Endocrine-Disrupting Chemicals during Pregnancywith Camil le Freeman, LDN

W I T H C A M I L L E F R E E M A N , L D N

What is an Endocrine-Disrupting Chemical?

“An exogenous chemical, or mixture of chemicals, that interfere with any aspect of hormone action.” (Gore et al., 2015)

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EDC and PregnancyWHAT SHOULD WE BE CONCERNED ABOUT?

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Concerns

Pregnancy as a critical window for health

Neurodevelopment

Metabolism

Thyroid health

Figure 1 from Sargis, Heindel & Padmanabhan (2019)

Figure 2 from Street et al. (2018)

Which EDC are concerning?

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BPA

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Air pollution

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Industrial chemicals

Toxic metals

Polychlorinated biphenyls (PCBs)

Pesticides

Figure 1 from Hertz-Picciotto et al. (2018)

Flame retardants

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How do we reduce exposure?

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Household and Personal Care

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Key Tips

Wash your hands regularly using non-scented soaps without antimicrobials

Don’t handle receipts/thermal paper

Avoid scented products

Check cosmetics for lead, fragrance and phthalates

Do you know what’s in your:

Cosmetics

Toothpaste

Lotion

Shampoo/Conditioner

Soaps

Nail Polish

Hair Dye

Cleaning products

Environmental Working Group

• The products listed on the previous slide may contain phthalates, artificial fragrances/dyes or other chemicals that may harm fertility

• Check your Household products with the EWG resources.

• Consider natural alternatives or doing without

• Example: Baking/soda vinegar works for almost all cleaning

• Prepare your own household/personal care products

• Rosemary Gladstar’s Herbal Recipes for Vibrant Health

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Menstrual Products

• Recent study found that menstrual pads – and disposable diapers - contain high levels of VOCs and phthalates. (Park et al., 2019)

• Consider silicone or rubber menstrual cups (e.g. Diva cup, Lunette) or re-usable cloth pads (check Etsy!)

• Organic/dye-free tampons and pads are also available

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Other Considerations

• Renovating your home? Buying a new car? New flooring, carpet, furniture and cars may off gas. Avoid buying new if possible; check manufacturer’s info on safety, and keep well-ventilated if you can’t avoid

• Check California’s proposition 65 website for info on products/substances known to have reproductive effects

• Avoid purchasing furniture or clothing with flame-retardant chemicals

• Avoid spraying gardens/lawns with herbicides or pesticides.

• Vinegar/dish soap makes a reasonable weed spray if needed

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Food and Beverages

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Be sure to consume enough:

Iodine (220 ug/day during pregnancy)

Iron (27 mg/day during pregnancy)

Calcium (1500-2000 mg/day during pregnancy)

Fiber (25 g/day during pregnancy)

Dirty Dozen

• Strawberries

• Spinach

• Kale

• Nectarines

• Apples

• Grapes

• Peaches

• Cherries

• Pears

• Tomatoes

• Celery

• Potatoes

• Hot Peppers

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Clean Fifteen• Avocados

• Sweet Corn

• Pineapple

• Sweet Peas (frozen)

• Onions

• Papayas

• Eggplants

• Asparagus

• Kiwis

• Cabbages

• Cauliflower

• Cantaloupes

• Broccoli

• Mushrooms

• Honeydew

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Link to FDA resource

Avoid Canned Foods and Beverages

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BPA and BPA-alternatives may harm male and female fertility

This includes fizzy water cans!

Consider SodaStream, tap/filtered water or foods and beverages in glass bottles instead

If you do eat from a can, drain and rinse the contents before using, which may decrease BPA exposure

Avoid Plastic Containers for Foods and Beverages

• May leech phthalates and other chemicals into food, particularly if heated

• Water and soda bottles

• Bring a glass or stainless-steel water bottle

• Store leftovers in glass or metal storage containers

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Other Considerations

• Non-stick pans: may leech or off gas, particularly if coating is damaged or old. Do not put in dishwasher

• Use Stainless Steel instead

• Consider water quality in your home. (IWG’s Tap Water Database)

• Invest in water filtration if necessary (EWG Guide to Water Filtration Systems)

