Reproductive health: More attention needed?
Occ-health professionals could be more proactive
Much attention has been given in recent years to the growth of employee prenatal care and the attendant health improvement and financial savings that have accrued. But reproductive health is far broader and more diverse — the entire spectrum of reproductive health may not be getting the attention it deserves, a leading expert says.
Occupational health professionals by and large are not as proactive as they could be when it comes to reproductive health hazards in the workplace, says Steven M. Schrader, PhD, chief of the reproductive health assessment section for the National Institute for Occupational Safety and Health (NIOSH) in Cincinnati.
"Back in the 1980s when DBCP [dibromochloropropane, now banned in the United States] was a big deal, one company talked about semen analysis in a study, but it didn’t work out very well," he notes. "Other than MSDS’ [material safety data sheets, used for potentially hazardous materials], there have not been a lot of proactive steps taken."
One reason for a cautious approach, he concedes, may be a Supreme Court ruling concerning lead, which said that women could not be excluded from working in a specific area even though exposure to lead could do prenatal damage.
"The court said they couldn’t discriminate’ against women," Schrader explains. "In some ways, it was a good ruling, but men need to be protected from exposure to lead as well."
A wide range of problems
In addition to lead, some pesticides, solvents, and ionizing radiation have been shown to impact reproductive health.
"Probably the most research has been done on lead," says Schrader, noting that it has been linked to "everything from sexual dysfunction to decreased sperm numbers and abnormal sperm morphology."
Pesticides, he continues, have been shown to cause sterility, lower sperm count, and motility.
"Ionizing radiation to the testes can cause mutation to sperm," he says. "Nonionizing radiation is a little more difficult to get a feel for. We saw men in the Army using high levels in radar that had a sperm count effect, but we looked at lower exposures and did not see those effects."
Solvents also are a difficult matter, says Schrader.
"Some, like glucol ethers, have a history of being male reproductive toxigens," he notes, citing one that had been used as a paint thinner in a foundry that caused reduced sperm counts.
However, the National Institute for Occupational Safety and Health (NIOSH) notes on its web site (www.cdc.gov/niosh/diseas.html), "Although numerous occupational exposures have been demonstrated to impair fertility, the overall contribution of occupational exposures to male and female infertility is unknown. . . . While more than 1,000 workplace chemicals have shown reproductive effects in animals, most have not been studied in humans."
Of course, research is ongoing, and there are one or two chemicals of particular concern to Schrader.
"We brought together a group to look at chemicals that had tested positive in animals," he reports. "What we found floated to the top were chemicals that ended in -amide.’"
Currently, he and fellow researchers are studying acrylamides.
"Another chemical of real concern is 1-bromopropane," he adds. "It’s used a lot as a solvent, as an adhesive carrier, and to clean electronic parts."
Research priorities for a number of chemicals based on estimated toxicity and estimated population size at risk were discussed in a special article in Reproductive Toxicology.1
Sound ergonomic practices can also limit reproductive health hazards, notes NIOSH.
"Substances and activities that upset the normal hormonal activity of the reproductive system . . . such as shift work . . . also need evaluation," says the agency. "Similarly, the effects of physical factors [such as prolonged standing, reaching or lifting] of the interactive effects of workplace stressors and exposures on pregnancy and fertility have not been rigorously investigated."
Then, of course, there’s common sense.
"There’s the old story about tight pants and tight underwear," says Schrader. "The testicles do need to be cooled, away from the body. There have also been some suggestions that vibration can have an impact."
If you are an occ-med professional in a workplace that uses some of these questionable chemicals, what should you do?
"That’s always a tough question," Schrader admits. "First, know what to look for. If you think something is affecting employees, you can always remove them from the exposure. The first step is to be sure they are using personal protective equipment as it should be used; check for poor work practices in and around the area. As a second step, consider removal from exposure."
You can certainly screen employees for potential problems, but, notes Schrader, there are a lot of reasons employees can have fertility problems.
You can always turn to NIOSH for help, says Schrader. NIOSH offers reproductive health assessments free of charge.
"Whenever someone thinks there are enough individuals affected — if they are really and truly concerned about the reproductive health of their population — the best thing to do is call us to evaluate," he says.
[For more information, contact:
- Steven M. Schrader, PhD, Chief, reproductive health assessment section, NIOSH, MS-C23, 4676 Columbia Parkway, Cincinnati, OH 4526. Telephone: (513) 533-8210. Fax: (513) 533-8138. E-mail: [email protected].]
Reference
1. Moorman WJ, et al. Prioritization of NTP reproductive toxicants for field study. Reproductive Toxicology 2000; 14:293-301.
Much attention has been given in recent years to the growth of employee prenatal care and the attendant health improvement and financial savings that have accrued. But reproductive health is far broader and more diverse the entire spectrum of reproductive health may not be getting the attention it deserves, a leading expert says.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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