environmental exposures

Environmental ExposuresEnvironmental Exposures Presented by: Cecilia EscorborePresented by: Cecilia Escorbore

Walden UniversityWalden UniversityEnvironmental Health – PUBH 6165-4Environmental Health – PUBH 6165-4

Professor: Dr.Thron Professor: Dr.Thron July 31, 2014July 31, 2014

Environmental ExposuresEnvironmental ExposuresDuring the Prenatal Months During the Prenatal Months

ObjectivesObjectives

At the end of this presentation:At the end of this presentation:Participants will have gained an understanding of environmental Participants will have gained an understanding of environmental

exposure risks associated with the unborn fetus.exposure risks associated with the unborn fetus.Participants will learn about different chemicals and toxins in the Participants will learn about different chemicals and toxins in the

environmentenvironmentParticipants will learn about different personal products that contain Participants will learn about different personal products that contain

several chemicals that can be a health hazard several chemicals that can be a health hazard Participants will have the knowledge needed to embrace the Participants will have the knowledge needed to embrace the

importance of educating pregnant women about the risk of importance of educating pregnant women about the risk of environmental exposures during pregnancy.environmental exposures during pregnancy.

Participants will have an idea of resources to utilize to give to their Participants will have an idea of resources to utilize to give to their clients as a reading guide about environmental exposures.clients as a reading guide about environmental exposures.

Environmental ExposuresEnvironmental Exposures

What are Environmental ExposuresWhat are Environmental ExposuresAs human beings we are exposed to the different As human beings we are exposed to the different

chemicals and toxins in the environment. Our health in chemicals and toxins in the environment. Our health in many cases is affected by the same environment we many cases is affected by the same environment we

live in and are exposed to on a daily basis. Many live in and are exposed to on a daily basis. Many diseases can be initiated, promoted, sustained, or diseases can be initiated, promoted, sustained, or

stimulated by environmental factors. In an effort to stimulated by environmental factors. In an effort to provide the unborn fetus with a healthy beginning in provide the unborn fetus with a healthy beginning in

life pregnant women must be made aware of the risk of life pregnant women must be made aware of the risk of certain factors during pregnancy.certain factors during pregnancy.

Source: Moeller D., 2011 Environmental Health (p 5-6) Source: Moeller D., 2011 Environmental Health (p 5-6)

Factors to ConsiderFactors to Consider

Chemical Chemical BiologicalBiological PhysicalPhysical SocioeconomicSocioeconomic

Source: Moeller D., 2011 Environmental Health (p 5-6) Source: Moeller D., 2011 Environmental Health (p 5-6)

Prenatal PeriodPrenatal Period

Prenatal women and the different exposures:Prenatal women and the different exposures:

Women are concerned with a healthy pregnancy Women are concerned with a healthy pregnancy and a positive outcome. Because of this reason and a positive outcome. Because of this reason

they are seeking prenatal care and are they are seeking prenatal care and are interested in all of the information available interested in all of the information available

for a healthy 10 months. This is also a time of for a healthy 10 months. This is also a time of heightened concern about the decisions they heightened concern about the decisions they are making. Hence the perfect opportunity.are making. Hence the perfect opportunity.

Source: Acog, 2013 Source: Acog, 2013

Reproductive Health Problems with Reproductive Health Problems with ExposureExposure

Some health problems to consider associated with Some health problems to consider associated with environmental exposure include:environmental exposure include:

Miscarriage and StillbirthMiscarriage and Stillbirth Impaired Fetal Growth and Low Birth WeightImpaired Fetal Growth and Low Birth Weight Preterm BirthPreterm Birth Childhood CancersChildhood Cancers Birth DefectsBirth Defects Cognitive/intellectual ImpairmentsCognitive/intellectual Impairments Thyroid ProblemsThyroid ProblemsSource: Acog, 2013Source: Acog, 2013

