To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.
written by David Tuller, DrPH, and Tracey J. Woodruff, PhD, MPH
In recent years, a growing body of research has documented that the in utero environment has a critical impact on future health and development. A strong body of evidence shows that prenatal exposure to toxic chemicals can usher in a host of adverse effects in childhood and across the lifespan, as well as in subsequent generations.
Now the world’s leading organization of reproductive health specialists, the International Federation of Gynecology and Obstetrics (FIGO), is urging medical professionals to demand stronger government regulation of toxic environmental chemicals. FIGO’s call to action resonates with the theme of this year’s World Environmental Health Day—Children’s Health and Safety and the Protection of Their Environment.
FIGO, which represents doctors in more than 125 countries and territories, published its opinion on reproductive health impacts of exposure to toxic environmental chemicals today, in advance of its World Congress in Vancouver. (Our group at UCSF, the Program on Reproductive Health and the Environment, co-authored the FIGO opinion.)
In its statement, FIGO outlines the compelling evidence of harm and recommends that “reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice.”
Tens of thousands of industrial chemicals are in everyday use, and biomonitoring studies indicate that virtually everyone is exposed to dozens if not hundreds of them, most never adequately tested for human or environmental safety. Yet efforts to strengthen the regulation of toxic chemicals, in the US and many other countries, have stalled under pressure from powerful business interests.
“What FIGO is saying is that physicians need to do more than simply advise patients about the health risks of chemical exposure,” said Dr. Jeanne A. Conry, a co-author of the FIGO opinion and past president of the American College of Obstetricians and Gynecologists, in a public statement that accompanied the release of the opinion. “We need to advocate for policies that will protect our patients and communities from the dangers of involuntary exposure to toxic chemicals.”
The chemicals of concern are ubiquitous—in consumer products like cosmetics and plastic containers, in pesticides, and in thousands of industrial goods. Pollutants also contaminate our food, water and air. These chemicals can interfere with normal development through multiple pathways. For example, many are known to be endocrine disruptors—that is, they impede the normal functions of reproductive and other hormones. Multiple studies have linked prenatal exposures to endocrine disruptors to a wide range of poor health outcomes, including miscarriage, low birth weight, and genital abnormalities, as well as delayed or impaired neurocognitive function and higher rates of some cancers.
Chemical manufacturing is a worldwide growth industry, as it has been for decades. Ineffective environmental regulations, lax trade agreements, rapid industrialization across much of the developing world and other factors have all contributed to our current high levels of exposures.
The global health burden is enormous, with the most severe effects falling, as usual, on the countries and populations that can least afford it. Yet when medical groups promote the importance of discussing the harms of environmental exposures with patients, chemical companies charge that they are frightening women unnecessarily. The facts cited in the FIGO opinion suggest that women, and all of us, have good reason to be concerned.
“We are drowning our world in untested and unsafe chemicals and the price we are paying in terms of our reproductive health is of serious concern,” noted Dr. Gian Carlo Di Renzo, FIGO’s honorary secretary and lead author of the opinion, in a public statement. Reproductive health professionals, he added, “witness first-hand the increasing numbers of health problems facing their patients, and preventing exposure to toxic chemicals can reduce this burden on women, children, and families around the world.”
 Di Renzo GC, et al, International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals. Int J Gynecol Obstet (2015) http://dx.doi.org/10.1016/j.ijgo.2015.09.002
David Tuller, DrPH, is academic coordinator of UC Berkeley’s joint masters program in public health and journalism and a collaborator in the UCSF Program on Reproductive Health and the Environment Pregnancy Exposure to Environmental Chemicals Children’s Center.
Tracey J. Woodruff, PhD, MPH, is professor and director of the University of California, San Francisco Program on Reproductive Health and the Environment and a co-author of the FIGO Opinion. She is a CHE partner. For more information on the Opinion go to http://prhe.ucsf.edu/prhe/.