Ask pregnant women about pollutant exposure, OB/GYNs urged

From mercury to pesticides, Americans are exposed daily to environmental chemicals that could harm reproductive health, the largest groups of obstetricians and fertility specialists in the U.S. says.

Monday's report urges doctors to push for stricter environmental policies to better identify and reduce exposure to chemicals that prove truly risky. But it's likely to scare pregnant women in the meantime.

That's because during the first prenatal visit, the American College of Obstetricians and Gynecologists wants doctors to ask mothers-to-be about their exposure to different chemicals. They're also supposed to teach women how to avoid some considered most worrisome during pregnancy.

"What we're trying to get is the balance between awareness and alarmist," said Dr. Jeanne Conry, president of the American College of Obstetricians and Gynecologists.

Specialists with ACOG and the American Society for Reproductive Medicine examined research about industrial chemicals and pollutants that people can absorb from the air, water, food and everyday products. Few chemicals hit the market with good information about safe levels — something the groups hope to change. But certain chemicals are linked to infertility, miscarriages, birth defects and other problems, the committee said.

Risks are greatest for women with high on-the-job exposure. So doctors should ask about workplaces during that first prenatal visit, the committee advised.

But the report also cited research suggesting virtually every pregnant woman is exposed to at least 43 different chemicals. It's unclear how many matter, but some can reach the fetus. For example, mercury pollution builds up in certain fish, and when eaten by a mother-to-be, can damage her unborn baby's developing brain. Prenatal exposure to certain pesticides can increase the risk of childhood cancer, the report found.

Poor and minority populations are disproportionately exposed to various pollutants, urging doctors to be aware of concerns unique to where they live, the committee said.

It's not just about pregnancy. High enough pesticide exposure in adult men has been linked to sterility and prostate cancer, the report noted.

But the report also raises some controversial examples. For example, most Americans have traces of BPA, or bisphenol-A, in their urine because it's so widely used in plastics, consumer goods and to line metal food cans to prevent contamination and spoiling. Makers of baby bottles and sippy cups stopped using BPA several years ago because of consumer concern that it might harm young children's development, and the U.S. Food and Drug Administration won't let it return to those baby products. But the FDA has maintained that BPA's use in other food containers is safe.

For now, Conry said the consumer advice is common-sense: Choose fresh fruits and vegetables over processed foods when possible and thoroughly wash produce. Pregnant women and young children should eat certain seafood to get the nutritional benefits without the mercury risk. That means avoiding shark, swordfish, king mackerel and tilefish. Low-mercury examples are shrimp, canned light tuna, salmon and catfish. (The FDA advises pregnant women to eat no more than 6 ounces or 170 grams a week of white or albacore tuna, which has more mercury than the canned light kind.)

"There's only so much people can do as individuals and families to limit chemical exposures," said University of Washington public health dean Dr. Howard Frumkin, an environmental health specialist not involved in the report. But he called the statement "a very balanced, reasonable and evidence-based contribution."

The industry's American Chemistry Council said current environmental regulations offer enough consumer protection, and that the new report will create "confusion and alarm among expectant mothers" and distract them from proven steps for a healthy pregnancy.