Long Lasting Health EffectsLong Lasting Health Effects

The exposure during pregnancy can lead to other long The exposure during pregnancy can lead to other long lasting effects for children and adulthood. Fetus that lasting effects for children and adulthood. Fetus that were exposed to environmental chemicals\pesticides were exposed to environmental chemicals\pesticides can develop certain cancers as children, they can also can develop certain cancers as children, they can also

interfere with the development of the fetus in all interfere with the development of the fetus in all stages. As teens females develop early into puberty stages. As teens females develop early into puberty

and even their reproductive functions can be affected. and even their reproductive functions can be affected. Males that have been exposed have been found to Males that have been exposed have been found to

experience altered semen quality, sterility, and even experience altered semen quality, sterility, and even prostate cancer. prostate cancer.

Source: National Institute of Environmental Health Science, 2014Source: National Institute of Environmental Health Science, 2014

Products & ChemicalsProducts & Chemicals

Chemicals are use in the following ProductsChemicals are use in the following Products Bisphenol-A – is used in large amounts to produce Bisphenol-A – is used in large amounts to produce

polycarbonate plastics and epoxy resins. polycarbonate plastics and epoxy resins. Polycarbonate is used in some containers of food, Polycarbonate is used in some containers of food,

drink packaging for example drinking bottles, infant drink packaging for example drinking bottles, infant bottles, CD’s, safety equipment, and medical devises.bottles, CD’s, safety equipment, and medical devises.

Epoxy resins are used as a coating for metal products Epoxy resins are used as a coating for metal products like food cans, bottle tops, and water pipes.like food cans, bottle tops, and water pipes.

Source: Acog, 2013Source: Acog, 2013

Reported Adverse OutcomesReported Adverse Outcomes

Several reports have revealed a number of adverse prenatal outcomes Several reports have revealed a number of adverse prenatal outcomes associated with the exposures of pregnant women to several environmental associated with the exposures of pregnant women to several environmental contaminants. contaminants.

Tobacco smoke – associated with reduced birth weight and preterm Tobacco smoke – associated with reduced birth weight and preterm delivery.delivery.

Pesticides & Polychlorinated Biphenyls – associated with decreased fetal Pesticides & Polychlorinated Biphenyls – associated with decreased fetal growth and the length of gestation.growth and the length of gestation.

Organic solvents & Chlorophenoxy Herbicides – associated with birth Organic solvents & Chlorophenoxy Herbicides – associated with birth defects.defects.

Dichlorodiphenyltrichloroethane & Bisphenol-A – associated with Dichlorodiphenyltrichloroethane & Bisphenol-A – associated with pregnancy loss.pregnancy loss.

Polyacrylamide – associated with adverse fetal development.Polyacrylamide – associated with adverse fetal development. Fumes – these can be emitted from gasoline, associated with reduced birth Fumes – these can be emitted from gasoline, associated with reduced birth

weight and preterm delivery. weight and preterm delivery.

Source: Environmental Health News, 2012Source: Environmental Health News, 2012

Adverse Outcomes ContinuedAdverse Outcomes Continued

In utero exposure can also increase the risk of In utero exposure can also increase the risk of developmental delays developmental delays

(impaired neurological function)(impaired neurological function)

Adult chronic illnesses Adult chronic illnesses

(heart disease, diabetes, cancer)(heart disease, diabetes, cancer)

Next generation effects Next generation effects

(reduced reproductive capacity)(reduced reproductive capacity)


Way of ExposureWay of Exposure

People come in contact with these chemicals mainly by People come in contact with these chemicals mainly by ingesting them. Also there could be exposures from air, ingesting them. Also there could be exposures from air, dust, and water consumption. dust, and water consumption.

According to the National Institute of Environmental According to the National Institute of Environmental Health the majority of the time we are consuming these Health the majority of the time we are consuming these chemicals by drinking from containers that were made chemicals by drinking from containers that were made utilizing these chemicals.utilizing these chemicals.

The temperature of these containers may be a factor for The temperature of these containers may be a factor for the leach of the chemical. For example if the container the leach of the chemical. For example if the container is placed in the microwave the risk of exposure is placed in the microwave the risk of exposure increases.increases.


