Chlordecone exposure and its hidden burden on human health: mechanisms, epidemiology, and biomonitoring.

Chlordecone is a highly persistent organochlorine pesticide that has caused long-term environmental contamination, particularly in the French West Indies, where it was widely used on banana plantations between the 1970s and the early 1990s. Its chemical stability, high lipophilicity, and strong affinity for organic matter have led to prolonged retention in soil, water, and food chains, resulting in chronic exposure of local populations. Experimental studies indicate that chlordecone acts as a neurotoxin, hepatotoxin, and endocrine disruptor, and is involved in biological processes consistent with carcinogenicity. Epidemiological evidence has reported associations between chlordecone exposure and adverse health outcomes, including prostate cancer incidence in Guadeloupe and Martinique. Emerging experimental studies in animal models suggest possible epigenetic alterations and transgenerational effects following chlordecone exposure. Advances in analytical techniques, particularly chromatography and mass spectrometry methods, have improved the sensitivity and reliability of exposure assessment, although difficulties remain in distinguishing recent exposures from cumulative exposures. This study summarizes current knowledge on the impacts on human health and experimental models, as well as methodological advances, highlighting critical gaps and priorities for future research aimed at mitigating the current risks associated with this persistent pollutant.