January 6-9, 2008
Bolinas, CA
This invitational workshop had three goals:
1) assess the key science linking environmental contaminant exposures to reproductive health outcomes currently being reported at ever greater rates in women and girls. In particular, this effort will examine xenobiotics and phytoestrogens and the deleterious effects of these compounds on normal ovarian, uterine, breast, and hypothalamic/ pituitary function;
2) identify research directions that will fill current gaps in the scientific understanding in this field;
3) translate this information for a lay audience of journalists, policymakers, NGOs, community groups and others who can develop a strategy for prevention and intervention.
Workshop Structure
Organized by the Collaborative on Health and the Environment (CHE), in partnership with the University of Florida and the University of California San Francisco's Program on Reproductive Health and the Environment (PRHE), the Women’s Reproductive Health and the Environment Workshop fostered a collaboration of eminent and up-and-coming scientists specializing in women’s reproductive health. It took place from January 6-9, 2008, at a retreat center (Commonweal) in Bolinas, California.
The workshop followed the same model that was so effective in producing Toppari et al. (1996). Each participant generated a list of 10-12 top research studies in his or her area of expertise. These studies were used to draft a white paper. During the workshop, the scientists reviewed, debated and rewrote the draft. The final version of the paper will include a scientific review and a short list of proposed studies to address major gaps in our understanding.
An executive summary will be produced for the scientific community and will be shared with directors of various agencies funding women’s health research. The manuscript itself will be submitted for publication. A lay companion guide that “translates” the science will be produced and disseminated to a diverse group of stakeholders for use with key constituencies.
The final paper, executive summary and lay companion guide are expected to be completed within the next few months.
Why Was This Workshop Necessary?
In the last fifty years, human activity has released thousands of chemicals into the environment. Some 80,000 synthetic compounds have been registered for use in the United States alone. There are limited requirements for the chemical industry to test their products for effects on human health, so the testing falls to overburdened federal and state agencies. More than 85 percent of those 80,000 registered compounds have never been assessed for how they affect the human body.
This is cause for concern because many of these compounds have been detected in air, soil, food and drinking water. Although some compounds may be harmless, a significant number of those that have been tested are now known to affect reproductive health.
Both male and female reproductive disorders are being diagnosed more frequently and the causes of these disorders are not well understood. The majority of the research has focused on genes and germs. But studies over the last decade have clearly demonstrated that environmental toxicants such as synthetic chemicals are implicated as causal agents (McLachlan 2001).
Toppari et al. (1996) provided the first comprehensive review of the scientific literature examining the relationships between environmental factors and male reproductive disorders. To date, no such review has been done for female reproductive health, despite research showing associations between environmental exposures and health effects including:
• endometriosis (Eskenazi et al, 2002; Louis et al, 2005)
• hormonal changes (Sharara et al, 1998)
• altered puberty onset (Denham et al, 2005)
• altered breast development (Guillette et al., 2006)
• premature ovarian failure (Toft et al, 2004; Rogan, 2005)
There is also concern about the role of environmental exposures in pregnancy and birth outcomes (including pre-eclampsia, preterm birth, low birth weight and stillbirth) and in reproductive tract birth defects (Sharpe and Irvine, 2004). Furthermore, breast cancer rates have climbed steadily over the past 50 years (National Cancer Institute statistics: www.cancer.gov) and an environmental component to this increase has repeatedly been hypothesized and in some cases documented (Soto et al., 2000).
There is a compelling need to examine the literature and clarify what we do and do not know about the impact of environmental toxicants on the reproductive health of women and girls so we can develop a strategy for prevention and intervention.