Prevention StrategiesPrevention Strategies

The National Institute of Environmental Health The National Institute of Environmental Health Sciences recommends that:Sciences recommends that:

People should not microwave (heat) polycarbonate People should not microwave (heat) polycarbonate plastic.plastic.

People should reduce the use of canned foods.People should reduce the use of canned foods.

People should utilize more glass, porcelain, or stainless People should utilize more glass, porcelain, or stainless steel containers ( especially for hot foods or for steel containers ( especially for hot foods or for liquids).liquids).

Source: US Department of Health and Human Services, 2005Source: US Department of Health and Human Services, 2005

Cosmetic Products and Other Cosmetic Products and Other Personal Use ProductsPersonal Use Products

Polyacrylamide is used in water treatment, pulp and Polyacrylamide is used in water treatment, pulp and paper production.paper production.

It is also used in the synthesis of dyes, adhesives, It is also used in the synthesis of dyes, adhesives, contact lenses, cosmetics, and skin creams.contact lenses, cosmetics, and skin creams.

The population is exposed to this chemical by dermal The population is exposed to this chemical by dermal contact and again by food\liquidscontact and again by food\liquids

Source: CDC, 2013Source: CDC, 2013

Exposure to Gasoline & Cigarette Exposure to Gasoline & Cigarette SmokeSmoke

The Centers for Disease Control and Prevention report The Centers for Disease Control and Prevention report that benzene is a chemical found in crude oil, that benzene is a chemical found in crude oil, gasoline, and cigarette smoke.gasoline, and cigarette smoke.

They also report that some industries use benzene to They also report that some industries use benzene to make other chemicals that are used for plastics, make other chemicals that are used for plastics, resins, and synthetic fibers.resins, and synthetic fibers.


Educating Pregnant WomenEducating Pregnant Women

What are some issues that doctors face when they What are some issues that doctors face when they provide prenatal care to a womenprovide prenatal care to a women

Preventing:Preventing: Pre-term laborPre-term labor

ObesityObesity HypertensionHypertension


OpportunitiesOpportunities

This prenatal period grants obstetricians the This prenatal period grants obstetricians the opportunity to educate women on the opportunity to educate women on the possible adverse health outcomes of possible adverse health outcomes of being exposed to certain chemicals being exposed to certain chemicals during the months of pregnancy.during the months of pregnancy.

In addition obstetricians can also educate In addition obstetricians can also educate women on some measures to take to women on some measures to take to reduce their risks of exposures.reduce their risks of exposures.


What Some Obstetricians ReportWhat Some Obstetricians Report

According to a report by Environmental Health News – According to a report by Environmental Health News – 4 out of 10 doctors report that they discuss chemical 4 out of 10 doctors report that they discuss chemical contaminations with pregnant women during their contaminations with pregnant women during their visits. visits.

Women see their doctors every month during pregnancy Women see their doctors every month during pregnancy and these visits increase as the trimesters progress.and these visits increase as the trimesters progress.

Source: Environmental Health News ,2012Source: Environmental Health News ,2012

Why Should Obstetricians take the Why Should Obstetricians take the Time to EducateTime to Educate

Some factors to take into consideration include:Some factors to take into consideration include: Positive birth outcomesPositive birth outcomes

Possibility of reducing infant mortalityPossibility of reducing infant mortality Reduction of long-term health effectsReduction of long-term health effects

Cost effectiveCost effective


Important StatisticsImportant Statistics

According to the Centers for Disease Control According to the Centers for Disease Control and Prevention in 2004, in the US, birth and Prevention in 2004, in the US, birth defects led to more than 139,000 hospital defects led to more than 139,000 hospital stays. These stays resulted in 2.6 billion stays. These stays resulted in 2.6 billion dollars in hospital cost. dollars in hospital cost.

One in every 33 babies is born with a birth One in every 33 babies is born with a birth defect every year.defect every year.

