlatt et al., 2022</xref>), especially during hormonally regulated sexual differentiation and brain development (<xref ref-type="bibr" rid="B107">Ottinger and vom Saal, 2002</xref>), which is important from a conservation perspective.</p>
<p>Given the evolutionary conservation of the endocrine system, all vertebrates and even some invertebrates are susceptible to the effects of EDCs. Since EDCs are now found in nearly all ecosystems, the true scale and impact of endocrine disruption on wild mammals are probably much greater than current research has revealed or documented.</p>
</sec>
<sec id="s3">
<label>3</label>
<title>Endocrine-disrupting chemicals</title>
<p>Most of the EDCs are persistent organic pollutants (POPs) and residues of pharmaceuticals. Although natural substances such as phytoestrogens, certain mycotoxins, and steroid metabolites in urine and faeces are not considered as EDCs, they might have endocrine-disrupting effects (<xref ref-type="bibr" rid="B29">Demaegdt et al., 2016</xref>; <xref ref-type="bibr" rid="B26">Darbre, 2022</xref>; <xref ref-type="bibr" rid="B162">Wojnarowski et al., 2021</xref>).</p>
<sec id="s3-1">
<label>3.1</label>
<title>Persistent organic pollutants (POPs) as endocrine-disrupting chemicals</title>
<p>POPs comprise numerous mainly human-made chemicals, including industrial products and by-products, pesticides and plasticizers. They are organic chemical substances with a special combination of physical and chemical properties that allow them to persist in ecosystems for long durations (<xref ref-type="bibr" rid="B74">Jones and De Voogt, 1999</xref>). POPs are highly mobile and can be dispersed through air, water, and migratory species, spreading contamination globally (<xref ref-type="bibr" rid="B91">Lohmann et al., 2007</xref>).</p>
<p>These substances bioaccumulate in the food web, affecting all trophic levels, especially higher levels, and causing adverse impacts (<xref ref-type="bibr" rid="B85">Leonards et al., 2008</xref>; <xref ref-type="bibr" rid="B13">Brown et al., 2018</xref>). Owing to their toxicity, certain POPs can cause serious acute and chronic health issues in humans and wildlife (<xref ref-type="bibr" rid="B114">Pelclova et al., 2006</xref>; <xref ref-type="bibr" rid="B134">Sharma et al., 2014</xref>; <xref ref-type="bibr" rid="B4">Alharbi et al., 2018</xref>). They accumulate in the fatty tissues and some of them affect the endocrine system (<xref ref-type="bibr" rid="B165">Wong et al., 2005</xref>; <xref ref-type="bibr" rid="B73">Johnson et al., 2013</xref>). Therefore, numerous POPs with endocrine-disrupting effects (The ED list n.d.) are present in the environment.</p>
<p>Dioxins are formed by the burning of organic material, which can result from human activity, forest fires, or volcanic activity. The most potent dioxin compound is 2,3,7,8-tetrachlorodibenzodioxin (TCDD). The acute toxic and carcinogenic effects of dioxins are well-known, while their probable contribution to atherosclerosis, hypertension, vascular damage and hepatotoxicity during long-term exposure is less well-known (<xref ref-type="bibr" rid="B114">Pelclova et al., 2006</xref>; <xref ref-type="bibr" rid="B134">Sharma et al., 2014</xref>). As EDCs, dioxins bind to the aryl hydrocarbon receptor, resulting in decreased 17&#x3b2;-estradiol levels (<xref ref-type="bibr" rid="B3">Aldeli et al., 2024</xref>). A decrease in progesterone levels was also reported after the exposure to low doses (2&#xa0;ng/kg) of TCDD (<xref ref-type="bibr" rid="B88">Li et al., 2006</xref>).</p>
<p>Organochlorine and organophosphate pesticides such as DDT (the first recognized EDC), lindane, aldrin, chlorpyrifos and endosulfan, which have long environmental half-lives, have been restricted in their application or removed from use entirely; however, owing to decades of widespread use, they are still present in the environment (<xref ref-type="bibr" rid="B110">Patisaul and Adewale, 2009</xref>; <xref ref-type="bibr" rid="B169">Zhuang et al., 2012</xref>). They interact with the endocrine system as androgen antagonists and oestrogen agonists and impact thyroid function (<xref ref-type="table" rid="T1">Table 1</xref>). Moreover, some currently used pesticides with short half-lives, such as the fungicide cyproconazole, also have endocrine-disrupting effects (<xref ref-type="bibr" rid="B61">He et al., 2024</xref>).</p>
<p>Further, pollution with polychlorinated biphenyls (PCBs) and their effects on the endocrine system are described in different species (<xref ref-type="bibr" rid="B175">Helle et al., 1976</xref>; <xref ref-type="bibr" rid="B121">Rier et al., 2001</xref>; <xref ref-type="bibr" rid="B104">No&#xeb;l et al., 2017</xref>; <xref ref-type="bibr" rid="B154">Troisi et al., 2020</xref>). They have pleiotropic endocrine-disrupting effects, affecting thyroid gland and sex hormone action (<xref ref-type="table" rid="T1">Table 1</xref>).</p>
<p>Plasticizers such as phthalates and bisphenol A (BPA) are known endocrine disruptors. Due to the continuous increase in global plastic production, they are now present in all ecosystems. Phthalates, an important class of EDCs, illustrate the pleiotropic mechanisms by which these chemicals operate. For example, at the hormonal level, phthalates can modify the release of hypothalamic, pituitary, and peripheral hormones and stimulate aromatase resulting in increased oestrogen synthesis. At the cellular level, these EDCs can interfere with membrane receptors, nuclear receptors, and intracellular signalling pathways and modulate the expression of genes associated with reproduction (<xref ref-type="bibr" rid="B157">Vandenberg et al., 2012</xref>; <xref ref-type="bibr" rid="B159">Wang and Qian, 2021</xref>). BPA exhibits oestrogenic activity (<xref ref-type="table" rid="T1">Table 1</xref>; <xref ref-type="bibr" rid="B79">Konieczna et al., 2015</xref>).</p>
<p>Previous studies have emphasized that POPs have impacts on both terrestrial and aquatic ecosystems (<xref ref-type="bibr" rid="B152">Teng et al., 2012</xref>; <xref ref-type="bibr" rid="B73">Johnson et al., 2013</xref>; <xref ref-type="bibr" rid="B95">McKinney et al., 2015</xref>; <xref ref-type="bibr" rid="B13">Brown et al., 2018</xref>). Marine mammals are exposed to POPs through contaminated water and prey (<xref ref-type="bibr" rid="B100">Moorhead, 2022</xref>). Several studies have demonstrated that EDCs negatively affect the endocrine system in a wide range of aquatic (<xref ref-type="table" rid="T2">Table 2</xref>), semiaquatic (<xref ref-type="table" rid="T3">Table 3</xref>) and terrestrial mammals (<xref ref-type="table" rid="T4">Table 4</xref>). Research on POP bioaccumulation as EDCs in terrestrial food webs is limited, largely due to lower environmental concentrations. Most studies have focused on Arctic ecosystems, where environmental conditions such as low temperatures, limited sunlight, and long-range atmospheric transport and climate-driven changes in contaminant fate promote POP accumulation (<xref ref-type="bibr" rid="B71">Jensen et al., 1977</xref>; <xref ref-type="bibr" rid="B87">Letcher et al., 2010</xref>; <xref ref-type="bibr" rid="B32">Dietz et al., 2015</xref>; <xref ref-type="bibr" rid="B92">Ma et al., 2016</xref>). In Arctic wild mammals, exposure to POPs has been linked to alterations in reproductive hormones, disrupted steroidogenic pathways, and impaired reproductive function, highlighting the potential endocrine-disrupting effects of these persistent pollutants.</p>
<table-wrap id="T2" position="float">
<label>TABLE 2</label>
<caption>
<p>Summary of studies reporting associations between EDCs and reproductive, endocrine, or health effects in aquatic wild mammals.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Species</th>
<th align="center">Effect</th>
<th align="center">Compound</th>
<th align="center">Tissue Data Report</th>
<th align="center">Reported Impacts</th>
<th align="center">References</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">
<italic>Globicephala melas</italic>
</td>
<td align="center">Endocrine disruption</td>
<td align="center">PCBs, heavy metals</td>
<td align="center">POP and metal concentrations measured in blubber and liver</td>
<td align="left">Despite high contaminant loads, no significant alterations in steroid or thyroid hormone levels were observed. The author suggested possible buffering effects due to low biotransformation capacity, though subtle or long-term endocrine impacts cannot be excluded</td>
<td align="center">
<xref ref-type="bibr" rid="B67">Hoydal (2017)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Tursiops truncatus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Blubber and blood</td>
<td align="left">The authors considered the reproductive impairments observed in navy dolphins as potentially linked to high tissue burdens of organochlorine EDCs, although direct causality was not definitively established</td>
<td align="center">
<xref ref-type="bibr" rid="B119">Reddy et al. (2001)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Tursiops truncatus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs</td>
<td align="center">Blubber</td>
