Environmental pollution and preconceptional health

Several experimental, clinical and epidemiological evidences attribute an important role to environmental factors of a chemical, physical or biological nature and unhealthy lifestyles in influencing female and male fertility and fetal development. Constant and prolonged exposure over time, even below the recognized toxic dose, during the critical phases of the body's development (intrauterine life, childhood, adolescence) can cause interference on the endocrine and reproductive system that can be the cause of infertility, andrological and gynecological diseases, tumors and malformations of the reproductive system.

Among the substances charged are: pesticides and plasticizers (phthalates, bisphenol). Other recognized environmental contaminants are chemicals such as pesticides, additives and preservatives of industrial and consumer products, some heavy metals (lead), chemicals of natural origin such as polyphenols (some known as phytoestrogens) and drugs with hormone-like action. All these chemicals can be dispersed into the environment either through air pollution (e.g. combustion dioxins in incinerators) or into water and soil. They can also be present in food and drinking water or contained in commonly used objects (plastics and metal boxes used for food preservation), in cosmetics and in hygiene and personal care products (solvents, acetone) and in other household products. Discretionary habits such as the consumption of alcohol or smoking or the abuse of pharmacological substances (e.g., food supplements) or doping substances can also affect fertility. And again, the habit of men wearing very tight clothing, which increases the temperature at the testicular level, may not favor the appropriate conditions for conception.  A recent estimate has calculated that, in the absence of actions to reduce risk, exposure to endocrine disruptors contributes at least 20% of the incidence of diseases of the reproductive system such as endometriosis, male infertility and cryptorchidism, the treatment of which involves serious social and economic costs.

Among the people most predisposed to this type of problem are: workers in companies producing plant protection products and farmers  due to exposure to pesticides, fertilizers and heavy metals present in plant protection formulations; workers in the construction sector due to exposure to dust, additive products, paints; workers in printing activities due to emissions of dust, volatile organic compounds, ozone, produced by laser printers and photocopiers; military personnel for transport, storage, preservation and exposure to toxic substances and/or ionizing radiation; workers in the chemical, petrochemical and mining  industries for potential exposure to the multiple chemical classes mentioned above. Among the categories at risk of hypofertility or infertility there are also pilots, stewards and stewardesses since altitude and pressure differences can affect the activity of the hypothalamic-pituitary-endocrine organ axis (ovary, testicle, thyroid, adrenal), and health workers who may be in contact with chemicals such as anesthetic gases.

The European Union considers it particularly important to identify endocrine disruptors existing on the European market (Article 57 of the REACH Regulation - Registration, Evaluation, Authorisation and Restriction of Chemicals of 2006) and to control the possible contamination of the environment and food.  It is therefore essential and of fundamental importance to respect and enforce adequate health conditions in private and working environments. recommending periodic andrological and gynecological examinations in order to monitor the effect of these substances on the state of reproductive health.