The effects of occupational exposure to synthetic estrogens in a pharmaceutical plant were investigated. Questionnaires were administered to 55 employees, 25 males and 30 females, involved in the manufacturing of synthetic estrogens. Clinical examinations for signs of hyperestrogenism were performed. Personal and area air samples and surface wipe samples were collected, and concentrations of mestranol (72333) and norethindrone (68224) were determined. Twenty percent of male employees had clinical gynecomastia or gave a history of gynecomastia. No cases of decreased libido nor increased areolar pigmentation were reported nor observed. A four fold increased risk of intermenstrual bleeding was found among female employees, as compared with matched controls. Widely variable amounts of estrogen and progesterone dust were found in area inclusive of wipe samples with personal samplers, ranging from undetectable up to 8.61 micrograms per cubic meter (microg/m3) for mestranol and 43.18microg/m3 for norethindrone. The authors conclude that occupational exposure to synthetic estrogens can cause clinical hyperestrogenism. The authors identify the need for establishment of an estrogen safety standard, as well as a need for further research into the potential hazards of occupational exposure to synthetic estrogens and other potent biologics.
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