Environmental pollution and preconception health

Several experimental, clinical and epidemiological evidences attribute an important role to chemical, physical or biological environmental factors 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 with the endocrine and reproductive systems that can cause infertility, andrological and gynecological pathologies, tumors and malformations of the reproductive system.

Among the substances accused are: pesticides and plasticizers (phthalates, bisphenol). Other recognized environmental contaminants are chemicals such as pesticides, additives and preservatives from industrial and consumer products, some heavy metals (lead), chemicals of natural origin such as polyphenols (some known as phytoestrogens), and hormone-like drugs. All these chemicals can be dispersed into the environment either through air pollution (e.g. dioxins from combustion in incinerators) or in water and soil. They can also be present in food and drinking water or contained in everyday objects (plastics and metal boxes used for food storage), in cosmetics and hygiene and personal care products (solvents, acetone) and in other household products. Indulgent habits such as alcohol consumption or smoking or abuse of pharmacological substances (e.g. food supplements) or doping agents can also affect fertility. And again, men's habit of wearing very tight clothing, which increases the temperature at the testicular level, may not favor the right conditions for conception.  A recent estimate has calculated that, in the absence of risk reduction actions, 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 entails serious social and economic costs.

Among the people most prone 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 for the emission 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 due to 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 organs axis (ovary, testis, 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 essential and of fundamental importance, therefore, to respect and enforce adequate health conditions in private environments as well as in work environments, recommending periodic andrological and gynaecological examinations in order to monitor the effect of these substances on the state of reproductive health.