Transcript Environmental Exposures Presented by: Cecilia Escorbore Walden University Environmental Health – PUBH 6165-4 Professor: Dr.Thron July 31, 2014

Environmental Exposures
Presented by: Cecilia Escorbore
Walden University
Environmental Health – PUBH 6165-4
Professor: Dr.Thron
July 31, 2014
Environmental Exposures
During the Prenatal Months
Objectives
At the end of this presentation:
Participants will have gained an understanding of environmental
exposure risks associated with the unborn fetus.
Participants will learn about different chemicals and toxins in the
environment
Participants will learn about different personal products that contain
several chemicals that can be a health hazard
Participants will have the knowledge needed to embrace the
importance of educating pregnant women about the risk of
environmental exposures during pregnancy.
Participants will have an idea of resources to utilize to give to their
clients as a reading guide about environmental exposures.
Environmental Exposures
What are Environmental Exposures
As human beings we are exposed to the different
chemicals and toxins in the environment. Our health in
many cases is affected by the same environment we live
in and are exposed to on a daily basis. Many diseases
can be initiated, promoted, sustained, or stimulated by
environmental factors. In an effort to provide the
unborn fetus with a healthy beginning in life pregnant
women must be made aware of the risk of certain
factors during pregnancy.
Source: Moeller D., 2011 Environmental Health (p 5-6)
Factors to Consider
Chemical
 Biological
 Physical
 Socioeconomic

Source: Moeller D., 2011 Environmental Health (p 5-6)
Prenatal Period
Prenatal women and the different exposures:
Women are concerned with a healthy pregnancy
and a positive outcome. Because of this reason
they are seeking prenatal care and are
interested in all of the information available
for a healthy 10 months. This is also a time of
heightened concern about the decisions they
are making. Hence the perfect opportunity.
Source: Acog, 2013
Reproductive Health Problems with
Exposure
Some health problems to consider associated with
environmental exposure include:
 Miscarriage and Stillbirth
 Impaired Fetal Growth and Low Birth Weight
 Preterm Birth
 Childhood Cancers
 Birth Defects
 Cognitive/intellectual Impairments
 Thyroid Problems
Source: Acog, 2013
Long Lasting Health Effects
The exposure during pregnancy can lead to other long
lasting effects for children and adulthood. Fetus that
were exposed to environmental chemicals\pesticides
can develop certain cancers as children, they can also
interfere with the development of the fetus in all
stages. As teens females develop early into puberty
and even their reproductive functions can be affected.
Males that have been exposed have been found to
experience altered semen quality, sterility, and even
prostate cancer.
Source: National Institute of Environmental Health Science, 2014
Products & Chemicals
Chemicals are use in the following Products
 Bisphenol-A – is used in large amounts to produce
polycarbonate plastics and epoxy resins.
 Polycarbonate is used in some containers of food,
drink packaging for example drinking bottles, infant
bottles, CD’s, safety equipment, and medical devises.
 Epoxy resins are used as a coating for metal products
like food cans, bottle tops, and water pipes.
Source: Acog, 2013
Reported Adverse Outcomes
Several reports have revealed a number of adverse prenatal outcomes
associated with the exposures of pregnant women to several environmental
contaminants.

Tobacco smoke – associated with reduced birth weight and preterm
delivery.

Pesticides & Polychlorinated Biphenyls – associated with decreased fetal
growth and the length of gestation.

Organic solvents & Chlorophenoxy Herbicides – associated with birth
defects.

Dichlorodiphenyltrichloroethane & Bisphenol-A – associated with
pregnancy loss.

Polyacrylamide – associated with adverse fetal development.

