一项系统评价：内分泌干扰化学物质暴露对妊娠时间衡量的生育力的影响。
A systematic review: Impact of endocrine disrupting chemicals exposure on fecundity as measured by time to pregnancy.
机构信息
School of Public Health and Social Work, Queensland University of Technology, QLD, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia.
School of Public Health and Social Work, Queensland University of Technology, QLD, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia; Department of Childhood, Social Work & Social Care, University of Chichester, England, UK.
出版信息
Environ Res. 2019 Apr;171:119-133. doi: 10.1016/j.envres.2018.12.065. Epub 2018 Dec 28.
BACKGROUND
Emerging scientific evidence suggests that exposure to environmental pollutants is associated with negative effects on fecundity as measured by time to pregnancy (TTP).
OBJECTIVES
To conduct a systematic review of the literature on the association between selected endocrine disrupting chemicals (EDCs), and fecundity as measured by TTP in humans. Compounds included in this review are: brominated flame retardants (BFRs) such as hexabromocyclododecane, tetrabromobiphenol A and polybrominated diphenyl ethers; organophosphates flame retardants (OPFRs); and phthalates.
METHODS
Scopus, MEDLINE via Ebscohost and EMBASE databases were searched for articles exploring the relationships between selected EDCs and fecundity as measured by time to pregnancy. We assessed the quality of included studies and evidence for causality was graded using the criteria developed by the World Cancer Research Fund.
RESULTS
14 studies of 191 full-text articles assessed for eligibility were included for qualitative synthesis. Five studies examined BFRs and 10 studies examined phthalates. Among the fourteen, one study assessed both BFRs and phthalates. There were no studies which investigated fecundity as measured by TTP on HBCD, TBBPA, or OPFRs. We recorded plausible fecundity outcomes as measured by TTP related to some of these EDCs. BFRs or phthalates increased TTP. However, results were inconsistent.
CONCLUSION
We recorded mostly weak associations between exposure to selected EDCs and fecundity. However, evidence was considered limited to conclude a causal relationship due to inconsistency of results. The health risks posed by these chemicals in exposed populations are only beginning to be recognized and prospective measurement of the environmental effects of the chemicals in large cohort studies are urgently needed to confirm these relationships and inform policies aimed at exposure prevention.
背景
新兴科学证据表明，环境污染物的暴露与受孕时间（TTP）衡量的生育能力下降有关。
目的
对环境内分泌干扰物（EDC）与人类 TTP 衡量的生育能力之间关联的文献进行系统综述。本综述包括的化合物有：溴化阻燃剂（BFRs），如六溴环十二烷、四溴双酚 A 和多溴联苯醚；有机磷酸酯阻燃剂（OPFRs）；和邻苯二甲酸酯。
方法
在 Scopus、MEDLINE 通过 Ebscohost 和 EMBASE 数据库中搜索探讨选定 EDCs 与 TTP 衡量的生育能力之间关系的文章。我们评估了纳入研究的质量，并使用世界癌症研究基金会制定的标准对因果关系的证据进行了分级。
结果
对 191 篇全文文章进行评估，其中 14 项研究符合纳入标准进行定性综合分析。五项研究检查了 BFRs，十项研究检查了邻苯二甲酸酯。在这十四项研究中，有一项研究同时评估了 BFRs 和邻苯二甲酸酯。没有研究调查 HBCD、TBBPA 或 OPFRs 对 TTP 的生育能力影响。我们记录了与这些 EDCs 相关的一些可能的生育能力结果，TTP 与 BFRs 或邻苯二甲酸酯有关。然而，结果不一致。
结论
我们记录了暴露于某些选定的 EDCs 与生育能力之间的关联大多较弱。然而，由于结果不一致，证据被认为不足以得出因果关系。这些化学物质对暴露人群构成的健康风险才刚刚开始被认识到，迫切需要在大型队列研究中对这些化学物质的环境影响进行前瞻性测量，以确认这些关系并为旨在预防暴露的政策提供信息。
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