<td align="left">Probabilistic risk assessment revealed that primiparous female bottlenose dolphins with elevated PCB levels had a 60%&#x2013;79% probability of reproductive failure, encompassing stillbirths, premature births, and neonatal mortality</td>
<td align="center">
<xref ref-type="bibr" rid="B130">Schwacke et al. (2002)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Tursiops truncatus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Blubber</td>
<td align="left">The authors considered that higher organochlorine burdens might impair reproduction in bottlenose dolphins, although the evidence remained correlative and causation was not established</td>
<td align="center">
<xref ref-type="bibr" rid="B160">Wells et al. (2005)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Orcinus orca</italic>
</td>
<td align="center">Endocrine disruption</td>
<td align="center">PCBs, DDTs, PBDEs</td>
<td align="center">Blubber</td>
<td align="left">The authors considered that elevated POP burdens&#x2014;especially in juveniles via maternal transfer&#x2014;may increase risk of immune and endocrine dysfunction, although direct hormone/endocrine biomarkers were not measured</td>
<td align="center">
<xref ref-type="bibr" rid="B80">Krahn et al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Delphinus delphis, Phocoena phocoena</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs and other POPs</td>
<td align="center">Blubber</td>
<td align="left">The authors considered that elevated POP burdens may inhibit ovulation or reduce reproductive activity in these species, although direct endocrine measures were not made</td>
<td align="center">
<xref ref-type="bibr" rid="B101">Murphy et al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Delphinus delphis, Phocoena phocoena</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs and other POPs</td>
<td align="center">Blubber</td>
<td align="left">The authors considered that elevated PCB burdens may contribute to reduced reproductive activity (e.g., lower pregnancy rates or ovulation indices) in female dolphins and porpoises, though direct hormone-endocrine measurements and causation remain unconfirmed</td>
<td align="center">
<xref ref-type="bibr" rid="B116">Pierce et al. (2008)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Phocoena phocoena</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs</td>
<td align="center">Blubber</td>
<td align="left">The authors considered that elevated PCB burdens were associated with reproductive failure (foetal death, stillbirth, non-offloading of contaminants) in mature females, though causality was not definitively established (blubber PCB concentrations: resting mature females mean &#x223c;18.5&#xa0;mg/kg lw; pregnant &#x223c;6&#xa0;mg/kg lw; lactating &#x223c;7.5&#xa0;mg/kg lw. 40%&#x2013;50% of mature females exceeded the reproductive toxicity threshold of 11&#xa0;mg/kg lw)</td>
<td align="center">
<xref ref-type="bibr" rid="B102">Murphy et al. (2015)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Zalophus californianus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">Organochlorines (PCBs, DDTs)</td>
<td align="center">Blubber</td>
<td align="left">The authors considered that elevated organochlorine pollutant burdens were associated with increased rates of premature births, though direct endocrine-mechanistic data were not provided (Organochlorine pesticide and PCB residues &#x201c;two to eight times higher&#x201d; in tissues of premature parturient females and pups compared to full-term parturient counterparts)</td>
<td align="center">
<xref ref-type="bibr" rid="B28">DeLong et al. (1973)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Zalophus californianus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">Organochlorines (PCBs, DDTs)</td>
<td align="center">Blubber and liver</td>
<td align="left">The authors considered that elevated organochlorine pollutant burdens along with viral and bacterial infections may contribute to premature parturition, although direct endocrine-hormone measurements were not reported</td>
<td align="center">
<xref ref-type="bibr" rid="B52">Gilmartin et al. (1976)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Halichoerus grypus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Blubber</td>
<td align="left">The authors considered that the slower decline in PCB concentrations may reflect a threshold effect on reproduction such that only females below a certain PCB burden could reproduce, implying enduring endocrine or reproductive risk</td>
<td align="center">
<xref ref-type="bibr" rid="B124">Roos et al. (1998)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Halichoerus grypus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Blubber</td>
<td align="left">The authors considered that declining organochlorine levels coincided with improved reproductive success (higher pregnancy rates, fewer uterine obstructions), supporting that historical contaminant exposure likely impaired reproduction, though direct endocrine-hormone measurements were not included</td>
<td align="center">
<xref ref-type="bibr" rid="B125">Roos et al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Pusa hispida</italic>
</td>
<td align="center">Endocrine disruption</td>
<td align="center">PCBs, OCPs, OH-metabolites</td>
<td align="center">Plasma</td>
<td align="left">The authors considered that elevated contaminant and metabolite burdens may affect thyroid hormone transport and retinol homeostasis in baltic ringed seals, suggesting endocrine disruption, though direct causal mechanisms remain complex</td>
<td align="center">
<xref ref-type="bibr" rid="B126">Routti et al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Phoca vitulina</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, organochlorines</td>
<td align="center">Blubber</td>
<td align="left">The authors reported that seals feeding on fish from polluted coastal waters had marked reproductive failures and attributed this to high PCB burdens, suggesting an endocrine or reproductive disruption effect, though detailed hormone measurements were not made (tissue levels of PCBs significantly higher in seals from polluted vs. less-polluted area)</td>
<td align="center">
<xref ref-type="bibr" rid="B120">Reijnders (1986)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Phoca vitulina</italic>
</td>
<td align="center">Endocrine disruption</td>
<td align="center">PCBs</td>
<td align="center">Blubber</td>
<td align="left">The authors demonstrated that higher PCB burdens were significantly associated with increased expression of thyroid hormone receptor &#x3b1; in blubber and decreased circulating thyroxine&#x2014;indicating measurable disruption of the thyroid endocrine axis</td>
<td align="center">
<xref ref-type="bibr" rid="B150">Tabuchi et al. (2006)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T3" position="float">
<label>TABLE 3</label>
<caption>
<p>Summary of studies reporting associations between EDCs and reproductive, endocrine, or health effects in semi-aquatic wild mammals.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Species</th>
<th align="center">Effect</th>
<th align="center">Compound</th>
<th align="center">Tissue/Serum data reported</th>
<th align="center">Reported impacts</th>
<th align="center">References</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">
<italic>Phoca vitulina</italic>
</td>
<td align="center">Endocrine disruption</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Blubber PCB: 2.1&#x2013;12.5&#xa0;&#x3bc;g/g lipid</td>
<td align="center">Increased expression of thyroid hormone receptor alpha (TR-&#x3b1;) in blubber (r &#x3d; 0.679; p &#x3c; 0.001) and decreased circulating total thyroxine (T4) (r &#x3d; &#x2212;0.711; p &#x3c; 0.001), indicating thyroid hormone disruption</td>
<td align="center">
<xref ref-type="bibr" rid="B150">Tabuchi et al. (2006)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Phoca vitulina</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Fish and tissue PCB/DDT levels reported</td>
<td align="center">The authors reported that populations of common seals feeding on fish from a heavily polluted coastal region exhibited marked reproductive failure, which they attributed to elevated PCB burdens, suggesting a causal link between contaminant exposure and reproductive impairment in marine mammals</td>
<td align="center">
<xref ref-type="bibr" rid="B120">Reijnders (1986)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Pusa hispida</italic>
</td>
<td align="center">Endocrine disruption</td>
<td align="center">PCBs, PBDEs, PFCs</td>
<td align="center">Liver: 0.8&#x2013;7.2&#xa0;&#x3bc;g/g lipid</td>
<td align="center">Elevated PCBs, PBDEs, and PFCs in baltic ringed seals were associated with decreased T4 and altered liver expression of genes involved in endocrine regulation, indicating endocrine disruption</td>
<td align="center">
<xref ref-type="bibr" rid="B126">Routti et al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Pusa hispida</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Blubber/fat: DDT &#x223c;75&#xa0;mg/kg (pregnant) vs. &#x223c; 130&#xa0;mg/kg (non-pregnant); PCB &#x223c;56&#xa0;mg/kg (pregnant) vs. &#x223c; 77&#xa0;mg/kg (non-pregnant) in extractable fat</td>
