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 in Committee Opinion #575 Exposure to Toxic Environmental Agents, from the American College of Obstetricians and Gynecologists (ACOG) in conjunction with the American Society for Reproductive Medicine (ASRM) and the University of California, San Francisco Program on Reproductive Health and the Environment.

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

Reducing exposure to toxic environmental agents is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals in the United States and worldwide. The International Federation of Gynecology and Obstetrics (FIGO), comprising ACOG and the obstetrician-gynecologist professional societies in 124 countries worldwide, released an opinion on the reproductive health effects of exposure to toxic environmental agents in October 2015 (jump to this resource). The FIGO opinion echoes ACOG and ASRM’s call for timely action to identify and reduce exposure to toxic environmental agents while addressing the consequences of such exposure.

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.

Other Resources*

Opinion on Reproductive Health Impacts of Exposure to Toxic Environmental Chemicals, October 2015, International Federation of Gynecology and Obstetrics (FIGO) In this opinion, FIGO outlines the reproductive and neurodevelopmental effects of exposure to environmental chemicals, emphasizing that the costs of exposure are disproportionately borne by low-income people and communities. FIGO suggests four actions for ob-gyns and other women's health care providers to take in order to reduce the effects of environmental chemical exposure on their patients and themselves.

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.

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.

Pediatric Environmental Health Specialty Units (PEHSUs)
The Pediatric Environmental Health Specialty Units (PEHSUs) form a network of clinicians located at academic medical centers across the United States who provide clinical expertise in environmental health. The PEHSUs respond to requests for information throughout North America regarding prevention, diagnosis, management, and treatment of environmentally-related health effects in fetal development, childhood and adolescence. The PEHSUs are eager to serve as a resource for obstetricians and gynecologists in recognition of the interconnection between reproductive/prenatal, and pediatric health. The PEHSUs are jointly managed by the American Academy of Pediatrics and the American College of Medical Toxicology. The Agency for Toxic Substances and Disease Registry and the U.S. Environmental Protection Agency jointly support the PEHSU network.

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.

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.

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.

*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.