Fumes – these can be emitted from gasoline, associated with reduced birth
weight and preterm delivery.
Source: Environmental Health News, 2012
Adverse Outcomes Continued
In utero exposure can also increase the risk of
developmental delays
(impaired neurological function)
Adult chronic illnesses
(heart disease, diabetes, cancer)
Next generation effects
(reduced reproductive capacity)
Source: National Institute of Environmental Health Science, 2014
Way of Exposure
People come in contact with these chemicals mainly by
ingesting them. Also there could be exposures from air,
dust, and water consumption.
According to the National Institute of Environmental
Health the majority of the time we are consuming these
chemicals by drinking from containers that were made
utilizing these chemicals.
The temperature of these containers may be a factor for the
leach of the chemical. For example if the container is
placed in the microwave the risk of exposure increases.
Source: National Institute of Environmental Health Science, 2014
Prevention Strategies
The National Institute of Environmental Health
Sciences recommends that:
People should not microwave (heat) polycarbonate
plastic.
People should reduce the use of canned foods.
People should utilize more glass, porcelain, or stainless
steel containers ( especially for hot foods or for
liquids).
Source: US Department of Health and Human Services, 2005
Cosmetic Products and Other
Personal Use Products
Polyacrylamide is used in water treatment, pulp and
paper production.
It is also used in the synthesis of dyes, adhesives,
contact lenses, cosmetics, and skin creams.
The population is exposed to this chemical by dermal
contact and again by food\liquids
Source: CDC, 2013
Exposure to Gasoline & Cigarette
Smoke
The Centers for Disease Control and Prevention report
that benzene is a chemical found in crude oil,
gasoline, and cigarette smoke.
They also report that some industries use benzene to
make other chemicals that are used for plastics,
resins, and synthetic fibers.
Source: Environmental Health News, 2012
Educating Pregnant Women
What are some issues that doctors face when they
provide prenatal care to a women
Preventing:
 Pre-term labor
 Obesity
 Hypertension
Source: Environmental Health News, 2012
Opportunities
This prenatal period grants obstetricians the
opportunity to educate women on the
possible adverse health outcomes of
being exposed to certain chemicals during
the months of pregnancy.
In addition obstetricians can also educate
women on some measures to take to
reduce their risks of exposures.
Source: Environmental Health News, 2012
What Some Obstetricians Report
According to a report by Environmental Health News –
4 out of 10 doctors report that they discuss chemical
contaminations with pregnant women during their
visits.
Women see their doctors every month during pregnancy
and these visits increase as the trimesters progress.
Source: Environmental Health News ,2012
Why Should Obstetricians take the
Time to Educate
Some factors to take into consideration include:
 Positive birth outcomes
 Possibility of reducing infant mortality
 Reduction of long-term health effects
 Cost effective
Source: CDC, 2014
Important Statistics
According to the Centers for Disease Control
and Prevention in 2004, in the US, birth
defects led to more than 139,000 hospital
stays. These stays resulted in 2.6 billion dollars
in hospital cost.
One in every 33 babies is born with a birth defect
every year.
Every 4.5 minutes a baby is born with a birth
defect.
Source: CDC, 2014
Important Statistics Continued
We know that it is almost impossible to prevent all of
the birth defects we come across in the medical field
each year.
We also know that there is more that we could do by
lending a helping hand to women.
We are not Alone in this Fight
It is important to mention some of the organizations and
institutions that play a vital role in educating women during
her prenatal months. Some partners include:
Obstetricians
Perinatologist
Midwifes
Nurse Practitioners
Programs like Healthy Start, and Home visiting programs
Lactation Consultants
Childbirth Educators
Nutritionist
WIC Office
Higher Learning Institutions
If we advocate and possibly present this information to
colleges we can start a trend for colleges and
universities to implement an addition of
environmental exposure topics to their students
courses. When the student graduates he or she already
has the foundation needed to talk to their patients
about environmental exposures during the perinatal
period.
Conclusion
As we have seen from the presentation we are all
exposed to the adverse health effects of
environmental pollutants \chemical, and
toxins. The population we discussed today is at
a vulnerable time of their lives. We can all
work together to help reduce some of the
adverse health effects discussed today.
Questions
If you think of any questions at a later
time please feel free to contact me at
(954)805-4041
or
[email protected]
Thank You!
References
Centers for Disease Control and Prevention, 2014 – Birth Defects – Retrieved from
http://www.cdc.gov/ncbddd/birthdefects/index.html
Centers for Disease Control and Prevention, 2013 - Facts About Benzene – Retrieved from
http://www.bt.cdc.gov/agent/benzene/basics/facts.asp
Kay .J, 2012 - Most doctors don't warn pregnant patients about environmental risks. Environmental Health news – Retrieved from
http://www.environmentalhealthnews.org/ehs/news/2012/ob-gyns-and-environmental-health
Moeller .D, 2011 – Environmental Health
National Institute of Environmental Health Science, 2014 - Bisphenol A (BPA) - Retrieved from
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
reproduction – Retrieved from
http://ntp.niehs.nih.gov/ntp/ohat/acrylamide/acrylamide_monograph.pdf#search=cosmetics that include chemicals that have
adverse health effects
Stillerman .K, Mattison . M,2012 - Environmental Exposures and Adverse Pregnancy Outcomes: A Review of the Science. Sage
Journals – Retrieved from
http://rsx.sagepub.com/content/15/7/631.short
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
Reproductive Health and the Environment – Retrieved from
http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-UnderservedWomen/Exposure-to-Toxic-Environmental-Agents
The American College of Obstetricians and Gynecologists, 2013 Environmental Chemicals Harm Reproductive Health. Ob-Gyns
Advocate for Policy Changes to Protect Health – Retrieved from
http://www.acog.org/About-ACOG/News-Room/News-Releases/2013/Environmental-Chemicals-Harm-Reproductive-Health
Sources
If you are interested in additional information or resources explore the
following cites:
The American College of Obstetricians and Gynecologist
www.acog.org/about-acog/news-room/news-releases/2013/environmental-chemicals-harmreproductive-health
Poster
www.acog.org/~/media/departments/health%20care%20for%20underserved%20women/images/e
nvironmentalchemicalsinfographic.jpg
Podcast – If you are pregnant don’t smoke
www.2c.cdc.gov/podcasts/player.asp?f=7868
Pocket Guide to Chemical Hazards
www.cdc.gov/niosh/npg
Center for Environmental Research & Children’s Health
www.cerch.org/research~programs/chamacos-community-outreach/increasing-awareness-ofchildrens-environmental-health/prenatal-kiosk/
Different Links for environmental information
www.Coeh.berkeley.edu/ucpehsu/linksg.html#prenatal