Human Penile Abnormalities Are a Canary in the Coal Mine - THE CONSEQUENCES OF Exposure to Endocrine Disrupting Chemicals

​Congenital penile anomalies (CPAs) are among the most common human hereditary disabilities. Reports of CPAs, which include hypospadias, chordee, micropenis, and ambiguous genitalia, have risen sharply in recent decades. The causes of these defects are complicated and cannot be tied to a specific reason. However, good science indicates these might be partly attributable to contaminant exposure in fetuses. These contaminants are primarily industrial discharges and water and wastewater treatment plant contaminants. 

Hypospadias, Where the Urethra is Not Located at the Tip of the Penis, is the Most Common PCA.

Defects in penis development are becoming increasingly common, with hypospadias now affecting up to 1 in every 125 live male births. The most common CPA is hypospadias (68.3%), followed by chordee (8.6%) and hypospadias plus chordee (5%), and 14% are reported as unspecified penile anomalies. Hypospadias is a congenital disorder in males where the opening of the urethra is on the underside of the penis. Its occurrence has swiftly enlarged over latest decades, mainly credited to our increased exposure to endocrine-disrupting chemicals.
​
Human contaminants in water pose risks to reproductive health. Most of these compounds are known as endocrine-disrupting chemicals (EDCs). EDCs can affect the endocrine system and harm animals' and humans' development and fertility. The sources of chemical contamination in water are varied, initiating from byproducts formed during wastewater treatment procedures, water treatment processes and chemicals, releases from industry, livestock sewage, and drugs that pass through human bodies and then are released into sewage.

Micropenis is a Tragic Consequence of In Utero Exposure to EDCs

About 686 compounds are classified as EDCs, consisting of seven broad groups: consumer products, farming and agricultural, industry, intermediates, natural sources, medicine, and health care contaminants.

Examples of anthropogenic compounds that are commonly present in surface water:

• Opioids.
• Hormones from birth control pills.
• Acetaminophen and ibuprofen.
• Caffeine.
• Diclofenac (anti-inflammatory).
• Carbamazepine (anti-seizure).
• Artificial sweeteners.

The disinfection of drinking water was one of the most critical public health accomplishments in the last century. Treating water with chlorine significantly reduced the incidence of water-borne diseases like cholera and raised life expectancy. The reaction between disinfection agents and organic or inorganic matter in water forms compounds called water disinfection byproducts (DBPs). The presence of DBPs in drinking water is a human health alarm because epidemiological studies have revealed connections between DBP exposure and an increased risk of cancer development and harmful reproductive effects.

Fluorinated substances are a broad group of organic and inorganic substances that include at least one fluorine atom. Fluorinated substances are used in various consumer products and are highly persistent in the environment. Fluorinated substances have been correlated with reproductive and fertility dysfunction in men and women.
​
Bisphenol A (BPA) is a high-production volume chemical widely used in industrial polycarbonate plastics and epoxy resin manufacturing. Polycarbonate plastics are components in food and drink packaging like water and infant bottles, impact-resistant safety gear, and medical devices. Epoxy resins are lacquers that coat metal products (food cans, bottle tops, water supply pipes. BPA can bind membrane and nuclear receptors such as androgen, estrogen, and thyroid receptors, causing endocrine disruption, tumors, harmful reproductive consequences, and transgenerational effects.

Megalopenis in Infant

​Various PCAs include:

• Absence of the penis, known as aphallia, is a rare congenital irregularity. It is a result of either the deficiency of the genital tubercle or its failure to form fully, and it is associated with the level of hormones and chromosomal changes.
• Pseudodiphallia, a rare kind of diphallia, is a small accessory penile-like tissue without a typical penile anatomy structure.
• Cryptorchidism, or undescended testes (UDT), is the most common disorder of the male endocrine glands in children. One-third of boys with true cryptorchidism have bilaterally cryptorchid testes, whereas two-thirds have only one testicle undescended.
• Megalopenis is when the penile length is more than two standard deviations above the mean average size for age.
• A sexual ambiguity or clitoromegaly frequently reveals true hermaphroditism. An individual with ovarian and testicular tissue is a true hermaphrodite. The phenotypical outer shell may be those of either sex, and the internal and external genitalia may range from those of an average female to those of a typical male.
• In the United States, the incidence of micropenis was 1.5 in 10 000 male children born between 1997 and 2000. The high prevalence of micropenis – not previously reported in the international literature – and the potential relationship between fetal exposure to pesticides and micropenis.

The growing body of epidemiological, clinical, and experimental studies clearly shows evidence of the impact of EDC exposure on penile development. Moreover, extensive epidemiological studies and studies on animals exposed in utero to EDCs point to the epigenetic effects of fetal exposure to EDCs that could be transmitted to future generations.

EDCs can be found in drinking water; the most common way to be exposed to them is by drinking treated water. Other ways to be exposed include consuming food and beverages prepared with treated water, inhalation, and dermal absorption.
​
There are no regulatory discharge limits in the United States for EDCs to avert their possible negative impacts. Moreover, conventional treatment processes fail to remove the persistent EDC pollutants, leading researchers to develop alternative treatment methods. 

Dorsal Chordee is an Extreme Curving of the Penis

Much of the EDC load comes from wastewater treatment fluids, both industrial and municipal, that discharge into receiving bodies of water. Innovative wastewater treatment methods are vital to destroy EDCs. These techniques include advanced oxidation methods (photocatalytic and catalytic oxidation), phytoremediation, membrane separation, adsorption, and hybrid systems. These techniques can eliminate contaminants enabling clean water discharge into receiving bodies.

EDCs cost society because of disease and disability. Still, unlike other toxic chemicals such as carcinogens, they have yet to be codified into regulations as a hazard category.  Still, the first step to improving the situation is including EDCs in federally mandated water and air discharge limits. When the federal limits require treatment, the cost of treatment systems will drop to become feasible. 

In the meantime, some things you can do to limit your exposure to EDCs include:

• Minimizing consumption of processed foods.
• Using filtered water instead of bottled water.
• Keep away from storing canned or plastic-packaged foods in hot areas.
• Avoid microwaving and otherwise heating food in plastic containers.

 
Control of these materials and resultant human exposure would not be prohibitively costly or otherwise bothersome. Potable water treatment technologies exist to manage these complex molecules and can be implemented to manage exposures. Removing them at industrial point discharge sources is similarly practical. 
​
Tolerating these persistent and hazardous substances is a subsidy to industry, as industrial concerns produce and profit from the compounds. The cost saved by the current unregulated status is nominal but the effects on human health are immense.  Unfortunately, the current regulatory climate is so business-friendly that regulation of EDCs is a faint hope.