In our society, exposure to chemicals is unavoidable. As a physician with a PhD in environmental biology, I have a longstanding interest in the many chemicals we come in contact with every day and their impact on our health. These answers do not come quickly. It can take many years and millions of exposures to fully assess the potential impact that chemicals have on humans.
Unlike the pharmaceutical industry—where the burden is on drug makers to prove a new medication is safe—there is no requirement that any chemical be registered or proven safe before release. Of the more than 84,000 chemicals produced, fewer than 200 have been studied, only 12 have been restricted, and FIVE banned in 35 years. With such lack of regulation, we can’t assume these chemicals are safe, especially as a growing field of research suggests that some lead to reproductive health problems and can negatively affect developing fetuses.
This week, ACOG and the American Society for Reproductive Medicine (ASRM) released a new statement warning of the reproductive health effects of exposure to certain environmental chemicals. The goal of this document is not to scare pregnant women or those considering having a baby, but to increase awareness in the health care community and with our patients about chemical exposures and to promote efforts to reduce these exposures where possible. (Find more resources on environmental chemicals and reproductive health here.)
Ob-gyns must be attuned to the risks of environmental exposures and understand how our patients might be affected. For example, minorities are more likely than whites to live in the counties with the highest levels of outdoor air pollution and to be exposed to a variety of indoor pollutants, including lead, allergens, and pesticides. Farm workers are also at higher risk for health problems because they repeatedly come in contact with toxic chemicals in pesticides. Knowing about our patients’ potential exposures will help us anticipate related health outcomes and properly educate them about their risks.
ACOG and ASRM recommend that health care professionals:
• 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 (shark, swordfish, king mackerel, 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
By advocating for a cleaner environment now, we can stand up for the health of our patients and of many generations to come.
Subscribe to the ACOG President’s Blog to receive an email alert every time a new blog is posted.