Simonelli Angela, Guadagni Rossella, De Franciscis Pasquale, Colacurci Nicola, Pieri Maria, Basilicata Pascale, Pedata Paola, Lamberti Monica, Sannolo Nicola, Miraglia Nadia
Occupational Medicine Area-Hygiene, Occupational and Forensic Section, Department of Experimental Medicine, School of Medicine, Second University of Naples, Caserta, Italy.
Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", Via S. Pansini 5, II Policlinico, Ed. 20, 80131, Naples, Italy.
Int Arch Occup Environ Health. 2017 Jan;90(1):49-61. doi: 10.1007/s00420-016-1171-1. Epub 2016 Oct 7.
The study aimed to give a first data set of bisphenol A (BPA) levels in the peritoneal fluid of patients suffering from endometriosis and to investigate the relationship between BPA exposure and endometriosis.
A questionnaire investigating the occupational context, life environment, and habits was administered to 68 patients suffering from endometriosis and 60 endometriosis-free subjects (control group). Urine and peritoneal fluids samples were collected and analysed by GC/MSMS for BPA dosage.
Some of the investigated environmental/lifestyle risk factors (closeness to industries/activities at risk) were associated with an increase in endometriosis; smoking resulted as protective factor; others (use of food plastic boxes) did not seem to influence the onset of pathology. The association between the occupational exposure summarising all examined risk factors (working activity, personal protective equipment, seniority) and endometriosis was statistically significant (χ = 5.252, p = 0.02). Contrasting results were obtained when specific activities were examined. Detectable urinary BPA levels were found in all analysed samples (patients: 1.17-12.68 pg/µl; mean ± SD, 5.31 ± 3.36 pg/µl; control group: 1.28-2.35 pg/µl; mean ± SD, 1.64 ± 0.49 pg/µl; median; 1.46 pg/µl), with a statistically significant difference between patients and controls, showing an association between BPA exposure and endometriosis. Only a few subjects from the control group supplied peritoneal fluid; hence, no comparison test with patients (range 0.39-1.46 pg/µl; mean ± SD, 0.67 ± 0.30 pg/µl; median, 0.58 pg/µl) was carried out.
Results highlight the potential association between BPA exposure and endometriosis, as well as the current lack of knowledge regarding occupational exposure to BPA and the need of epidemiological studies focused on single activities/occupations, such as housewives, cleaners, students.
本研究旨在提供子宫内膜异位症患者腹腔液中双酚A（BPA）水平的首个数据集，并探讨BPA暴露与子宫内膜异位症之间的关系。
对68例子宫内膜异位症患者和60例无子宫内膜异位症的受试者（对照组）进行了一项调查职业背景、生活环境和习惯的问卷。收集尿液和腹腔液样本，通过气相色谱-串联质谱法（GC/MSMS）分析BPA剂量。
一些调查的环境/生活方式风险因素（靠近有风险的行业/活动）与子宫内膜异位症的增加有关；吸烟是保护因素；其他因素（使用食品塑料盒）似乎不影响疾病的发生。总结所有检查风险因素（工作活动、个人防护设备、工龄）的职业暴露与子宫内膜异位症之间的关联具有统计学意义（χ² = 5.252，p = 0.02）。当检查特定活动时，得到了相反的结果。在所有分析样本中均检测到可检测的尿BPA水平（患者：1.17 - 12.68 pg/µl；平均值±标准差，5.31 ± 3.36 pg/µl；对照组：1.28 - 2.35 pg/µl；平均值±标准差，1.64 ± 0.49 pg/µl；中位数；1.46 pg/µl），患者与对照组之间存在统计学显著差异，表明BPA暴露与子宫内膜异位症之间存在关联。对照组中只有少数受试者提供了腹腔液；因此，未与患者进行比较测试（范围0.39 - 1.46 pg/µl；平均值±标准差，0.67 ± 0.30 pg/µl；中位数，0.58 pg/µl）。
结果突出了BPA暴露与子宫内膜异位症之间的潜在关联，以及目前对BPA职业暴露缺乏了解，以及需要针对单一活动/职业（如家庭主妇、清洁工、学生）开展流行病学研究。
