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Assessment of reproductive disorders and birth defects in communities near hazardous chemical sites. II. Female reproductive disorders.
Scialli-AR; Swan-SH; Amler-RW; Baird-DD; Eskenazi-B; Gist-G; Hatch-MC; Kesner-JS; Lemasters-GK; Marcus-M; Paul-ME; Schulte-P; Taylor-Z; Wilcox-AJ; Zahniser-C
Reprod Toxicol 1997 Mar; 11(2/3):231-242
The workgroup on assessment of female reproductive disorders in communities near hazardous chemical sites considered methods which could be used to evaluate menstrual dysfunction, infertility, pregnancy loss, lactation disorders, and pregnancy complications. A nested strategy was considered to test each function. The strategy was based on progressive levels of effort available to conduct field investigations. The lowest level of effort consisted only of questionnaires, diaries, and reviews of maternal and infant medical records. The medium level of effort included the collection of data from questionnaires and diaries and some biological specimens. Laboratory analyses considered included measuring progesterone in saliva and several glucoprotein hormones in urine that evaluate menstrual dysfunction, infertility, and pregnancy loss. Prospective collection of diary information and simultaneous collection of biological specimens were characteristics of the highest level of effort. The choice of level of effort was guided by several considerations including exposure assessment. An elaborate, expensive study may make little sense unless an exposed population can be identified. Sample size and cost are important considerations. Daily urinary human chorionic gonadotropins (hCG) require a sufficient number of sexually active women not using contraceptives and is very expensive to administer. A practical compromise is the use of less expensive home kits for hCG at designated times of the cycle. An important component of all studies is a questionnaire designed to evaluate reproductive and menstrual cycle experience.
NIOSH-Author; Menstrual-disorders; Reproductive-hazards; Reproductive-system-disorders; Fetus; Fertility; Humans; Environmental-health-monitoring; Humans; Hormone-activity
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Page last reviewed: March 11, 2019
Content source: National Institute for Occupational Safety and Health Education and Information Division