Reproductive outcomes

Additional studies of the Woburn population have been completed (MDPH 1994). The final report indicated that there was an increased prevalence in choanal atresia, a rare respiratory effect, and hypospadias/congenital chordee. A small increase in eye defects was observed, but there was no association between TCE exposure and heart defects. There was no statistically significant associations between exposure concentrations and birth defects, although analyses was limited by the small number of cases observed. Based on four cases in the Woburn population, a rate of 0.88 was observed in the exposed population, compared to rates of 0.11 and 0.13 in the Atlanta and California comparison populations, respectively. In a prospective study completed after well closure, the rate of choanal atresia was 0.88 (based on 1 case) in Woburn, 0.11 in the surrounding communities, and 0.2 and 0.13 in Atlanta and California, respectively. The study authors cautioned that their study did not rule out moderate increases in rates of the less common adverse reproductive outcomes. For these outcomes only large increases would have been detected. 

With the exception of studies examining reproductive outcome in people exposed to trichloroethylene in drinking water (ATSDR 1997 MDPH 1994), intermediate-duration studies in humans following oral exposure were not available. Intermediate-duration oral studies of trichloroethylene in animals (Barret et al. 1991, 1992 Buben and O Flaherty 1985 Constan et al. 1995 Dawson et al. 1993 Goel et al. 1992 Isaacson et al. 1990 Mason et al. 1984 Merrick et al. 1989 NCI 1976 NTP 1988, 1990 Stott et al. 1982 Tucker et al. 1982 Zenick et al. 1984) are available, but did not adequately provide exposure levels that could be... 

Volume 1 Analysis of reproductive outcomes and environmental exposures in Woburn, MA. Massachusetts Department of Public Health, Bureau of Environmental Health Assessment, Massachusetts of Health Research Institute in collaboration with the Division of Birth Defects and Developmental Disabilities, U.S. Centers for Disease Control and Prevention. 

STROM B L, SCHINNAR R, ZIEGLER E E, BARNHART K T, SAMMEL M D, MACONES G A, STALLINGS V A, DRULis j M, NELSON s E, HANSON s A (2001) Exposure to soy-based formula in infancy and endocrinological and reproductive outcomes in young adulthood. JAMA. 286 807-14. 

According to EPA (1986a), lead was used in preparations sold as abortifacients in Britain around the turn of the century. These preparations were apparently effective at levels that produced marked signs of lead poisoning in the women. The available studies were methodologically inadequate and did not provide dose-effect information. Evidence for adverse reproductive outcomes in women with obvious lead poisoning is of little help in defining the effects of lead at much lower exposure levels. 

Xu X Harvard School of Public Health, Boston, MA The effects of lead exposure on endocrine dysfunction and adverse reproductive outcomes in China National Institute of Environmental Health Sciences... 

Zenick H. 1984. Mechanisms of environmental agents by class associated with adverse male reproductive outcomes. In Reproduction The new frontier in occupational and environmental health research. Prog Clin Biol Res 160 335-361. 

Nieuwenhuijsen MJ, Toledano MB, Eaton NE, Fawell J, Elliott P (2000) Chlorination disinfection byproducts in water and their association with adverse reproductive outcomes a review. Occup Environ Med 57(2) 73-85... 

Swan SH (2008) Environmental phthalate exposure in relation to reproductive outcomes and other health endpoints in humans. Environ Res 108 177-184... 

Chlordecone is thought to produce some of its reproductive outcomes by mimicking the effects of excessive estrogens. The ability to cause constant estrus and other estrogen-like effects has been repeatedly confirmed in rodents. ... 

Baranski B Effects of the workplace on fertility and related reproductive outcomes. Environ Health Perspect Suppl 101 81-90, 1993... 