Every 4.5 minutes a baby is born with a birth Every 4.5 minutes a baby is born with a birth defect. defect.


Important Statistics ContinuedImportant Statistics Continued

We know that it is almost impossible to prevent all of We know that it is almost impossible to prevent all of the birth defects we come across in the medical field the birth defects we come across in the medical field each year. each year.

We also know that there is more that we could do by We also know that there is more that we could do by lending a helping hand to women.lending a helping hand to women.

We are not Alone in this FightWe are not Alone in this Fight

It is important to mention some of the organizations and It is important to mention some of the organizations and institutions that play a vital role in educating women during institutions that play a vital role in educating women during her prenatal months. Some partners include:her prenatal months. Some partners include:

ObstetriciansObstetriciansPerinatologistPerinatologistMidwifesMidwifesNurse PractitionersNurse PractitionersPrograms like Healthy Start, and Home visiting programsPrograms like Healthy Start, and Home visiting programsLactation ConsultantsLactation ConsultantsChildbirth EducatorsChildbirth EducatorsNutritionistNutritionistWIC OfficeWIC Office

Higher Learning InstitutionsHigher Learning Institutions

If we advocate and possibly present this information to If we advocate and possibly present this information to colleges we can start a trend for colleges and colleges we can start a trend for colleges and

universities to implement an addition of universities to implement an addition of environmental exposure topics to their students environmental exposure topics to their students

courses. When the student graduates he or she already courses. When the student graduates he or she already has the foundation needed to talk to their patients has the foundation needed to talk to their patients

about environmental exposures during the perinatal about environmental exposures during the perinatal period.period.

ConclusionConclusion

As we have seen from the presentation we are all As we have seen from the presentation we are all exposed to the adverse health effects of exposed to the adverse health effects of environmental pollutants \chemical, and environmental pollutants \chemical, and

toxins. The population we discussed today is toxins. The population we discussed today is at a vulnerable time of their lives. We can all at a vulnerable time of their lives. We can all

work together to help reduce some of the work together to help reduce some of the adverse health effects discussed today.adverse health effects discussed today.

QuestionsQuestions

If you think of any questions at a later If you think of any questions at a later time please feel free to contact me at time please feel free to contact me at

(954)805-4041(954)805-4041

oror

[email protected]

Thank You!Thank You!

ReferencesReferencesCenters for Disease Control and Prevention, 2014 – Birth Defects – Retrieved from Centers for Disease Control and Prevention, 2014 – Birth Defects – Retrieved from http://www.cdc.gov/ncbddd/birthdefects/index.htmlhttp://www.cdc.gov/ncbddd/birthdefects/index.htmlCenters for Disease Control and Prevention, 2013 - Facts About Benzene – Retrieved from Centers for Disease Control and Prevention, 2013 - Facts About Benzene – Retrieved from http://www.bt.cdc.gov/agent/benzene/basics/facts.asphttp://www.bt.cdc.gov/agent/benzene/basics/facts.aspKay .J, 2012 - Kay .J, 2012 - Most doctors don't warn pregnant patients about environmental risks. Most doctors don't warn pregnant patients about environmental risks. Environmental Health news – Retrieved fromEnvironmental Health news – Retrieved fromhttp://www.environmentalhealthnews.org/ehs/news/2012/ob-gyns-and-environmental-healthhttp://www.environmentalhealthnews.org/ehs/news/2012/ob-gyns-and-environmental-healthMoeller .D, 2011 – Moeller .D, 2011 – Environmental HealthEnvironmental Health National Institute of Environmental Health Science, 2014 - Bisphenol A (BPA) - Retrieved fromNational Institute of Environmental Health Science, 2014 - Bisphenol A (BPA) - Retrieved fromhttp://www.niehs.nih.gov/health/topics/agents/sya-bpa/http://www.niehs.nih.gov/health/topics/agents/sya-bpa/National Toxicology Program – US Department of Health and Human Services, 2005 -Center for the evaluation of risks to human National Toxicology Program – US Department of Health and Human Services, 2005 -Center for the evaluation of risks to human

