Published online February 1, 2008
PEDIATRICS Vol. 121 Supplement February 2008, pp. S167-S171 (doi:10.1542/peds.2007-1813C)
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SUPPLEMENT ARTICLE


Role of Environmental Factors in the Timing of Puberty

Susan Y. Euling, PhDa, Sherry G. Selevan, PhDa, Ora Hirsch Pescovitz, MDb and Niels E. Skakkebaek, MD, DMScc

a National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Washington, DC
b Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana
c University Department of Growth and Reproduction, Rigshospitalet, Blegdamsvej, Copenhagen, Denmark

Puberty-timing measures have historically been used as indicators of adequate nutrition and growth. More recently, these measures have been examined in relation to exposure to estrogenic or antiandrogenic agents, as well as other environmental factors. The scientific community has debated whether puberty timing is occurring earlier today than in the mid-1900s in the United States and, if so, whether environmental factors play a role; however, no one has asked a multidisciplinary panel to resolve this question. Thus, a multidisciplinary expert panel jointly sponsored by the US Environmental Protection Agency, the National Institute of Environmental Health Sciences, and Serono Symposia International was convened to examine the evidence of a secular trend, identify potential environmental factors of concern, and identify research needs regarding environmental factors and puberty timing at "The Role of Environmental Factors on the Timing and Progression of Puberty" workshop. The majority of the panelists concluded that the girls' data are sufficient to suggest a secular trend toward earlier breast development onset and menarche from 1940 to 1994 but that the boys' data are insufficient to suggest a trend during this same period. The weight-of-the-evidence evaluation of human and animal studies suggest that endocrine-disrupting chemicals, particularly the estrogen mimics and antiandrogens, and body fat are important factors associated in altered puberty timing. A change in the timing of puberty markers was considered adverse from a public health perspective. The panel recommended research areas to further our understanding of the relationships among environmental factors, puberty-timing outcomes, and other reproductive and adult disease at the individual and population levels.

Key Words: puberty • precocious puberty • growth and development • endocrine disruptors • body fat • environmental health • public health • environmental exposure • environmental pollutants

Abbreviations: EDC—endocrine-disrupting chemical

Accepted Sep 5, 2007.