About
About the EDES Protocol
EDES — Endocrine Disruptor Exposure Screen — is a family of open-access clinical screening tools designed to help healthcare professionals conduct structured, practical assessments of environmental endocrine-disruptor exposure.
The tools are intended for use in everyday clinical settings: primary care consultations, paediatric assessments, preconception planning, environmental health reviews, and related contexts where exposure history is clinically relevant but often unaddressed.
What EDES is not
EDES tools are clinical support resources, not formal clinical guidelines. They do not diagnose conditions, determine causation, or replace clinical judgement. They are designed to prompt structured conversation and help clinicians identify exposure domains that may warrant further discussion, investigation, or practical advice.
The Clinical Translation Gap
The scientific literature on environmental endocrine disruptors has grown substantially over the past two decades. Evidence now links common chemical exposures — including plasticisers, pesticide residues, flame retardants, and personal care product ingredients — to a range of hormonally mediated health outcomes.
These include effects on reproductive development, fertility, thyroid function, metabolic regulation, neurodevelopment, and puberty timing, among others. Exposure windows during critical developmental periods — including the prenatal period, infancy, early childhood, and adolescence — are of particular clinical concern.
Despite growing awareness, clinicians rarely have access to a practical, structured framework for raising and discussing these exposures with patients. EDES was developed to address that gap — providing a consistent, evidence-informed assessment structure that does not require specialist training to use.
The EDES Tool Family
EDES currently comprises three tools, each designed for a distinct clinical population and context.
How the Tools Are Structured
Each EDES tool is organised around discrete exposure domains — categories of environmental chemical exposure that are both practically identifiable and clinically relevant. Domains are selected based on strength of evidence, real-world prevalence, and the availability of practical reduction strategies.
Within each domain, the tool provides:
- A structured question or prompt to guide the clinical conversation.
- A brief rationale note indicating the evidence basis for inclusion.
- A flag level indicating relative clinical priority (High / Moderate / Low).
- Practical counselling notes to support brief-intervention style advice.
Each tool page also includes a dedicated scoring and interpretation guide, which explains how to use flagged domains to prioritise follow-up and structure counselling.
Evidence Approach and Limitations
Evidence approach
Domain inclusion and flag levels are based on review of published epidemiological, toxicological, and clinical literature, with particular weight given to systematic reviews, prospective cohort studies, and expert body assessments where available.
EDES does not apply a single formal evidence-grading system. Instead, flag levels reflect a pragmatic synthesis of evidence quality, consistency of findings, and clinical relevance — with the intent of supporting practical decision-making rather than making formal causal claims.
Limitations and caveats
- EDES tools reflect a structured summary of available evidence at a point in time. They will require periodic review as the evidence base develops.
- The tools do not cover all possible endocrine-active exposures. Domain selection reflects a balance of clinical relevance, evidence strength, and practical usability.
- Exposure assessment by clinician interview is inherently limited by patient recall, self-reporting accuracy, and the complexity of real-world exposure patterns.
- EDES tools are not validated diagnostic instruments. They have not undergone formal clinical validation studies at this time.
- Use of these tools does not imply endorsement by any named institution, regulatory body, or expert reviewer unless explicitly stated.
A full list of references and evidence notes is available on the Evidence Base page.
Licensing and Permitted Use
All EDES tools and associated documentation are published as open-access resources under a Creative Commons Attribution–NonCommercial–ShareAlike licence (CC BY-NC-SA), subject to final legal review.
You may:
- Use the tools freely in clinical, educational, and public-health settings.
- Copy and share the tools with colleagues and institutions.
- Adapt the tools for non-commercial purposes, provided attribution is preserved.
You may not:
- Use the tools for commercial purposes without explicit permission.
- Remove or alter the medical disclaimer language.
- Imply endorsement by the EDES project or any named contributor.
Relationship to Endocrine Resilience
EDES is a project of Endocrine Resilience — an educational and implementation platform focused on translating endocrine health science into practical clinical and public-health tools.
The EDES site is intentionally maintained as a focused, standalone protocol resource. Endocrine Resilience provides the broader educational and implementation layer — including extensive clinician and patient documentation, consultation guides, and expanded science translation content.
Visit implementation resourcesExpert Review and Feedback
EDES is an evolving resource. We welcome evidence-based review, commentary, and suggested amendments from researchers, clinicians, epidemiologists, toxicologists, and public-health professionals.
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