Prevention for All Tracey J. Woodruff, PhD, MPH Program on - - PowerPoint PPT Presentation

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Prevention for All Tracey J. Woodruff, PhD, MPH Program on - - PowerPoint PPT Presentation

Jan 12, 2024 251 likes •656 views

(Photo source: http://weekspregnanttips.com) Prevention for All Tracey J. Woodruff, PhD, MPH Program on Reproductive Health and the Environment, UCSF March 12, 2014 EPA/NIEHS Childrens Centers 2014 Webinar Series 1 PRHE Mission: To create a

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Prevention for All

Tracey J. Woodruff, PhD, MPH Program on Reproductive Health and the Environment, UCSF March 12, 2014 EPA/NIEHS Children’s Centers 2014 Webinar Series

(Photo source: http://weekspregnanttips.com)
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PRHE

Mission: To create a healthier

environment for human reproduction and development by advancing scientific inquiry, clinical care, and health policies that prevent exposures to harmful chemicals in

  • ur environment
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Our Challenge

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Prevalence of chronic conditions among children and youth increased from 1988 to 2006

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1988 to 1994 1994 to 2000 2000 to 2006 51.5% 27.8%

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SLIDE 5 Federal reserve data on chemical production is only offered as relative production, which is unit-less. A specific reference year is chosen and values are calculated relative to that years production. In this particular data set 2007 is the reference year and is assigned a value of 100. Data from: U.S. Federal Reserve Board, Division of Research and Statistics

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Today

80,000 chemical substances registered for use in U.S. commerce 3,000 chemicals manufactured or imported in excess of 1 million pounds 700 new industrial chemicals introduced into commerce each year

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Everywhere, Everyday, and Everyone

Outdoor environment Workplace Home/Indoor Food supply Personal care products

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Toxic Chemicals

in Pregnant Woman in the US

Woodruff TJ, Zota AR, Schwartz JM. Environmental chemicals in pregnant women in the United States: NHANES 2003-2004. Environ Health Perspect. 2011 Jun;119(6):878-85. Epub 2011 Jan 10.

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Environmental chemicals can cross the placenta

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ACOG/ASRM Committee Opinion

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Woodruff, Zota, Schwartz EHP 2011

98 - 100%

Phthalates

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Woodruff, Zota, Schwartz EHP 2011

99%

PFCs

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Woodruff, Zota, Schwartz EHP 2011

62-100%

Pesticides

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PBDEs________

  • 100% pregnant women exposed
  • In vitro, disruption of fetal

human brain cells development

  • In animals, affect learning,

memory, and attention

  • In humans, associated with

decrements in IQ – similar to that of lead

(Schreiber et al., 2010, Driscoll et al., 2008, Viberg et al. 2006)

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The evidence that links exposure to toxic environmental agents and adverse reproductive and developmental health outcomes is sufficiently robust, and the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine join leading scientists and

  • ther clinical practitioners in calling for timely action to identify and reduce

exposure to toxic environmental agents while addressing the consequences of such exposure.

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ACOG/ASRM Committee Opinion

“Environmental exposures can have a profound and lasting impact on the health of our patients and future generations”

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ACOG/ASRM Committee Opinion

All exposures are not created equal

Underserved and minority populations disproportionately impacted

More likely to be exposed to higher levels of outdoor and indoor pollutants

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ACOG/ASRM Committee Opinion

All exposures are not created equal

Women of reproductive age with occupational exposure to toxic chemicals are highly vulnerable to adverse reproductive health outcomes

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Actions Matters – Clinical

http://prhe.ucsf.edu/prhe/toxicmatters.html

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ACOG/ASRM Committee Opinion Individual Action Alone is Not Enough

  • Nine pregnant women tested

from Washington, Oregon, and California, during the second trimester had detectable:

– Bisphenol A – Mercury – At least four phthalates – At least two and up to 4 perfluorinated chemicals

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January 10, 2014

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4-methylcyclohexanemethanol (MCHM)

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Used to decide “safe” level

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JANUARY 13 Monday Residents told water is safe to drink

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JANUARY 13 Monday 14 Tuesday Residents told water is safe to drink ?

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JANUARY 13 Monday 14 Tuesday 15 Wednesday Residents told water is safe to drink ? “CDC recommends - out of an abundance of caution that pregnant women drink bottle water until there are no longer detectable levels

  • f 4 4-methylcyclohexane

methanol, or MCHM, in the water distribution system. "

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January 16 – Company makes other toxicology studies public - based on adult male/female rats

6 Days after the spill

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Tip of an Iceberg

~200 chemicals tested for health effects ~3000 chemicals manufactured/imported > 1 million pounds ~700 new chemicals added each year ~62,000 chemicals “grandfathered in” TSCA, not tested

(87,000 chemicals registered for use in the U.S. commerce as of 2006) 33
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– Pharmaceuticals must have data to show efficacy and safety prior to use – Do manufactured chemicals have to have data on safety before use?

NO

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“… 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.” Dr. Jeanne Conry, President ACOG

Linda C. Giudice, MD, PhD, President American Society for Reproductive Medicine and Jeanne C. Conry, MD, PhD, President, American Congress of Obstetricians and Gynecologists – October 2013, Washington, DC 36
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Actions Matter – Policy

Zota A.R., et al. 2013 ES&T.

10 20 30 40 50 60 70 80 90 100 2006 2008-2009 2011-2012 PBDEs concentration ng/g lipid YEAR

PBDEs in Pregnant Women

39%

June 2006, California State bans PBDEs

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Summary

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  • Exposure to toxic environmental chemicals

among pregnant women are ubiquitous

  • Health impacts can manifest across the

lifespan and generations

  • Preventing exposure to reproductive

toxicants requires improved public policy

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Thanks for listening! Questions?