<td align="center">The authors considered that significantly higher DDT and PCB burdens in non-pregnant females were associated with low pregnancy rates and evidence of foetal resorption/abortion, suggesting reproductive impairment likely linked to organochlorine exposure, although a direct mechanistic causation was not definitively established</td>
<td align="center">
<xref ref-type="bibr" rid="B175">Helle et al. (1976)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Halichoerus grypus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs</td>
<td align="center">Blubber/tissue contaminant levels reported</td>
<td align="center">Adrenocortical hyperplasia and reproductive tract lesions associated with elevated environmental PCB levels</td>
<td align="center">
<xref ref-type="bibr" rid="B172">Bergman and Olsson, (1985)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Halichoerus grypus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Blubber concentrations in juveniles and adults reported; long-term monitoring shows &#x3a3;DDT and &#x3a3;PCB declined markedly over decades (&#x223c;11&#x2013;12%/yr for DDT, &#x223c;2&#x2013;4%/yr for PCBs)</td>
<td align="center">The authors observed that higher historic POP burdens were associated with suppressed reproductive success, and that reproductive indices improved as organochlorine concentrations declined, supporting a link between contaminant burden and reproduction, although direct mechanistic causation was not definitively proven</td>
<td align="center">
<xref ref-type="bibr" rid="B124">Roos et al., 1998</xref>; <xref ref-type="bibr" rid="B125">Roos et al., 2012</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Tursiops truncatus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">Organochlorines (&#x3a3;DDT, &#x3a3;PCB)</td>
<td align="center">Blubber/milk/blood OC levels; mean &#x3a3;DDT &#x3e;3&#xd7; higher in females whose calves died vs. those that survived &#x3e;6 months (P &#x3d; 0.002)</td>
<td align="center">The authors found that females with higher organochlorine burdens (especially &#x3a3;DDT) had higher rates of calf mortality, suggesting a likely link between OC exposure and reproductive failure, although direct causation could not be definitively established</td>
<td align="center">
<xref ref-type="bibr" rid="B119">Reddy et al. (2001)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Tursiops truncatus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs</td>
<td align="center">Tissue/blubber PCB levels measured</td>
<td align="center">The authors estimated a high likelihood of impaired reproductive success (stillbirth/neonatal mortality) in primiparous females linked to elevated PCB burdens, though causation cannot be definitively established. The authors reported excess risk of reproductive failure (stillbirth or neonatal mortality) in primiparous female bottlenose dolphins of approximately 60% (beaufort, NC), 79% (Sarasota, FL), and 78% (Matagorda bay, TX)</td>
<td align="center">
<xref ref-type="bibr" rid="B130">Schwacke et al. (2002)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Tursiops truncatus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, organochlorines</td>
<td align="center">Blubber and plasma organochlorine concentrations reported for individuals of known age, sex and birth order (47 blubber samples)</td>
<td align="center">The authors found that higher maternal burdens of OCs were associated with higher first-born calf mortality and reduced lifetime calving success in mothers, suggesting likely effects of organochlorine exposure on reproductive success, although definitive causation remains unproven</td>
<td align="center">
<xref ref-type="bibr" rid="B160">Wells et al. (2005)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Orcinus orca</italic>
</td>
<td align="center">Endocrine disruption</td>
<td align="center">POPs (PCBs, PBDEs, pesticides)</td>
<td align="center">Blubber POP concentrations measured</td>
<td align="center">Higher blubber POP concentrations in juveniles and adult males suggest maternal transfer and life-history accumulation patterns that increase the likelihood of immune and endocrine disruption, although direct causation was not measured</td>
<td align="center">
<xref ref-type="bibr" rid="B80">Krahn et al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Delphinapterus leucas</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs</td>
<td align="center">Liver/blubber PCB levels reported</td>
<td align="center">PCB exposure associated with altered steroid hormones (increased cortisol, decreased testosterone), indicating endocrine disruption; potential reproductive toxicity</td>
<td align="center">
<xref ref-type="bibr" rid="B173">De Guise et al. (1995)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Phocoena phocoena</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs, PBDEs</td>
<td align="center">Blubber/tissue PCB/DDT/PBDE levels reported</td>
<td align="center">The authors considered that higher POP burdens in blubber and tissues were associated with reproductive failure, including foetal loss and reproductive tract infections, likely via endocrine or immunotoxic pathways, although causation could not be definitively established</td>
<td align="center">
<xref ref-type="bibr" rid="B102">Murphy et al. (2015)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Zalophus californianus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Blubber/tissue PCB/DDT levels reported</td>
<td align="center">The authors considered the increased rate of premature births as being associated with high levels of organochlorine pollutants in blubber and tissues, likely through endocrine disruption, although causation could not be definitively established</td>
<td align="center">
<xref ref-type="bibr" rid="B28">DeLong et al. (1973)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Zalophus californianus</italic>
</td>
<td align="center">Reproductive disorder</td>
<td align="center">PCBs, DDTs</td>
<td align="center">Blubber/tissue PCB/DDT levels measured</td>
<td align="center">Premature parturition and reproductive failure associated with elevated DDTs and PCBs, indicating endocrine-mediated disruption of reproductive function</td>
<td align="center">
<xref ref-type="bibr" rid="B52">Gilmartin et al. (1976)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T4" position="float">
<label>TABLE 4</label>
<caption>
<p>Summary of studies reporting associations between EDCs and reproductive, endocrine, or health effects in terrestrial wild mammals.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="center">Species</th>
<th align="center">Effect</th>
<th align="center">Compound</th>
<th align="center">Tissue/Serum data reported</th>
<th align="center">Reported impacts</th>
<th align="center">References</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">
<italic>Macaca mulatta</italic> (exposure type: Experimental)</td>
<td align="left">Reproductive/endocrine disruption</td>
<td align="left">TCDD, dioxin-like PCBs</td>
<td align="left">Serum TCDD: 0.1&#x2013;1&#xa0;ng/g; PCB measured in serum</td>
<td align="left">Chronic oral exposure disrupted reproductive hormone regulation (estradiol, progesterone, LH, FSH), and higher PCB/TCDD burdens were associated with increased severity of endometriosis</td>
<td align="center">
<xref ref-type="bibr" rid="B121">Rier et al. (2001)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Apodemus speciosus</italic> (exposure type: Experimental)</td>
<td align="left">Reproductive disorder (male gametogenesis)</td>
<td align="left">Dioxins (TCDD)</td>
<td align="left">Serum TCDD levels reported; testis CYP1A1 expression</td>
<td align="left">The authors found that increased hepatic dioxin burdens and upregulated CYP1A1 expression were associated with reduced numbers of active spermatozoa, suggesting disruption of male reproduction via endocrine/oxidative pathways, although causation could not be definitively proven</td>
<td align="center">
<xref ref-type="bibr" rid="B69">Ishiniwa et al. (2013)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Vulpes lagopus</italic>
</td>
<td align="left">Endocrine disruption</td>
<td align="left">General POPs (PCBs, DDTs)</td>
<td align="left">Plasma hormones measured; tissue POPs reported</td>
<td align="left">Dietary exposure in juvenile males reduced plasma testosterone by &#x223c;75%, while thyroid hormones and vitamins A/E remained unaffected</td>
<td align="center">
<xref ref-type="bibr" rid="B58">Hallanger et al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Ursus arctos horribilis</italic>
</td>
<td align="left">Endocrine disruption/contaminant accumulation</td>
<td align="left">PCBs, DDTs</td>
<td align="left">Liver and adipose tissue POP levels measured</td>
<td align="left">The authors considered that POP accumulation during hibernation could lead to endocrine disruption, although hormone levels were not directly measured</td>
<td align="center">