A two- to threefold increased risk of birth defects among children of Vietnam war veterans exposed to Agent Orange has been suggested by several epidemiological studies, but these studies have been criticized on a number of grounds, including exposure assessment, outcome verification, and potential for recall bias. Animal studies have not demonstrated clear-cut adverse effects of phenoxyherbicide exposure on reproductive outcomes. ... 

Remasters GK, Samuels SJ, Morrison JA, et al Reproductive outcomes of pregnant workers employed at 36 reinforced plastics companies. II. Lowered birth weight J Occup Med 31 115-120, 1989... 

Although a variety of environmental exposures involving sulfur dioxide have been linked to human reproductive effects, there is no clear relationship between sulfur dioxide concentrations and adverse reproductive outcomes. ... 

Smith AH et al Preliminary report of reproductive outcomes among pesticide applicators using 2,4,5-T. NZ Med J 93 177-179, 1981... 

Bove FJ, Fulcomer MC, Klotz JB, et al. 1992a. Population-based surveillance and etiological research of adverse reproductive outcomes and toxic wastes. Report on Phase IV-A Public drinking water contamination and birthweight, fetal deaths, and birth defects. A cross-sectional study. New Jersey Department of Health. 

It is only infrequently that local tolerance of a compound can have effects on the reproductive outcome. For most topically applied compounds, the degree of absorption and systemic exposure is likely to be low for the adult and hence for the conceptus. If severe local effects are induced such that the integrity of the skin is compromised and its barrier function reduced, then it is possible for larger amounts to be absorbed systemically and reproductive effects might be more likely. The local tolerance in clinical use and the human systemic exposure should be considered in determining whether any effects in animals are likely to be clinically relevant. 

There have been some concerns expressed regarding the possible health consequences in adulthood (endocrinological and reproductive outcomes) of early-life isoflavone exposure from soy-based infant formula. The daily exposure of infants to isoflavones in soy-based infant formulas is 6- to 11-fold higher on a body weight basis than the dose that has hormonal effects in adults consuming soy foods. " However, evidence from adult and infant populations indicates that dietary isoflavones in soy-based infant formulas do not adversely affect human growth, development, or reproduction. 

The adequacy of epidemiological studies of reproductive outcome and genetic and related effects in humans is evaluated by the same criteria as are applied to epidemiological studies of cancer. 

Utilize previously studied birth cohorts to investigate the incidence of latent adverse reproductive outcomes later in life (cohorts with pregnancy exposure data are extremely important). 

Jarrell JF, Gocmen A, Foster WG, Brant R, Chan S, Sevcik M (1996) Evaluation of reproductive outcomes in women inadvertently exposed to hexachlorobenzene in southeastern Turkey in the 1950 s. Reprod Toxicol, 12 469-476. 

Health Status of Vietnam Veterans. III. Reproductive Outcomes and Child Health, ibid. 259 (1988) 2715-19. 

W. H. Wolfe et al., Paternal Serum Dioxin and Reproductive Outcomes Among Veterans of Operation Ranch Hand, Epidemiology 6 (1995) 17-22. 

High-dose lead exposure is a recognized risk factor for stillbirth or spontaneous abortion. Epidemiologic studies of the impact of low-level lead exposure on reproductive outcome such as low birth weight, preterm delivery, or spontaneous abortion have yielded mixed results. However, a well-designed nested case-control study recently detected an odds ratio for spontaneous abortion of 1.8 (95% Cl 1.1-3.1) for every 5 / g/dL increase in maternal blood lead across an approximate range of 5-20 g/dL (Boija-Aburto et al, 1999). In males, blood lead concentrations in excess of 40 / g/dL have been associated with diminished or aberrant sperm production. 

Stockbauer JW, Hoffman RE, Schramm WF, et al. 1988. Reproductive outcomes of mothers with potential exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Am J Epidemiol 128 410-419. 

Wolfe WH, Michalek JE, Miner JC, et al. 1995. Paternal serum dioxin and reproductive outcomes among veterans of Operation Ranch Hand. Epidemiol 6 17-22. 

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