Documents Marcus, Michele 4 results

"There is a significant public health concern about the potential effects of occupational exposure to toxic substances on reproductive outcomes. Several toxicants with reported reproductive and developmental effects are still in regular commercial or therapeutic use and thus present potential exposure to workers. Examples of these include heavy metals, organic solvents, pesticides and herbicides, and sterilants, anesthetic gases, and anticancer drugs used in health care. Many other substances are suspected of producing reproductive or developmental toxicity but lack sufficient data. Progress has been limited in identifying hazards and quantifying their potencies and in separating the contribution of these hazards from other etiologic factors. Identifying the causative agents, mechanisms by which they act, and any potential target populations, present the opportunity to intervene and protect the reproductive health of workers. The pace of laboratory studies to identify hazards and to underpin the biologic plausibility of effects in humans has not matched the pace at which new chemicals are introduced into commerce. Though many research challenges exist today, recent technologic and methodologic advances have been made that allow researchers to overcome some of these obstacles. The objective of this article is to recommend future directions in occupational reproductive health research. By bridging interdisciplinary gaps, the scientific community can work together to improve health and reduce adverse outcomes. Key words: communication, environmental exposure, occupational exposure, reproduction, research design, risk factors."(Authors' abstract)

The limitations and methodology inherent in human factors and epidemiological studies of upper extremity musculoskeletal disorders and video display terminal (VDT) use were considered. Human factors studies, while frequently being used to question the safety of data entry tasks, have suffered from the limitation of having a small number of subjects, and short term exposure under conditions found in the laboratory, and the questionable practice of using short term outcomes to predict chronic health effects. Difficulties in interpreting data taken from epidemiologic studies usually have been traced to limitations in the methodology established in the research outlines. These difficulties in epidemiologic studies relate to obtaining a poor measurement of exposure and health outcomes and neglecting potentially confounding variables. Some studies have improved the measures of VDT usage but these improvements have not resulted in improved consistencies in the findings. The authors stress the need for additional studies attempting to clarify exposure and effect relationships by well conducted epidemiologic studies. Research should examine associations between VDT use and upper extremity disorders but only when measures of both exposure and adverse health effects are standard, objective, and valid.

"To our knowledge, reproductive health effects among male leather tannery workers have not been previously investigated. Tannery work involves exposure to chromium, solvents, and other chemicals, which has been associated with adverse pregnancy and fertility outcomes in animals or humans in some studies. This study retrospectively investigates the association of male leather tannery work with preterm delivery, spontaneous abortion, time to pregnancy, and infertility by comparing tannery employees to other workers in Ulaanbaatar, Mongolia. Participants were randomly selected from current employee rosters at eight tanneries and two bread-making companies. The results of this research suggest that tannery work may be associated with reduced fertility in males. The study had limited statistical power, and some factors are likely to have biased findings toward the null hypothesis; other limitations and possible sources of undetermined bias give reason for cautious interpretation. Additional studies should be conducted to further examine fertility among tannery workers."