<xref ref-type="bibr" rid="B19">Christensen et al. (2007)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Vulpes lagopus</italic>
</td>
<td align="left">Endocrine disruption/contaminant accumulation</td>
<td align="left">Organochlorines (PCBs, DDTs)</td>
<td align="left">Tissue (liver, fat) concentrations measured</td>
<td align="left">The authors considered that environmental exposure led to POP accumulation during hibernation and may disrupt reproductive and thyroid hormone systems, although hormone data were not directly measured</td>
<td align="center">
<xref ref-type="bibr" rid="B112">Pedersen et al. (2015)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s3-2">
<label>3.2</label>
<title>Residues of pharmaceuticals in the environment as endocrine-disrupting chemicals</title>
<p>The role of the environmental presence of pharmaceuticals with endocrine activity and their possible endocrine effects constitute a gap in present knowledge about EDCs. Most frequently mentioned in the literature is the influence of drug residues with oestrogenic effects. In these cases, the main drugs used are contraceptives, hormone replacement therapy and gynaecological treatment. As contraceptives, oestrogenic drugs are used in combination with progestins, which can also have an endocrine-disrupting effect on nontarget organisms. The synthetic oestrogen 17&#x3b1;-ethynyl oestradiol (EE2) is one of the most widely used oestrogenic drugs. Although environmental EE2 does not pose a risk to human health because of its extremely low concentration in drinking water (<xref ref-type="bibr" rid="B82">Laurenson et al., 2014</xref>), it can be present in relatively high concentrations in wastewater and can influence aquatic organisms. EE2 is a stable compound that can be deposited in sediments and triggers endocrine effects in nontarget organisms at very low water concentrations (ng/L) (<xref ref-type="bibr" rid="B6">Aris et al., 2014</xref>). Similar characteristics have also been reported for other pharmaceutical oestrogens (<xref ref-type="bibr" rid="B82">Laurenson et al., 2014</xref>). One of the most notorious oestrogenic pharmaceuticals, diethylstilbestrol (DES), may also have endocrine-disrupting effects in nontarget organisms. Increased susceptibility to hormone-related tumours has been reported to be passed on to the next generations of offspring of both sexes by maternal lines previously exposed to low doses of DES. The mechanisms include genetic and epigenetic processes that are passed on to subsequent generations (<xref ref-type="bibr" rid="B103">Newbold et al., 2006</xref>; <xref ref-type="bibr" rid="B63">Herr&#xe1;ez et al., 2023</xref>). Therefore, although the use of DES has been banned for decades, we can assume that its effects persist in the populations of several species. As mentioned above, synthetic progestins are also used to control reproductive functions. Medroxyprogesterone, and altrenogest, the most commonly used synthetic progestins, which are used also in veterinary medicine for oestrus synchronization have been reported to be toxic to aquatic plants in combination with microplastics and can enter the food chain (<xref ref-type="bibr" rid="B94">Martins et al., 2025</xref>). Medroxyprogesterone has progestogenic, androgenic and anti-oestrogenic effects (<xref ref-type="bibr" rid="B128">Schindler et al., 2008</xref>). In addition, medroxyprogesterone has been identified as a disruptor of the hypothalamic&#x2013;pituitary&#x2013;gonadal (HPG) axis and leads to impairment of brain, gonad and eye development; altered sex differentiation; and a reduced sperm count in zebrafish (<xref ref-type="bibr" rid="B168">Zhao et al., 2015</xref>; <xref ref-type="bibr" rid="B137">Shi et al., 2019</xref>; <xref ref-type="bibr" rid="B138">Shi et al., 2020</xref>).</p>
<p>Synthetic glucocorticoids such as dexamethasone and methylprednisolone and their metabolites can also occur in the environment. These compounds can affect steroidogenesis, testosterone levels, sperm production and embryonic development in fish (<xref ref-type="bibr" rid="B81">LaLone et al., 2012</xref>; <xref ref-type="bibr" rid="B97">Milla et al., 2009</xref>) and present a risk for mammals. Furthermore, glucocorticoids can affect hippocampal synaptogenesis in foetuses whose mothers have been exposed to them (<xref ref-type="bibr" rid="B25">Dai et al., 2024</xref>). Importantly, however, exposure to environmental residues of glucocorticoids may disrupt the homeostasis of the hypothalamic&#x2013;pituitary&#x2013;adrenal (HPA) axis in adult animals (<xref ref-type="bibr" rid="B109">Paragliola et al., 2017</xref>).</p>
<p>Various growth promoters used in livestock farming in some parts of the world also have a little-known ecotoxicological role. The synthetic androgen trenbolone acetate is used together with 17&#x3b2;-oestradiol as an implant with anabolic activity in beef production. Animals with implants constantly excrete active substances and their metabolites, such that the environment is directly contaminated by excreta or slurry and manure, especially in the grazing areas of large farms. It has been reported that low doses of trenbolone can disrupt the endocrine system in adult fish and impair development. Disruption of steroidogenesis and testosterone synthesis, masculinization of females and an altered sex ratio with an increased number of males in the population have been observed (<xref ref-type="bibr" rid="B5">Ankley et al., 2018</xref>). However, the impact of steroid growth promotors on mammals remains unclear.</p>
<p>From an ecotoxicological perspective, special attention should also be paid to residues of drugs with antagonistic effects on the endocrine system, such as tamoxifen, an anti-oestrogenic drug used to treat breast cancer; the 3&#x3b2;-hydroxysteroid dehydrogenase inhibitor trilostane, which is used in veterinary medicine to treat Cushing&#x2019;s disease; and the antimycotic ketoconazole, which inhibits steroidogenesis. Tamoxifen has been shown to be toxic to aquatic model organisms, as demonstrated in laboratory studies (<xref ref-type="bibr" rid="B106">Orias et al., 2015</xref>). Although acute and chronic toxicological effects have been described for many drugs that influence the endocrine system (including CYP450 inducers and inhibitors such as ketoconazole, rifampicin, trilostane, synthetic prostaglandins, and aromatase inhibitors), there are often insufficient data on their adverse effects as EDCs. Although their effects on the endocrine system in nontarget organisms have not been reported, it can be expected that such effects exist. The lack of such data represents a gap in knowledge about the impact of these substances on the environment; this topic needs further investigation.</p>
</sec>
<sec id="s3-3">
<label>3.3</label>
<title>Natural endocrine-disrupting chemicals</title>
<p>Wildlife in aquatic and terrestrial ecosystems are exposed to various natural compounds that are characteristic of each ecosystem and can affect the endocrine system. Several terrestrial plants that can serve as food for herbivores and omnivores contain phytoestrogens. For example, legumes contain isoflavones and coumestans, which are known to have an oestrogenic effect (<xref ref-type="bibr" rid="B30">Desmawati and Sulastri, 2019</xref>). Among all legumes, soybeans contain the highest amounts of phytoestrogens, of which the isoflavones genistein, daidzein, glycitein, formononetin, and biochanin A are the most representative. Other legumes found in grasslands or growing in uncultivated areas, such as various clovers and alfalfa, are also part of the diet of herbivores. The isoflavones and coumestans they contain can enter the food web and disrupt oestrogen homeostasis in herbivores and, moreover, in carnivores. In addition, lignans, which are plant cell wall components that have an oestrogenic effect, are found in some cereals (such as flaxseeds and sesame), fruits (apples, pears, pomegranates and berries) and nuts. Their endocrine effect has been described (<xref ref-type="bibr" rid="B149">Stiefel and Stintzing, 2023</xref>), but lignans have also been reported to have positive effects on the health of humans and experimental animals because of their anticancer effects (<xref ref-type="bibr" rid="B48">Gao et al., 2024</xref>; <xref ref-type="bibr" rid="B155">Truan et al., 2012</xref>). Moreover, stilbenes such as resveratrol are agonists of oestrogen receptors and are found in grapes, peanuts, mulberries and cranberries (<xref ref-type="bibr" rid="B86">Lephart, 2021</xref>). Resveratrol interacts with nuclear and membrane oestrogen receptors and thus influences gene expression and homeostasis of the HPG axis. It can also influence the concentration of the sex-hormone-binding globulin in plasma (<xref ref-type="bibr" rid="B117">Qasem, 2020</xref>).</p>
