Fertil Steril. 2013 Oct;100(4):931-4. doi: 10.1016/j.fertnstert.2013.08.043.
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.Prenatal exposure to certain chemicals has been documented to increase the risk of cancer in childhood; adult male exposure to pesticides is linked to altered semen quality, sterility, and prostate cancer; and postnatal exposure to some pesticides can interfere with all developmental stages of reproductive function in adult females, including puberty, menstruation and ovulation, fertility and fecundity, and menopause. 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. The evidence that links exposure to toxic environmental agents and adverse reproductive and developmental health outcomes is sufficiently robust, and the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine 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.
减少接触有毒环境因素是妇产科医生和其他生殖健康护理专业人员的一个重要干预领域。患者接触有毒环境化学物质和其他压力源的情况普遍存在，而在受孕前和孕期接触有毒环境因素会对整个生命过程中的生殖健康产生深远而持久的影响。有文献记录表明，某些化学物质的产前接触会增加儿童期癌症的风险；成年男性接触杀虫剂会导致精液质量改变、不育和前列腺癌；而产后接触某些杀虫剂会干扰成年女性生殖功能的所有发育阶段，包括青春期、月经和排卵、生育力和生育能力以及绝经期。许多对生殖健康有害的环境因素不成比例地影响到脆弱和服务不足的人群，这使得一些人群，包括服务不足的妇女，比其他人群更容易受到生殖健康不良影响。接触有毒环境因素与生殖和发育健康不良后果之间的联系证据充分，美国妇产科医师学会和美国生殖医学学会与领先的科学家和其他临床医生一起呼吁及时采取行动，识别和减少接触有毒环境因素，同时解决此类接触的后果。
