PEPS'PE study. Prioritization of health effects to be monitored as part of the monitoring program in connection with endocrine disruptors from Santé publique France. Methodological report

Santé publique France is planning to extend monitoring of health indicators related to endocrine disruptors (EDs) within the framework of the National Strategy on Endocrine Disruptors (SNPE), the National Health Environment Plan 3 and the WHO recommendations, and also in response to the increasingly significant expectations that the public authorities and the general public have of the agency regarding EDs. For this reason, Santé Publique France has undertaken a project to prioritise the health effects associated with EDs, with the aim of setting the framework for the agency's surveillance programme on this topic. Santé Publique France is proposing a method of prioritising the health effects to be monitored because of a suspected link with exposure to EDs. This method consists of ranking effects firstly according to the weight of the existing evidence, and secondly according to the epidemiological and societal value of implementing this surveillance. In order to evaluate these two criteria, Santé publique France is proposing a complementary method that combines available data from the literature and the opinions of experts and stakeholders in the field using the Delphi method. This project fits into a rationale of health monitoring rather than taking an approach focused on a substance or exposure: it involves monitoring the evolution of a health indicator in the general population where there is a suspected link to exposure to EDs, instead of characterising the effect of an EDs product (or group of products) on health. The Delphi method involves organising the consultation of a panel of experts to obtain a final and convergent opinion from the group. It will be organised around two questionnaires available online, one looking at the scientific component, and the other asking about the societal component. To complete these questionnaires, two groups of experts are formed, bringing together experts from the scientific field and also stakeholders in the field of EDs. With a view to determining the agency's monitoring schedule, Santé publique France will then analyse whether it is feasible to monitor the effects that emerge as priority after the consultation. The proposed methodology aims to seek the best compromise between a scientifically robust, workable and clear process for all. This report summarises the methodology suggested by Santé publique France to prioritise health indicators in the context of exposure to EDs.