<p>In addition to phytoestrogens, wild herbivores and aquatic organisms can be exposed to various other natural endocrine disruptors, such as mycotoxins and cyanotoxins, which are increasingly being recognized as important environmental contaminants. Dead plant parts decompose under the influence of numerous microorganisms, including fungi of the genus <italic>Fusarium</italic>. Some <italic>Fusarium</italic> species produce mycoestrogens, such as zearalenone and deoxynivalenol (<xref ref-type="bibr" rid="B35">D&#xf6;ll and D&#xe4;nicke, 2011</xref>), which are important contaminants of livestock feed but can also occur in the environment (<xref ref-type="bibr" rid="B37">Eagles et al., 2021</xref>). During cold seasons, when fresh vegetation is scarce, wild herbivores consume decomposing plant material, which may be contaminated with mycoestrogens. Consequently, these mycoestrogens can enter the food web, potentially impacting animal and ecosystem health.</p>
<p>Similarly, aquatic ecosystems face contamination by cyanotoxins produced by cyanobacteria, with saxitoxin being the most well-known neurotoxin that accumulates in shellfish (<xref ref-type="bibr" rid="B24">Cusick and Sayler, 2013</xref>). While high concentrations cause acute poisoning characterized by neurotoxicity, hepatotoxicity, and dermal toxicity, low levels of cyanotoxins can disrupt endocrine function in exposed animals. For example, microcystins and cylindrospermopsin exert pleiotropic effects by binding to oestrogen receptors, disrupting endocrine axes, altering the expression of genes involved in steroidogenesis, and inducing oxidative stress (<xref ref-type="bibr" rid="B17">Casas-Rodriguez et al., 2022</xref>). Since cyanobacteria are found in freshwater and seawater, aquatic and semi-aquatic organisms are directly exposed to cyanotoxins, while terrestrial animals primarily encounter them through contaminated drinking water.</p>
<p>Additionally, natural steroid hormones and their metabolites, excreted via urine and faeces, can be found on plant surfaces, in soil, and in water, potentially causing endocrine disruption (<xref ref-type="bibr" rid="B1">Adeel et al., 2017</xref>). Although sunlight degrades these hormones quickly (<xref ref-type="bibr" rid="B161">Wester et al., 2016</xref>), continuous sources maintain or increase contamination. Research and public attention focus mainly on oestrogens, although other steroids and thyroid hormones have also been detected in the environment (<xref ref-type="bibr" rid="B167">Zhang et al., 2021</xref>; <xref ref-type="bibr" rid="B162">Wojnarowski et al., 2021</xref>). Sources include livestock herds, wild animal populations, wastewater and runoff. Wild herbivores are exposed to natural hormones from the environment through contaminated plants and water. Exposure to natural hormones is greater when wild herbivores graze alongside domestic livestock or in sewage-polluted areas. However, some steroid derivatives released by animals serve as pheromones, playing key roles in communication, reproduction, and behaviour, and thus should not be classified as endocrine-disrupting chemicals (<xref ref-type="bibr" rid="B89">Liberles, 2014</xref>).</p>
</sec>
</sec>
<sec id="s4">
<label>4</label>
<title>The potential effects of endocrine-disrupting chemicals on wild mammals</title>
<sec id="s4-1">
<label>4.1</label>
<title>Reproductive dysfunction and developmental impairments</title>
<p>While many environmental contaminants impair reproductive performance, not all disrupt the hormonal regulation of reproductive activity. In wild mammals, EDCs have been shown to alter hormone levels, gonadal development, and offspring viability through interference with sex steroid pathways (<xref ref-type="bibr" rid="B55">Guillette et al., 1994</xref>; <xref ref-type="bibr" rid="B59">Hayes et al., 2003</xref>; <xref ref-type="bibr" rid="B104">No&#xeb;l et al., 2017</xref>; <xref ref-type="bibr" rid="B154">Troisi et al., 2020</xref>; <xref ref-type="fig" rid="F2">Figure 2</xref>).</p>
<p>As thoroughly reviewed by <xref ref-type="bibr" rid="B93">Marlatt et al. (2022)</xref>, certain EDCs accumulate in aquatic and terrestrial vertebrates, affect HPG axis homeostasis, and disrupt reproductive performance. Although several observational studies report endocrine-disrupting effects in fish, amphibians, lizards and birds, the effects of EDCs on wild mammals are reported in aquatic and semiaquatic species, but less frequently in terrestrial species. It was shown that the concentrations of several POPs negatively corelate with sex steroids and thyroid hormones in polar bears, Baltic grey seals (<italic>Halichoerus grypus</italic>), Wadden Sea harbour seals (<italic>Phoca vitulina</italic>) and ringed seals (<italic>Phoca hispida</italic>). In addition, in harbour and grey seals, PCBs were associated with altered expression of genes regulating steroidogenesis and with modified sex hormone concentrations (<xref ref-type="bibr" rid="B104">No&#xeb;l et al., 2017</xref>; <xref ref-type="bibr" rid="B154">Troisi et al., 2020</xref>). Reviews of domestic ruminants indicate that contaminants such as PCBs, BPA, and phthalates disrupt spermatogenesis and sperm maturation by interfering with steroidogenic enzymes, gonadotropin secretion, and oxidative stress pathways (<xref ref-type="bibr" rid="B57">Guvvala et al., 2020</xref>). Most EDCs are lipophilic due to their molecular structure which typically contain non-polar groups and lack polar groups (<xref ref-type="bibr" rid="B118">Rashidian et al., 2025</xref>). These non-polar characteristics increase their affinity for lipids allowing them to accumulate in fatty tissues and can be transmitted through the placenta to foetuses and through colostrum and milk to newborn offspring. From a conservation perspective, the impact on foetuses and newborns is probably the most important point, since exposure to EDCs at this stage can dramatically influence gonadal development and reproductive performance in the next-generation. As reviewed by <xref ref-type="bibr" rid="B93">Marlatt et al. (2022)</xref>, smaller penile bones were found in minks and otters, which is associated with exposure to organochlorine compounds. Also, in polar bears exposed to organohalogen contaminants, smaller penile bone, testis, and ovarian size were observed. Similar effects were also found in some cetaceans. These developmental impairments can lead to reduced reproductive ability in both sexes.</p>
<p>Considering the information described, the question arises whether low sex steroid levels in polar bears and seals result from the direct action of EDCs on steroidogenesis in adult animals, or from the impact of EDCs during early developmental stages, when sexual differentiation occurs. A possible option is also a combined effect of both.</p>
<p>Moreover, it has been reported that the incidence of cryptorchidism in humans has dramatically increased in recent decades (<xref ref-type="bibr" rid="B111">Paulozzi, 1999</xref>; <xref ref-type="bibr" rid="B66">Holmboe et al., 2024</xref>). Most likely, this is associated with uterine exposure to certain EDCs, which disrupt hormonally regulated descent of the testes. Interestingly, an increased incidence of cryptorchidism has not been reported in wild mammals. Since the descent of the testes in mammals is regulated by the same mechanism, the presence of EDCs in the environment would be expected to increase the incidence of cryptorchidism in wild mammals. However, it appears that no studies have focused on this issue, which could be a topic for further research.</p>
</sec>
<sec id="s4-2">
<label>4.2</label>
<title>Behavioural changes</title>
<p>EDCs can significantly alter animal behaviour, often through disruptions in hormone signalling (<xref ref-type="bibr" rid="B20">Clotfelter et al., 2004</xref>; <xref ref-type="bibr" rid="B164">Wolstenholme et al., 2012</xref>). The endocrine system not only directly influences behaviour but also interacts with physiological traits such as metabolism, building a feedback loop between behavioural changes and neuroendocrine activity (<xref ref-type="bibr" rid="B54">Guillette and Gunderson, 2001</xref>; <xref ref-type="bibr" rid="B107">Ottinger and vom Saal, 2002</xref>; <xref ref-type="bibr" rid="B166">Zala and Penn, 2004</xref>). Moreover, EDCs do not merely induce behavioural changes; in some laboratory animals, they have also been shown to produce epigenetic and transgenerational effects (<xref ref-type="bibr" rid="B163">Wolstenholme et al., 2011</xref>; <xref ref-type="bibr" rid="B103">Newbold et al., 2006</xref>; <xref ref-type="bibr" rid="B63">Herr&#xe1;ez et al., 2023</xref>). The most extensively studied pollutants affecting behaviour include DDT, EE2, genistein, organophosphate insecticides, PCBs, and TCDD (<xref ref-type="bibr" rid="B45">Frye et al., 2012</xref>). In wild mammals, behavioural changes can serve as early indicators of environmental contamination, as behaviour is a direct manifestation of an organism&#x2019;s physiological response to its environment (<xref ref-type="bibr" rid="B140">Sih et al., 2011</xref>). Most studies have been conducted in humans or laboratory animals, due to the relative ease of sample collection and the ability to perform controlled experiments over shorter timeframes. However, the effects of EDCs impact on behaviour in wild mammals remain largely unexplored. Despite the growing recognition of the importance of behavioural measures, the potential of these changes as reliable bioindicators remains underexplored.</p>
