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Added a brief section on noise. This impacts fetal development more than fertility but is worth including. |
KwanFlakes (talk | contribs) m →Ionizing radiation: added missing preposition |
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[[File:GHS-pictogram-silhouette.svg|thumb|The [[Globally Harmonized System of Classification and Labeling of Chemicals|international]] [[GHS hazard pictograms|pictogram]] for chemicals that are sensitising, [[mutagen]]ic, [[carcinogen]]ic or toxic to reproduction]]
'''Reproductive toxicity''' refers to the potential risk from a given chemical, physical or biologic agent to adversely affect both male and female fertility as well as [[teratogen|offspring development]].<ref>{{cite web|last=Occupational Health and Safety Administration|title=Reproductive Hazards|url=https://www.osha.gov/reproductive-hazards|accessdate=6 February 2022|website=osha.gov}}</ref> Reproductive toxicants may adversely affect sexual function, ovarian failure, fertility as well as causing developmental toxicity in the offspring.<ref name="CLP">{{cite journal | title = Regulation (EC) No 1272/2008 of the EUROPEAN PARLIAMENT and of the COUNCIL | journal = Official Journal of the European Union | url = https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2008:353:0001:1355:EN:PDF | date = 16 December 2008 | quote = Annex I, section 3.7 labelling and packaging of substances and mixtures, amending and repealing Directives 67/548/EEC and 1999/45/EC, and amending Regulation (EC) No 1907/2006.}}</ref><ref name="IPCS">{{Cite journal | author = International Programme on Chemical Safety | title = Principles For Evaluating Health Risks To Reproduction Associated With Exposure To Chemicals | journal = Environmental Health Criteria | volume = 225 | url = http://www.inchem.org/documents/ehc/ehc/ehc225.htm | location = Geneva | publisher = [[World Health Organization]] | year = 2001 | author-link = International Programme on Chemical Safety }}</ref> Lowered effective [[fertility]] related to reproductive toxicity relates to both male and female effects alike and is reflected in decreased [[sperm]] counts, [[semen]] quality and ovarian failure.
== Infertility ==
[[Infertility]] is medically defined as a failure of a couple to conceive over the course of one year of unprotected intercourse.<ref name=":122">{{Cite book |title=Current Medical Diagnosis & Treatment |vauthors=Long J |publisher=McGraw Hill |year=2022}}</ref> Primary infertility indicates that a person has never been able to achieve pregnancy while secondary inferility is defined as a person having at least one pregnancy before.<ref name="Infertility">{{Cite web |title=Infertility |url=https://www.who.int/news-room/fact-sheets/detail/infertility |access-date=2024-04-11 |website=www.who.int |language=en}}</ref> As many as 20% of couples experience infertility.<ref name=":122" /> Infertility may be caused by an issue along any part of the process of fertilizing an egg through birth of the child. This can include: the release of the egg, the ability of the sperm to fertilize the egg, the implantation of the egg in the uterine wall, and the ability of the fetus to complete development without miscarriage.<ref name=":9">{{Cite web |date=2023-04-26 |title=Infertility {{!}} CDC |url=https://www.cdc.gov/reproductivehealth/infertility/index.htm |access-date=2024-04-11 |website=www.cdc.gov |language=en-us}}</ref> Among males [[oligospermia]] is defined as a paucity of viable spermatozoa in the [[semen]], whereas [[azoospermia]] refers to the complete absence of viable spermatozoa in the semen.<ref name=":122" /> Males may also experience issues in sperm [[Semen analysis|motility]] and [[Morphology (biology)|morphology]], which means the sperm are less likely to make it to the egg or to be able to fertilize the egg.<ref name=":9" /> Female infertility could be a result of an issue regarding their uterus, ovaries, or fallopian tubes and can be impacted by various diseases, endocrine/hormone disruption, or reproductive toxicant.<ref name=":9" /><ref name="Infertility"/>
