Association between environmental endocrine disruptors and autoimmune diseases: A systematic review and meta-analysis

Environmental endocrine disruptors (EDCs) affect the immune system and influence the development of autoimmune diseases (ADs). However, a comprehensive summary of the relationship between EDCs and ADs has not been developed. Consequently, we conducted a systematic review and meta-analysis of previous observational studies examining the association between exposure to EDCs and AD outcomes. We searched relevant literature published from January 2008 to the present, which ultimately included 19 studies. The synthesis of evidence demonstrated a positive association between AD risk and exposure to major EDC classes such as bisphenols (strongest association: OR = 2.38, 95% CI: 1.27-4.45), organochlorine pesticides, phthalates, and polycyclic aromatic hydrocarbons. This trend was not observed for polychlorinated biphenyls. These findings position EDC exposure as a potential risk factor for ADs, yet the mechanistic pathways require elucidation. Future high-quality longitudinal and experimental studies are essential to confirm these relationships and explore the underlying biology.