Mendola Pauline, Messer Lynne C, Rappazzo Kristen
US EPA, Human Studies Division, National Health and Environmental Effects Research Laboratory, Research Triangle Park, North Carolina 27711, USA.
Fertil Steril. 2008 Feb;89(2 Suppl):e81-94. doi: 10.1016/j.fertnstert.2007.12.036.
To broadly review the recent literature linking environmental factors and adult female reproductive health for the UCSF-CHE Summit on Environmental Challenges to Reproductive Health and Fertility.
Reviewed articles indexed in PubMed from 1999-2007 addressing environment and puberty, menstrual and ovarian function, fertility, and menopause.
RESULT(S): The strongest evidence of environmental contaminant exposures interfering with healthy reproductive function in adult females is for heavy metals, particularly lead. Compounds that can influence hormone function, including pesticides and persistent pollutants, are also associated with risk. The pattern of effects for these endocrine-active compounds is often complex, with no clear dose response, but alterations in function and poor reproductive health outcomes are observed. From a clinical perspective, most modifiable risk appears to be associated with exposures in unique populations (contaminated fish consumers) or occupational groups (farmworkers). Many compounds have demonstrated increased risks for reproductive health impairment in women, but the literature is largely cross-sectional in nature and too sparse or inconclusive to support causal inference.
CONCLUSION(S): Reproductive function in adult females is impaired by lead exposure. Pesticides and persistent pollutants can alter hormone function resulting in adverse reproductive health effects. Coordinated research is needed to address contaminant effects across the life span.
为旧金山加州大学-化学与环境健康峰会关于生殖健康与生育的环境挑战，广泛回顾近期将环境因素与成年女性生殖健康联系起来的文献。
回顾1999年至2007年在PubMed中索引的文章，这些文章涉及环境与青春期、月经和卵巢功能、生育能力及更年期。
环境污染物暴露干扰成年女性健康生殖功能的最有力证据是重金属，尤其是铅。包括农药和持久性污染物在内的可影响激素功能的化合物也与风险相关。这些内分泌活性化合物的影响模式通常很复杂，没有明确的剂量反应，但观察到功能改变和不良生殖健康结果。从临床角度看，大多数可改变的风险似乎与特定人群（食用受污染鱼类者）或职业群体（农场工人）的暴露有关。许多化合物已证明会增加女性生殖健康受损的风险，但文献在很大程度上是横断面性质的，过于稀疏或无定论，无法支持因果推断。
成年女性的生殖功能会因铅暴露而受损。农药和持久性污染物会改变激素功能，导致不良生殖健康影响。需要开展协调研究以解决污染物在整个生命周期中的影响。