</sec>
<sec id="s4-3">
<label>4.3</label>
<title>Metabolic disorders</title>
<p>EDCs interfere with hormonal regulation and metabolic pathways, contributing to disorders such as obesity, insulin resistance, and type 2 diabetes in humans (<xref ref-type="bibr" rid="B83">Le Magueresse-Battistoni et al., 2018</xref>; <xref ref-type="bibr" rid="B98">Mimoto et al., 2017</xref>). Compounds including BPA and certain phthalates activate PPAR&#x3b3;, promoting preadipocyte differentiation and adipogenesis, which increases fat mass and alters adipose tissue metabolism (<xref ref-type="bibr" rid="B115">Petrakis et al., 2017</xref>). EDCs disrupt pancreatic &#x3b2;-cell function, impair insulin secretion via oxidative damage and calcium signalling interference, and exacerbate insulin resistance through upregulation of inflammatory cytokines such as TNF-&#x3b1; and IL-6, which blunt insulin signal transduction in liver and muscle (<xref ref-type="bibr" rid="B115">Petrakis et al., 2017</xref>; <xref ref-type="bibr" rid="B77">Khalil et al., 2023</xref>). Adipokine secretion is altered, with increased leptin and decreased adiponectin, further disrupting insulin sensitivity. Metabolic disruptions, often linked to thyroid and insulin regulation, represent sensitive early indicators of environmental stress in animals (<xref ref-type="bibr" rid="B83">Le Magueresse-Battistoni et al., 2018</xref>). Although the metabolic effects of EDCs have been extensively investigated in humans, comparable evidence in wild mammals remains limited, although several studies in polar bears and grey seals have reported associations between contaminant burdens and metabolic disruption (<xref ref-type="bibr" rid="B151">Tartu et al., 2017</xref>; <xref ref-type="bibr" rid="B122">Robinson et al., 2018</xref>). These findings highlight a critical knowledge gap and suggest that further research is needed to assess the mechanistic and ecological impacts of EDCs on metabolism in wild mammal populations.</p>
</sec>
<sec id="s4-4">
<label>4.4</label>
<title>Effects of endocrine-disrupting chemicals across ecological levels</title>
<p>The effects of EDCs can be observed at various levels, including the individual, population, and community levels, with distinct impacts occurring at each level (<xref ref-type="bibr" rid="B148">Stickel, 1975</xref>; <xref ref-type="bibr" rid="B127">Saaristo et al., 2018</xref>).</p>
<p>At the individual level, EDCs can directly affect an organism&#x2019;s health, reproductive capacity, behaviour, and development (<xref ref-type="bibr" rid="B158">Vos et al., 2000</xref>). Therefore, foraging efficiency, mate selection, and predator avoidance ultimately influence an organism&#x2019;s ability to survive and reproduce.</p>
<p>At the population level, the cumulative effects of EDCs on individuals can manifest as changes in population size, structure, and dynamics (<xref ref-type="bibr" rid="B139">Sibly et al., 2005</xref>). Reduced reproductive success, skewed sex ratios, and increased incidence of disease can lead to population declines and a reduction in genetic diversity (<xref ref-type="bibr" rid="B18">Chiba et al., 2023</xref>). Furthermore, the spread of diseases or a weakened immune system due to EDC exposure can increase mortality rates and further threaten population viability. In cases where reproductive health is significantly compromised, EDC exposure can lead to long-term population imbalances and even local extinctions (<xref ref-type="bibr" rid="B54">Guillette and Gunderson, 2001</xref>; <xref ref-type="bibr" rid="B177">Ruzzin et al., 2010</xref>).</p>
<p>At the community level, EDCs can disrupt interactions between species, including competition, predation, and symbiotic relationships, leading to broader ecological shifts. For example, if a pollutant reduces the reproductive success of one species, it may affect its ability to compete with other species, altering the community composition (<xref ref-type="bibr" rid="B15">Candolin and Wong, 2019</xref>). This could result in the proliferation of certain species while others decline, ultimately disrupting the ecological balance. The cascading effects of pollutant exposure at the community level may lead to a reduction in biodiversity, affecting ecosystem stability and function (<xref ref-type="bibr" rid="B166">Zala and Penn, 2004</xref>; <xref ref-type="bibr" rid="B140">Sih et al., 2011</xref>).</p>
<p>Understanding these multifaceted effects is crucial for effective environmental management and the conservation of ecosystems.</p>
</sec>
</sec>
<sec sec-type="discussion" id="s5">
<label>5</label>
<title>Discussion</title>
<p>In this overview, we have described some EDCs found in the environment and their effects on organisms. Although endocrine disruption is a well-known phenomenon reported in many research articles, the subject is vast and somewhat mysterious and constantly raises new questions. Studies of endocrine disruption are carried out as retrospective, observational and epidemiological studies of the changes occurring in ecosystems, more in the context of pollution monitoring, and in laboratories under controlled conditions (<xref ref-type="bibr" rid="B121">Rier et al., 2001</xref>; <xref ref-type="bibr" rid="B58">Hallanger et al., 2012</xref>; <xref ref-type="bibr" rid="B69">Ishiniwa et al., 2013</xref>; <xref ref-type="bibr" rid="B40">Encarna&#xe7;&#xe3;o et al., 2019</xref>). Additionally, <italic>in vitro</italic> and <italic>in vivo</italic> laboratory dose&#x2012;response studies and mechanistic studies have revealed the effects of individual EDCs and mixtures of EDCs and explained the mechanisms of their action. However, wildlife is typically exposed to complex mixtures of EDCs, the compositions of which can vary over time and across locations. Therefore, exposure to EDCs and their effects are unpredictable, even if they are expected. The discrepancies between controlled laboratory conditions and uncontrolled environmental conditions highlight the importance of observational research in wildlife conservation and management. Here, we highlight some gaps in knowledge about EDCs and suggest research opportunities to elucidate some of the links between the presence of EDCs and changes in ecosystems (<xref ref-type="table" rid="T5">Table 5</xref>). This knowledge will enable action to reduce the impact of EDCs on the environment.</p>
<table-wrap id="T5" position="float">
<label>TABLE 5</label>
<caption>
<p>The most important gaps in knowledge on endocrine disruption and suggested studies.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="center">Identified gaps in knowledge on endocrine disruption</th>
<th align="center">Suggested further studies</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Toxicokinetics of EDCs</td>
<td align="left">Toxicokinetic studies using appropriate animal model (laboratory animals)</td>
</tr>
<tr>
<td align="left">Inter-species differences in sensitivity to EDCs</td>
<td align="left">In sillico modelling of receptor binding, receptor-based assays, Comparative inter-species studies</td>
</tr>
<tr>
<td align="left">Developmental disorders (e.g., cryptorchidism) in wild mammals</td>
<td align="left">Long-term field observational studies, biomonitoring, linkage with exposure data</td>
</tr>
<tr>
<td align="left">Effects of mixtures of EDCs</td>
<td align="left">In silico modelling, artificial intelligence approaches, Observational and experimental mixture studies</td>
</tr>
<tr>
<td align="left">Epigenetic and transgenerational effects</td>
<td align="left">Epigenomic analyses &#x2013; DNA methylation, Histone modifications according to (predicted) contamination</td>
</tr>
<tr>
<td align="left">Interaction between EDCs and other environmental stressors</td>
<td align="left">Multifactorial experimental designs, longitudinal field studies linking exposure profiles with ecological and health endpoints</td>
</tr>
<tr>
<td align="left">The role of hormones present in carnivore feed in maintaining endocrine system homeostasis</td>
<td align="left">Observational study on carnivores fed with isotope-labelled hormone feed and hormone-free feed</td>
</tr>
<tr>
<td align="left">Limited data for mammalian species</td>
<td align="left">Use of nonivasive sampling for chemical and biological monitoring, behavioural studies, population studies</td>
</tr>
</tbody>
</table>
</table-wrap>
<p>First, many observational and controlled laboratory studies have shown the effects of some EDCs on fish and reptiles (<xref ref-type="bibr" rid="B55">Guilette et al., 1994</xref>; <xref ref-type="bibr" rid="B168">Zhao et al., 2015</xref>; <xref ref-type="bibr" rid="B137">Shi et al., 2019</xref>; <xref ref-type="bibr" rid="B138">Shi et al., 2020</xref>; <xref ref-type="bibr" rid="B81">LaLone et al., 2012</xref>; <xref ref-type="bibr" rid="B5">Ankley et al., 2018</xref>), but there are few data on their effects in wild mammals (<xref ref-type="table" rid="T2">Tables 2</xref> and <xref ref-type="table" rid="T3">3</xref>). We would like to emphasize that this does not mean that there is no influence on wild mammals but rather that the effect on mammals has not yet been verified or confirmed. Many observational studies of aquatic ecosystems dedicate limited attention to mammals, largely because mammal populations are often too small to provide statistically meaningful data or because no clear signs of threat or decline are detected in those species.</p>