The [[Globally Harmonized System of Classification and Labelling of Chemicals]] (GHS) separates reproductive toxicity from [[germ cell]] [[mutagen]]icity and [[carcinogen]]icity, even though both these hazards may also affect fertility.<ref>{{Cite book |last=Nations |first=United |url=https://www.un-ilibrary.org/content/books/9789210573207 |title=Globally Harmonized System of Classification and Labelling of Chemicals (GHS): Sixth Revised Edition |date=2015-06-19 |publisher=United Nations |isbn=978-92-1-057320-7 |language=en |doi=10.18356/591dabf9-en}}</ref>
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==== Lead ====
[[File:A piece of lead.jpg|alt=A piece of dark black metallic substance representing elemental lead.|thumb|Elemental lead]]
[[Lead]], a heavy metal that can exist in both organic and inorganic forms, and is associated with adverse effects on male libido, erectile disfunction, premature ejaculation and poor sperm quality.<ref name="LaDou_2014">{{Cite book| vauthors = LaDou J |title=Current Diagnosis and Treatment: Occupational Mediccine|publisher=McGraw Hill Medical|year=2014|isbn=978-1-259-25145-0|location=United States|pages=455–459 |language=English}}</ref> Lead is also associated with negative effects on the female reproductive system particularly for pregnant people.<ref name=":
==== Cadmium ====
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==== Mercury ====
Elemental mercury( Hg<sup>0</sup>) is a metal that exists as liquid form at room temperature and is commonly found in thermometers, blood pressure cuffs and dental amalgams. In terms of exposure, the route of absorption is primarily via inhalation through mercury vapor, which can in turn lead to [[mercury poisoning]].<ref name=":22">{{cite journal |vauthors=Davis BJ, Price HC, O'Connor RW, Fernando R, Rowland AS, Morgan DL |date=February 2001 |title=Mercury vapor and female reproductive toxicity |journal=Toxicological Sciences |volume=59 |issue=2 |pages=291–296 |doi=10.1093/toxsci/59.2.291 |pmid=11158722}}</ref> Occupational exposure to inorganic mercury can occur in industries such as dentistry, fluorescent lamp production, and Chloralkali workers'''.'''<ref name="onlinelibrary.wiley.com">{{Cite journal |last1=Bjørklund |first1=Geir |last2=Chirumbolo |first2=Salvatore |last3=Dadar |first3=Maryam |last4=Pivina |first4=Lyudmila |last5=Lindh |first5=Ulf |last6=Butnariu |first6=Monica |last7=Aaseth |first7=Jan |date=October 2019 |title=Mercury exposure and its effects on fertility and pregnancy outcome |url=https://onlinelibrary.wiley.com/doi/10.1111/bcpt.13264 |journal=Basic & Clinical Pharmacology & Toxicology |language=en |volume=125 |issue=4 |pages=317–327 |doi=10.1111/bcpt.13264 |pmid=31136080 |issn=1742-7835|hdl=11250/2648768 |hdl-access=free }}</ref> Data among female dental technicians exposed to mercury vapors have demonstrated decreased fertility among those who were exposed and practiced poor industrial hygiene while handling dental amalgams.<ref name=":
[[File:Chromium(Cr).JPG|alt=Picture of silvery metal showing chromium.|thumb|Elemental chromium.]]
