Ob/Gyns advocate for environmental policy changes to help safeguard reproductive health.
The American College of Obstetricians and Gynecologists (The College) and the American Society for Reproductive Medicine (ASRM) jointly are urging ob/gyns to advocate for government policy changes to identify and reduce exposure to toxic environmental agents.
Toxic chemicals in the environment harm our ability to reproduce, negatively affect pregnancies, and are associated with numerous other long-term health problems, report The College and the ASRM.
“Lawmakers should require the US Environmental Protection Agency and industry to define and estimate the dangers that aggregate exposure to harmful chemicals pose to pregnant women, infants, and children and act to protect these vulnerable populations,” said Jeanne A. Conry, MD, PhD, president of The College.
“Every pregnant woman in America is exposed to many different chemicals in the environment,” said Dr Conry. “Prenatal exposure to certain chemicals is linked to miscarriages, stillbirths, and birth defects.”
Many chemicals that pregnant women absorb or ingest from the environment can cross the placenta to the fetus. Exposure to mercury during pregnancy, for example, is known to harm cognitive development in children.
The scientific evidence confirms that exposure to toxic environmental agents before conception and during pregnancy can have significant and long-lasting effects on reproductive health. These and other health problems associated with exposure to toxic environmental agents include the following:
• Miscarriage and stillbirth.
• Impaired fetal growth and low birth weight.
• Preterm birth.
• Childhood cancers.
• Birth defects.
• Cognitive/intellectual impairment.
• Thyroid problems.
Approximately 700 new chemicals are introduced into the US market each year, and more than 84,000 chemical substances are being used in manufacturing and processing or are being imported, explained The College and the ASRM.
“The scary fact is that we don’t have safety data on most of these chemicals even though they are everywhere-in the air, water, soil, our food supply, and everyday products,” Dr Conry said. “Bisphenol A (BPA), a hormone disruptor, is a common toxic chemical contained in our food, packaging, and many consumer products.”
“To successfully study the impact of these chemical exposures, we must shift the burden of proof from the individual health care provider and the consumer to the manufacturers before any chemicals are even released into the environment,” said Dr Conry.
Certain groups of people and communities have higher exposures to harmful environmental chemicals than others. “For example, women exposed to toxic chemicals at work are at higher risk of reproductive health problems than other women,” Dr Conry said. “Low-wage immigrants who work on farms have higher exposures to chemicals used on the crops that they harvest.”
“As reproductive health care physicians, we are in a unique position to help prevent prenatal exposure to toxic environmental agents by educating our patients about how to avoid them at home, in their community, and at work,” said Linda C. Guidice, MD, PhD, president of ASRM.
What can you do? The College and the ASRM suggest that health care providers can:
• Learn about toxic environmental agents common in their community.
• Educate patients on how to avoid toxic environmental agents.
• Take environmental exposure histories during preconception and first prenatal visits.
• Report identified environmental hazards to appropriate agencies.
• Encourage pregnant and breastfeeding women and women in the preconception period to eat carefully washed fresh fruits and vegetables and avoid fish containing high levels of methyl-mercury (eg, shark, swordfish, king mackerel, and tilefish).
• Advance policies and practices that support a healthy food system.
• Advocate for government policy changes to identify and reduce exposure to toxic environmental agents.
Easier said than done? You tell us…
Committee opinion no. 575: exposure to toxic environmental agents. Obstet Gynecol. 2013;122:931-935.