<p>Furthermore, wildlife is usually exposed to a mixture of EDCs in their natural environment and determining the harmful effects of each individual compound is difficult. In response to EDC exposure, differences between species have been observed (<xref ref-type="bibr" rid="B72">Jocsak et al., 2019</xref>). As already described, these differences result from the position of the species in the food web and thus from exposure to EDCs. However, there are also important differences in the toxicokinetic properties of EDCs and other xenobiotics between fish and mammals. The differences occur in the intensity of absorption, the distribution of individual EDCs in the body, and the intensity of xenobiotic metabolism and excretion. Additionally, the toxicodynamic properties should also be considered when different classes of vertebrates are compared. This also applies to the interaction between EDCs and receptors and the dose&#x2012;response relationship, where interspecies variations are to be expected.</p>
<p>Research on endocrine disruption is difficult to conduct for ethical reasons, as experiments on the effects of EDCs on target animals are not acceptable. Some nonmammalian animal models such as zebrafish and zebrafish embryos are generally used for laboratory testing of the disrupting effects of individual EDCs. Considering legislation and ethical reasons, experiments can be performed on laboratory rodents only if no other animal model is available, which is why researchers often do not use laboratory mice or rats. Therefore, basic information on the effects of EDCs on organisms under laboratory conditions can be obtained from embryos and adult zebrafish; however, for more detailed studies of the effects of EDCs on mammals, mammalian models should be included in research. We consider the lack of information on many EDCs that may affect the mammalian endocrine system to be an important gap in the knowledge of endocrine disorders. In silico methods and emerging digital technologies, such as artificial intelligence, can be used to assess the effects of multiple EDCs on individual animals and animal populations. These results may reflect real-world ecological conditions; however, observational studies should also be conducted continuously to validate and complement such findings.</p>
<p>Although EDCs can affect almost all endocrine signalling pathways, public attention has focused mainly on the disruption of oestrogen signalling. At the population level, disruption of reproductive homeostasis leads to a decline in reproduction and endangers the survival of the species. For this reason, understanding and good knowledge of EDC activities is an important prerequisite as part of the conservation strategy. As mentioned previously, many EDCs affect oestrogenic signalling. This raised the question of why several chemically different substances can bind the same receptor. Oestrogen receptors (a and b subtypes) do not seem to be highly specific. They belong to the family of nuclear receptors that contain a ligand-binding domain and a DNA-binding domain involved in the transcriptional activation of target genes (<xref ref-type="bibr" rid="B47">Gajadeera and Hanson, 2019</xref>). For the cellular effects of oestrogens, these receptors require several coregulatory proteins and peptides (<xref ref-type="bibr" rid="B62">Heldring et al., 2007</xref>), which can also be targets of EDCs. Since numerous compounds can interact with oestrogen receptors, it appears that oestrogen receptors, particularly their ligand-binding domain, are less specific for binding various ligands than other nuclear receptors (e.g., thyroid or glucocorticoid). We have not found an explanation for this statement in the literature, but interspecies variations in oestrogen receptors are well documented (<xref ref-type="bibr" rid="B7">Asnake et al., 2019</xref>). 17&#x3b2;-oestradiol, a physiological endogenous ligand with the same chemical structure in all vertebrates, can bind oestrogen receptors and thus provides physiological effects. However, the effects of different xenobiotics on the organism can vary between species and depend on the species-specific receptor expression and differences in receptor structure (<xref ref-type="bibr" rid="B72">Jocsak et al., 2019</xref>; <xref ref-type="bibr" rid="B9">Baker, 2022</xref>). This could explain why EDCs have more or less intense adverse effects in different species living in the same environment. This topic has not been sufficiently studied to draw conclusions and requires further investigation. Moreover, interspecies differences in the oestrogenic effects of EDCs are expected, as there are well-documented interspecies variations in the activation of PPAR&#x3b3; which is also a target of EDCs. PPAR&#x3b3; acts as a receptor regulating fatty acids, prostaglandins, and leukotrienes, and decreases the transcription of oestrogen-dependent genes (<xref ref-type="bibr" rid="B49">Garoche et al., 2021</xref>). To address this issue, the binding affinity of EDCs to oestrogen receptors across different species should be investigated using <italic>in silico</italic> modelling and receptor-based assays. At the ecosystem level, if endocrine-disruptive effects are observed in one species, a detailed examination of other species inhabiting the same environment should also be conducted.</p>
<p>Another little-known effect of EDCs on wildlife populations is their epigenetic effect. EDCs can directly influence oogenesis and spermatogenesis, and the germ cells themselves via DNA methylation and epimutation. Thus, many compounds can cause transgenerational epigenetic effects (<xref ref-type="bibr" rid="B99">Montjean et al., 2022</xref>; <xref ref-type="bibr" rid="B36">Dutta et al., 2023</xref>; <xref ref-type="bibr" rid="B63">Herr&#xe1;ez et al., 2023</xref>), meaning that changes in gene expression induced by EDC exposure in one generation can persist for multiple subsequent generations, even when those descendants have not been directly exposed to the chemical.</p>
<p>For example, studies in rodents have demonstrated that prenatal exposure to the fungicide vinclozolin during the critical window of foetal gonadal development induces altered DNA methylation in the male germline, resulting in reproductive and health disorders that persist to at least the F3 generation (<xref ref-type="bibr" rid="B142">Skinner and Anway, 2007</xref>; <xref ref-type="bibr" rid="B143">Skinner et al., 2008</xref>). Moreover, ancestral vinclozolin exposure has been associated with changes in brain transcriptomes, stress responses, mate preference, and behaviour in descendants, highlighting the profound and heritable nature of these epigenetic changes (<xref ref-type="bibr" rid="B23">Crews et al., 2012</xref>). The long-term consequences of such epigenetic effects are difficult to predict, but they likely impact the ecological balance by reducing population fitness, altering developmental trajectories, and increasing heritable susceptibility to disease, with serious implications for wildlife conservation. Future studies should focus on explaining the persistence and reversibility of EDC-induced epigenetic changes across generations in wild populations using integrated genomic, endocrine, and ecological approaches. Long term monitoring combined with epigenetic markers should be established to evaluate how EDCs impacts the population structure and adaptation to certain contaminants.</p>
<p>Several endangered species face increasing threats from climate change, human activities, illegal hunting, habitat loss, and ecological imbalances. Some of these species inhabit environments contaminated with EDCs. To what extent, if at all, do EDCs contribute to their extinction? In some well-documented cases, population declines have been linked to EDCs, such as alligators in Lake Apopka, Florida (<xref ref-type="bibr" rid="B55">Guilette et al., 1994</xref>), but it is not entirely clear, for example, what is happening to the smallest harbour porpoise, the vaquita (<italic>Phocoena sinus</italic>), in the Gulf of California. The species is highly endangered because of illegal fishing with gillnets used to catch totoaba fish. The number of vaquita decreased from approximately 600 in 1997 to approximately 10 in 2024. (<xref ref-type="bibr" rid="B70">Jaramillo-Legorreta et al., 2019</xref>). Moreover, several EDCs have been reported to be present in the tissues of different species from the Gulf of California (<xref ref-type="bibr" rid="B146">Stack et al., 2022</xref>). The main reason for the extinction of the vaquita is known, but EDCs can severely affect the reproduction of marine animals (<xref ref-type="bibr" rid="B120">Reijnders, 1986</xref>; <xref ref-type="bibr" rid="B101">Murphy et al., 2010</xref>; <xref ref-type="bibr" rid="B102">Murphy et al., 2015</xref>; <xref ref-type="bibr" rid="B67">Hoydal, 2017</xref>), which may be an additional reason for the decline in the vaquita population. This is just one example from the list of endangered species. Using this example, we suggest that conservation strategies should consider the impact of EDCs, even if it appears that the problem lies elsewhere.</p>
