**3.4 Cancers**

*Environmental Issues and Sustainable Development*

leads to insulin resistance and type 2 diabetes [35].

*Exposure to EDCs can cause diabetes through multiple mechanisms.*

Diabetes (type 1 and type 2) is a complex metabolic disease resulting from deficiency of insulin secretion and/or action [35, 53]. The incidence of diabetes has risen significantly over the last several decades [35, 54]. The role of several EDCs in the development of diabetes has been extensively investigated. However, prospective studies are still needed to support the current findings (**Figure 5**)

Prenatal and early-life exposures to EDCs can play a role in the development of type 1 diabetes by increasing the risk of autoimmunity and affecting β-cell development and function [37]. EDCs with androgenic activity (e.g., bisphenol A) may interfere with β-cell function, impair insulin secretion by accelerating insulitis, and

Several EDCs (obesogens) may promote the development of type 2 diabetes through weight gain and the resulting insulin resistance. Exposure to bisphenol A

The hypothalamic–pituitary-gonadal axis is the most vulnerable endocrine axis to EDCs action. Several disorders have been reported including intersex variation (ambiguous genitalia), cryptorchidism (undescended testicles), hypospadias (abnormal opening of urethra), precocious puberty, infertility, polycystic ovarian disease, endometriosis, uterine fibroids, and cancers [1–4, 10, 12, 13, 21–23, 25, 38–40].

Over the past several years, male reproductive health has been on the decline with the increase incidence of congenital malformations and poor semen quality [23, 40]. Experimental and epidemiological studies support the hypothesis that prenatal exposure to EDCs with estrogenic and/or antiandrogenic activity (e.g., diethylstilbestrol, bisphenol A, and phthalates) may disrupt the secretion and/or action of two Leydig cell hormones (testosterone and insulin-like peptide 3) regulating testicular descent, leading to cryptorchidism in newborn (**Figure 6**) [40].

**3.2 Diabetes**

[3, 4, 10, 15, 16, 34–37].

cause type 1 diabetes [35].

**3.3 Reproductive disorders**

**Figure 5.**

*3.3.1 Male reproductive disorders*

**372**

Exposure to some EDCs (e.g., dioxins, organochlorines, arsenic, and cadmium) may promote the occurrence of different cancers including thyroid cancer, testicular cancer, prostate cancer, uterine cancer, breast cancer, skin cancer, and lymphoma (**Figure 7**) [2–4, 10, 12, 13, 18, 21, 22, 38, 44, 45].

**Figure 7.** *EDCs can promote the occurrence of different types of cancer.*
