Toxic Environmental Agents

Environmental Chemicals Infographic

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Toxic chemicals in the environment harm our ability to reproduce and negatively affect pregnancies.  Many chemicals that pregnant women absorb or ingest from the environment can cross the placenta to the fetus.

The scientific evidence over the last 15 years shows that exposure to toxic environmental agents before conception and during pregnancy can have significant and long-lasting effects on reproductive health, as outlined below in the Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG). In addition, the following provides additional resources for providers and patients on environmental toxic agents and reproductive health.

Committee Opinion: Exposure to Toxic Environmental Agents (September 23, 2013)

The Committee on Health Care for Underserved Women, ACOG, developed a Committee Opinion (#575) on Exposure to Toxic Environmental Agents in conjunction with the American Society for Reproductive Medicine (ASRM) and the University of California, San Francisco Program on Reproductive Health and the Environment.

Reducing exposure to toxic environmental agents is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals. Patient exposure to toxic environmental chemicals and other stressors is ubiquitous, and preconception and prenatal exposure to toxic environmental agents can have a profound and lasting effect on reproductive health across the life course. Many environmental factors harmful to reproductive health disproportionately affect vulnerable and underserved populations, which leaves some populations, including underserved women, more vulnerable to adverse reproductive health effects than other populations.

ACOG and ASRM join leading scientists and other clinical practitioners in calling for timely action to identify and reduce exposure to toxic environmental agents while addressing the consequences of such exposure.

Read the press release

Other ACOG Resources

Companion Piece to Committee Opinion #575 "Exposure to Toxic Environmental Agents"
This document was developed in tandem with Committee Opinion #575 "Exposure to Toxic Environmental Agents" and provides a detailed overview of the health issues associated with environmental exposure to endocrine disruptors and other chemicals.

"Aiming for A BPA-Free Pregnancy" 
In this blog post, ACOG President Jeanne A. Conry, MD, PhD, describes the health risks associated with exposure to bisphenol A (BPA) during pregnancy and provides tips for minimizing exposure.

ACOG In the News: Environmental Toxic Agents

The following is a representative sample of media coverage on the release of the Committee Opinion on Environmental Toxic Agents. ACOG's president, Jeanne A. Conry, MD, PhD, is quoted and featured in many of the articles.

Other Resources*

The following outside resources* provide additional information about environmental chemicals and reproductive health. 

Disrupted Development: The Dangers of Prenatal BPA Exposure, September 2013, The Breast Cancer Fund.
This report includes a comprehensive review of the literature linking exposure to BPA in utero to health problems in childhood and beyond.
http://www.breastcancerfund.org/big-picture-solutions/make-our-products-safe/cans-not-cancer/disrupted-development-prenatal-bpa-exposure.html

The Program on Reproductive Health and the Environment at the University of California, San Francisco
This program provides a number of resources, including educational materials for patients and their families, multiple examples regarding obtaining an exposure history, and a compilation of professional society policy statements calling for regulatory and other efforts to address exposure to toxic chemicals. 
http://prhe.ucsf.edu/prhe/clinical_resources.html

Association of Occupational and Environmental Clinics (AOEC), Pediatric Environmental Health Specialty Units 
The AOEC is a network of investigators across the United States who support clinical capacity related to environmental health. The Pediatric Environmental Health Specialty Units respond to requests for information throughout North America regarding prevention, diagnosis, management, and treatment of environmentally-related health effects in children and, as such, are poised to serve as a resource for obstetricians and gynecologists in recognition of the inextricable relationship between reproductive and pediatric health. Occupational Medicine Programs at regional academic centers can serve as a resource for evaluating occupational exposure to chemicals.

Reproductive Health Resources, National Institute of Environmental Health Sciences (NIEHS), NIH
This web page provides a list of resources on reproductive health and the environment. The mission of the NIEHS is to discover how the environment affects people in order to promote healthier lives.
http://www.niehs.nih.gov/health/topics/conditions/repro-health/index.cfm

US Environmental Protection Agency (US EPA), Integrated Risk Information System (IRIS)
The US EPA evaluates risk information on human health effects that may result from exposure to environmental contaminants. www.epa.gov/iris/

California Environmental Protection Agency (Cal-EPA) 
The Cal-EPA provides the list of chemicals known by the State of California to cause cancer or reproductive or developmental toxicity. http://oehha.ca.gov/prop65/prop65_list/Newlist.html

*The resources listed above are for information purposes only. Referral to these sources and sites does not imply the endorsement of ACOG. Further, ACOG does not endorse any commercial products that may be advertised or available from these organizations or on these websites. These lists are not meant to be comprehensive. The exclusion of a source or site does not reflect the quality of that source or site. Please note that sites and URLs are subject to change without notice.