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Contributions Jos Vaessen (JV), Maren Duvendack (MD), Hugh Waddington (HW) and FransLeeuw (FL) contributed to the writing and revising of this systematic review. JV, Ana Rivas and Ger van Gils (GG) contributed to the design of the review and the information retrieval activities associated with the review. In the quality assessment of selected studies, we distinguish between assessment of methodological quality, carried out by MD, Richard Palmer Jones (RPJ) and HW, and assessment of the quality of the theoretical framework of selected studies carried out by GG and FL. The meta-analysis was conducted by MD, RPJ and HW, with additional support from Jorge Hombrados. The qualitative synthesis was conducted by GG, FL and JV. Nathalie Holvoet and Johan Bastiaensen helped developing the theoretical framework on microcredit and empowerment. Ruslan Lukach contributed to methodological design. JV will be responsible for updating this review as additional evidence accumulates and as funding becomes available.

The chemical structure of hydroxylated diphenylalkanes or bisphenols consists of two phenolic rings joined together through a bridging carbon. This class of endocrine disruptors that mimic estrogens is widely used in industay, particularly in plastics. Bisphenol F, bisphenol A, fluorinecontaining bisphenol A (bisphenol AF), and other diphenylalkanes were found to be estrogenic in a bioassay with MCF7 human breast cancer cells in culture (ESCREEN assay). Bisphenols promoted cell proliferation and increased the synthesis and secretion of cell type-specific proteins. 'When ranked by proliferaitive potency, the longer the alkl substituent at the bridging carbon, the lower the concentration neded for maximal cell yield; the most active compound contained two propyl chains at the bridging carbon. Bisphenols with two hydrox groups in the para position and an angular configurtion are suitable for appropriate hydrogen bonding to the acceptor site of the estrogen receptor. Our data suggest that estrogenicity is influenced not only by the length of the substituents at the bridging carbon but also by their nature. Because

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