<p>Wildlife is also exposed to natural hormones that are excreted from other animals via urine and faeces and contaminate the environment or are present in the environment as phytoestrogens and mycotoxins. Omnivores and carnivores in particular are also exposed to natural hormones present in the tissues of their prey. All animal tissues and excreta contain natural hormones (<xref ref-type="bibr" rid="B144">Snoj and Majdi&#x10d;, 2018</xref>; <xref ref-type="bibr" rid="B108">Palacios et al., 2020</xref>). Some wild omnivores and carnivores also forage in urban areas, near human dwellings, in garbage and dumps where they can find discarded meat and dairy products. The amounts of hormones in animal tissue vary greatly and depend on the animal&#x2019;s sex, age, reproductive status, endocrine disorders, health status and stress responses. Since carnivores have been exposed to hormones from other animals throughout their evolution, the question arises as to whether these exogenous hormones play a physiological role in carnivorous species. This question remains largely unexplored in the current literature. Interestingly, some studies report that the levels of sex hormones and glucocorticoids are generally greater in carnivores than in herbivores, potentially reflecting specific physiological or ecological adaptations (<xref ref-type="bibr" rid="B33">Dixit et al., 1985</xref>; <xref ref-type="bibr" rid="B132">Seal et al., 1985</xref>; <xref ref-type="bibr" rid="B43">Felska-Blaszczyk et al., 2012</xref>; <xref ref-type="bibr" rid="B76">Karaer et al., 2023</xref>). We are aware that many environmental and endogenous factors influence blood hormone concentrations and that we cannot conclude that sex hormone and glucocorticoid levels are relatively high in carnivores in every comparable situation. Unfortunately, the proportion of exogenous hormones in the total concentration is not known. However, it is certainly greater in carnivores than in herbivores, which is why the possible physiological role of the exogenous hormones as mentioned above should be investigated in further studies. A study in carnivore species in which animal feed is supplemented with isotope-labelled exogenous hormones would partially elucidate this question.</p>
<p>Given the diverse effects of EDCs across species and their complex interactions within ecosystems, adopting a One Health perspective offers a crucial framework for understanding their broader implications. Future studies should aim to link EDC presence in wildlife not only to observable ecological changes but also to mechanistic outcomes that may affect domestic animals and human health. Integrating observational field studies, laboratory-based mechanistic research, and ecotoxicological monitoring will enable assessment of how EDCs propagate through trophic networks, influence reproductive and endocrine systems, and potentially increase disease susceptibility across species. By combining data from wildlife populations, livestock, and humans, researchers can elucidate shared pathways of endocrine disruption, including receptor-mediated and epigenetic mechanisms, and determine how these effects contribute to population-level outcomes. Such an integrative approach would support the development of evidence-based conservation strategies and public health policies to mitigate the environmental and health impacts of EDCs, highlighting the interconnectedness of ecosystems, wildlife, domestic animal, and human health.</p>
<p>Finally, we would like to emphasize that although is well known from historical experience that several synthetic compounds (or their metabolites) exhibit endocrine-disrupting effects&#x2013;often recognized decades after their introduction to the market&#x2013;there is currently no single, universal rule requiring all new chemicals to be screened for endocrine-disrupting activity before entering the market. Regulatory requirements vary depending on the type of substance and its intended use. In the European Union, regulations such as REACH (<xref ref-type="bibr" rid="B41">European Parliament and Council, 2006</xref>) and the EU Biocidal Products Regulation (<xref ref-type="bibr" rid="B42">European Parliament and Council, 2012</xref>) provide frameworks for the identification and control of substances with endocrine-disrupting properties, but the obligation to test a new compound depends on its classification, hazard profile, and product category. Similarly, other sectors such as cosmetics and pharmaceuticals follow separate directives, and not all new compounds are automatically subjected to EDC-specific testing. Considering the One Health approach, these facts highlight the need for implementation of global testing standards for chemicals in order to minimize environmental hazards.</p>
</sec>
<sec id="s6">
<label>6</label>
<title>Conclusion and suggestions</title>
<p>In conclusion, this overview highlights key gaps in our understanding of endocrine disruption and suggests important topics for further investigation. While the disrupting effects of pesticides and industrial contaminants are well documented, the potential endocrine-disrupting role of pharmaceutical residues remains poorly understood. Similarly, natural compounds with endocrine activity (e.g., phytoestrogens, mycotoxins, cyanotoxins, and hormones excreted by animals) may also contribute to endocrine disruption, either independently or through interactions with other EDCs. Species-specific endocrine responses to EDC exposure are also a topic that requires a multidisciplinary research approach. Furthermore, the epigenetic role of different EDCs needs to be considered. The endocrine effects of mixtures of several EDCs are also important challenges for researchers, as the ratio of EDCs in the mixture is constantly changing.</p>
<p>Notably, if industrial and agricultural activities continue to release pollutants, ecosystems face increasing threats, underscoring the need for effective pollution control. Renewable energy may help reduce endocrine disruption in wild mammals by lowering reliance on fossil fuels and decreasing the release of harmful pollutants. This transition could lower the risk of endocrine-related health issues in ecosystems and promote the sustainable use of natural resources, preserving biodiversity. Similarly, adopting organic farming methods, reducing pesticide use, and promoting biological control can help protect ecosystems. Sustainable farming practices, efficient water management, and advanced technologies such as sensors can further reduce environmental contamination. Stricter regulations on toxic chemicals in agriculture may also help protect wildlife and improve overall ecosystem health. These strategies collectively contribute to reducing endocrine disruption and promoting environmental sustainability. Ultimately, every individual can contribute to the preservation of biodiversity by making small lifestyle changes. We urge everyone to focus on using renewable energy sources, using less plastic, buying food and other goods wisely and disposing of waste properly. In this way, with little effort, we can reduce&#x2014;although, of course, not stop&#x2014;the pollution of the environment with substances whose effects on ecosystems often remain unknown. From this point of view, it is necessary to disseminate knowledge about endocrine disruption, which can be achieved through publications on social media. In addition to political actions such as international environmental agreements, everyone can contribute to reducing the number of unknown negative effects on the environment, leading to fewer cases where, in the words of Jorge Bucay as quoted in our introduction &#x2018;<italic>we cannot have control over that we are unable to name&#x2019;</italic>.</p>
</sec>
</body>
<back>
<sec sec-type="author-contributions" id="s7">
<title>Author contributions</title>
<p>MK: Conceptualization, Data curation, Formal Analysis, Investigation, Writing &#x2013; original draft, Writing &#x2013; review and editing. TS: Conceptualization, Investigation, Supervision, Writing &#x2013; original draft, Writing &#x2013; review and editing.</p>
</sec>
<sec sec-type="COI-statement" id="s9">
<title>Conflict of interest</title>
<p>The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="ai-statement" id="s10">
<title>Generative AI statement</title>
<p>The author(s) declared that generative AI was not used in the creation of this manuscript.</p>
<p>Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.</p>
</sec>
<sec sec-type="disclaimer" id="s11">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
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<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1454244/overview">Abolaji Samson Olagunju</ext-link>, Humanitas Research Hospital, Italy</p>
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