Effects of occupational exposure to estrogen and progestogens and how to detect them.

This report describes the health effects of occupational exposure during manufacturing processes that utilize synthetic estrogens and progestogens, and demonstrates the usefulness of various laboratory assays in identifying workers who have experienced actual hormone absorption. In late 1978 the health status of exposed and unexposed workers was compared by standardized questionnaire, physical examination, and laboratory studies. A higher proportion of exposed than unexposed men gave histories of breast swelling (p less than .0001), nodules (p = .0003), and nipple discharge (p = .037). Physical examination showed no significant differences between groups. Exposed and unexposed workers showed no clinically significant differences on any routine laboratory studies. Hormone studies revealed significantly lower natural total serum estrogen levels in exposed men and women. Serum norethindrone levels were useful in identifying workers with hormone exposure in their recent past. Hormone exposure continued to cause physiologic disturbances during the period studied despite efforts to control exposure. Measuring blood norethindrone levels may be a valuable way of identifying exposed workers.