reproduction – Retrieved fromreproduction – Retrieved fromhttp://ntp.niehs.nih.gov/ntp/ohat/acrylamide/acrylamide_monograph.pdf#search=cosmetics that include chemicals that have http://ntp.niehs.nih.gov/ntp/ohat/acrylamide/acrylamide_monograph.pdf#search=cosmetics that include chemicals that have

adverse health effectsadverse health effectsStillerman .K, Mattison . M,2012 - Environmental Exposures and Adverse Pregnancy Outcomes: A Review of the Science. Sage Stillerman .K, Mattison . M,2012 - Environmental Exposures and Adverse Pregnancy Outcomes: A Review of the Science. Sage

Journals – Retrieved fromJournals – Retrieved fromhttp://rsx.sagepub.com/content/15/7/631.shorthttp://rsx.sagepub.com/content/15/7/631.shortThe American College of Obstetricians and Gynecologists - Committee on Health Care for Underserved Women, 2013 American The American College of Obstetricians and Gynecologists - Committee on Health Care for Underserved Women, 2013 American

Society for Reproductive Medicine Practice Committee. The University of California, San Francisco Program on Society for Reproductive Medicine Practice Committee. The University of California, San Francisco Program on Reproductive Health and the Environment – Retrieved fromReproductive Health and the Environment – Retrieved from

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Exposure-to-Toxic-Environmental-AgentsExposure-to-Toxic-Environmental-Agents

The American College of Obstetricians and Gynecologists, 2013 Environmental Chemicals Harm Reproductive Health. Ob-Gyns The American College of Obstetricians and Gynecologists, 2013 Environmental Chemicals Harm Reproductive Health. Ob-Gyns Advocate for Policy Changes to Protect Health – Retrieved fromAdvocate for Policy Changes to Protect Health – Retrieved from

http://www.acog.org/About-ACOG/News-Room/News-Releases/2013/Environmental-Chemicals-Harm-Reproductive-Healthhttp://www.acog.org/About-ACOG/News-Room/News-Releases/2013/Environmental-Chemicals-Harm-Reproductive-Health

SourcesSources

If you are interested in additional information or resources explore the If you are interested in additional information or resources explore the following cites:following cites:

The American College of Obstetricians and GynecologistThe American College of Obstetricians and Gynecologistwww.acog.org/about-acog/news-room/news-releases/2013/environmental-chemicals-harm-www.acog.org/about-acog/news-room/news-releases/2013/environmental-chemicals-harm-

reproductive-healthreproductive-healthPosterPosterwww.acog.org/~/media/departments/health%20care%20for%20underserved%20women/images/www.acog.org/~/media/departments/health%20care%20for%20underserved%20women/images/

environmentalchemicalsinfographic.jpgenvironmentalchemicalsinfographic.jpgPodcast – If you are pregnant don’t smokePodcast – If you are pregnant don’t smokewww.2c.cdc.gov/podcasts/player.asp?f=7868www.2c.cdc.gov/podcasts/player.asp?f=7868 Pocket Guide to Chemical HazardsPocket Guide to Chemical Hazardswww.cdc.gov/niosh/npgwww.cdc.gov/niosh/npg Center for Environmental Research & Children’s HealthCenter for Environmental Research & Children’s Healthwww.cerch.org/research~programs/chamacos-community-outreach/increasing-awareness-of-www.cerch.org/research~programs/chamacos-community-outreach/increasing-awareness-of-

childrens-environmental-health/prenatal-kiosk/childrens-environmental-health/prenatal-kiosk/Different Links for environmental informationDifferent Links for environmental informationwww.Coeh.berkeley.edu/ucpehsu/linksg.html#prenatalwww.Coeh.berkeley.edu/ucpehsu/linksg.html#prenatal

environmental exposures

Documents

environmental factors

environmental exposureswhat

environmental exposuresduring

health hazard participants

reproductive health

exposuresome health

different exposures

healthy pregnancy