Chemicals taking a toll on reproductive health of Americans

Chemicals from a variety of sources are having an increasingly negative effect on human health—especially in children—so ob-gyns need to step up efforts to reverse this trend through advocacy and education, said Linda C. Giudice, MD, PhD, during the Donald F. Richardson Memorial Lecture on Monday, May 6, at the Annual Clinical Meeting.

Dr. Giudice presented “Environmental Chemical Effects on Reproductive Health Outcomes: Strength of the Evidence and What We Can Do for Our Patients, Learners, and Communities.” She is the Robert B. Jaffe, MD, Endowed Professor in the Reproductive Sciences at the University of California, San Francisco.

“Our scientists are taking a good look at the data and are finding trends that are disconcerting. We now have an opportunity to do something,” she said, pointing out that since lead was phased out of gasoline in 1973, blood lead levels have plummeted. “We can transform exposures.”

In the past 20 years, impaired fecundity in the US has increased from 8% to 12%, and 90% of that change has come in the 15–24 age group. In males, sperm counts and testosterone levels have declined about 1% per year in recent decades, Dr. Giudice said. At the same time, hypospadias and testicular germ cell tumors have increased.

“Malformations of the male reproductive system are among the most common birth defects today,” she said.

In adults, unhealthy trends have also developed. Prostate and breast cancers are increasing, and aggressive breast cancer has increased 36%.

Today, 80,000 chemical substances are registered for use in US commerce, and 700 new industrial chemicals are introduced into commerce each year. However, these chemicals are not monitored closely. “It is only when something happens and there are questions that this product or chemical is looked into in more depth,” Dr. Giudice said.

Evidence for adverse reproductive outcomes from exposure to endocrine-disrupting chemicals is strong, she said. “What can we as health professionals do? I think we can strengthen professional education in reproductive and environmental health at the undergraduate and medical education levels and at the graduate medical education level,” Dr. Giudice said. “I think we should share what we know with our patients. We should together advocate for chemical policy reform.”