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=== Ionizing radiation ===
[[Ionizing radiation]] in the form alpha, beta and gamma emissions are well known to adversely affect male and female fertility, as well as fetal development.<ref name=":0">{{Cite web |date=2023-05-01 |title=Radiation - Ionizing - Reproductive Health {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/repro/ionizingradiation.html |access-date=2024-04-11 |website=www.cdc.gov |language=en-us}}</ref><ref name="Kesari_20182">{{cite journal |vauthors=Kesari KK, Agarwal A, Henkel R |date=December 2018 |title=Radiations and male fertility |journal=Reproductive Biology and Endocrinology |volume=16 |issue=1 |pages=118 |doi=10.1186/s12958-018-0431-1 |pmc=6240172 |pmid=30445985 |doi-access=free}}</ref> Exposure to low doses of ionizing radiation can occur naturally in the environment or due to medical treatment or diagnosis, however, higher exposures may be associated with occupation.<ref name=":0" /> Occupations with documented risk include: healthcare workers who interact with radioactive material, certain manufacturing processes, and airline personnel.<ref name=":0" /> Exposure in the range of 0.1 to1.2 Gy is associated with spermatogonial injury; whereas between 4-6 Gy reductions of sperm counts have been reported.<ref name="Kesari_20182" /> Ionizing radiation is considered a hazard particularly in pregnancy, due to its potential impact of gestational development.<ref name=":0" /> More specifically, ionizing radiation is associated with an increased risk of miscarriage and stillbirth.<ref>{{Cite journal |last1=Frangione |first1=Brianna |last2=Hinton |first2=Patrick |last3=Villeneuve |first3=Paul J. |date=January 2023 |title=Low-dose ionizing radiation and adverse birth outcomes: a systematic review and meta-analysis |journal=International Archives of Occupational and Environmental Health |language=en |volume=96 |issue=1 |pages=77–92 |doi=10.1007/s00420-022-01911-2 |issn=0340-0131 |pmc=9823032 |pmid=35913560|bibcode=2023IAOEH..96...77F }}</ref> Recent studies suggest that routine medical examinations that expose a pregnant person to ionizing radiation are not associated with an increase of risk of miscarriage or stillbirth.<ref>{{Cite journal |last=Lowe |first=Sandra A. |date=August 2020 |title=Ionizing radiation for maternal medical indications |url=https://pubmed.ncbi.nlm.nih.gov/31697844/ |journal=Prenatal Diagnosis |volume=40 |issue=9 |pages=1150–1155 |doi=10.1002/pd.5592 |issn=1097-0223 |pmid=31697844}}</ref>
=== Radio frequency electromagnetic fields ===
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=== Antineoplastic Drugs (Chemotherapy) ===
Antineoplastic drugs, commonly known as [[chemotherapy]] drugs, are considered hazardous drugs by the CDC, including hazardous to reproductive health.<ref>{{Cite report |url=https://www.cdc.gov/niosh/docs/2016-161/ |title=NIOSH list of antineoplastic and other hazardous drugs in healthcare settings, 2016. (Supersedes 2014-138). |date=2016-09-01 |publisher=U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health |doi=10.26616/nioshpub2016161 |language=en}}</ref> Exposure to chemotherapy drugs most often occurs through treatment for cancer, however, unintentional occupational exposure may occur in for workers involved in pharmaceutical production, pharmacists or technicians preparing the drugs, and nurses or other healthcare professionals who are administering medication to patients.<ref name=":42">{{Cite web |date=2020-02-20 |title=Antineoplastic Agents: Hazardous Drug Exposures in Healthcare {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/hazdrug/antineoplastic.html |access-date=2024-03-07 |website=www.cdc.gov |language=en-us}}</ref> Other hospital staff, particularly custodial workers, who interact or handle antineoplastic drugs in any capacity may also be at risk of exposure.
=== Non-Chemical Toxicants ===
==== Work Schedule ====
Work schedule can become a reproductive toxicant when working hours are during the employee's typical sleeping hours (night shift), when a worker has an irregular work schedule ([[shift work]]) or long working hours.<ref name=":52">{{Cite web |date=2023-05-01 |title=Work Schedule - Reproductive Health {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/repro/workschedule.html |access-date=2024-03-28 |website=www.cdc.gov |language=en-us}}</ref> Work schedule's reproductive toxicity is primarily a result of impact on regularity, quality, and rhythm of sleep.
==== Physical Demands ====
Physical demands can include bending, lifting, and standing. Physical demands are considered a reproductive toxicant as they can increase the risk of adverse outcomes during pregnancy.<ref name=":6">{{Cite web |date=2023-05-01 |title=Physical Demands (lifting, standing, bending) - Reproductive Health {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/repro/physicaldemands.html |access-date=2024-04-11 |website=www.cdc.gov |language=en-us}}</ref> Bending, lifting, and standing are often associated with occupational responsibilities as the risk is minimal unless physical activity is prolonged.<ref name=":6" /> Standing and walking for more than three hours a day is associated with an increased risk of pre-term birth, while standing for six to eight hours a day is associated with an increased risk of miscarriage.
==== Noise ====
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