• Berkey Water Filtration

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In the garden/yard

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Key Tips

Plant native trees and preserve forests

Do not burn leaf litter or wood

Use hand-powered or electric lawn care equipment

Eliminate all use of pesticides and herbicides

Avoid outdoor activities when air pollution levels are high

Environmental Concerns

Quit smoking & avoid 2nd/3rd hand smoke

Check your local air quality (ALA State of the Air database)

Wipe dust in home and office regularly with a damp cloth

Keep floors clean using a wet mop or a vacuum with a HEPA filter

Wash hands before eating

Consider air filtration if necessary

Getting Around

Avoid spending time near gas-powered

engines

Avoid enclosed parking garages

When pumping gas, move a few steps away from the pump to avoid

fumes

Do not get gas on your skin

Wash hands after pumping gas

Wipe dust from car regularly with wet cloth

Vacuum car upholstery with HEPA-filtered

vacuum

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Thank you!For support and guidance:

www.camillefreeman.com

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Resources

• Berg, V., Nøst, T. H., Skeie, G., Thomassen, Y., Berlinger, B., Veyhe, A. S., … Hansen, S. (2017). Thyroid homeostasis in mother–child pairs in relation to maternal iodine status: The MISA study. European Journal of Clinical Nutrition, 71(8), 1002–1007. https://doi.org/10.1038/ejcn.2017.83

• Bernier, M. R., & Vandenberg, L. N. (2017). Handling of thermal paper: Implications for dermal exposure to bisphenol A and its alternatives. PloS One, 12(6), e0178449. https://doi.org/10.1371/journal.pone.0178449

• Brook, R. D., Xu, X., Bard, R. L., Dvonch, J. T., Morishita, M., Kaciroti, N., … Rajagopalan, S. (2013). Reduced metabolic insulin sensitivity following sub-acute exposures to low levels of ambient fine particulate matter air pollution. The Science of the Total Environment, 448, 66–71. https://doi.org/10.1016/j.scitotenv.2012.07.034

• Chen, C.-Y., Chou, Y.-Y., Lin, S.-J., & Lee, C.-C. (2015). Developing an intervention strategy to reduce phthalate exposure in Taiwanese girls. The Science of the Total Environment, 517, 125–131. https://doi.org/10.1016/j.scitotenv.2015.02.021

• Esteves, S. C., & Bento, F. C. (2016). Air quality control in the ART laboratory is a major determinant of IVF success. Asian Journal of Andrology, 18(4), 596–599. https://doi.org/10.4103/1008-682X.166433

• Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., … Zoeller, R. T. (2015). EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocrine Reviews, 36(6), E1–E150. https://doi.org/10.1210/er.2015-1010

• Ha, S., Yeung, E., Bell, E., Insaf, T., Ghassabian, A., Bell, G., … Mendola, P. (2019). Prenatal and early life exposures to ambient air pollution and development. Environmental Research, 174, 170–175. https://doi.org/10.1016/j.envres.2019.03.064

• Heid, M. (2018). You Asked: Can Indoor Plants Really Purify the Air? Retrieved July 27, 2019, from Time website: https://time.com/5105027/indoor-plants-air-quality/

• Hertz-Picciotto, I., Sass, J. B., Engel, S., Bennett, D. H., Bradman, A., Eskenazi, B., … Whyatt, R. (2018). Organophosphate exposures during pregnancy and child neurodevelopment: Recommendations for essential policy reforms. PLoS Medicine, 15(10). https://doi.org/10.1371/journal.pmed.1002671

• Hwang, S., Lim, J.-E., Choi, Y., & Jee, S. H. (2018). Bisphenol A exposure and type 2 diabetes mellitus risk: A meta-analysis. BMC Endocrine Disorders, 18(1), 81. https://doi.org/10.1186/s12902-018-0310-y

• Berg, V., Nøst, T. H., Skeie, G., Thomassen, Y., Berlinger, B., Veyhe, A. S., … Hansen, S. (2017). Thyroid homeostasis in mother–child pairs in relation to maternal iodine status: The MISA study. European Journal of Clinical Nutrition, 71(8), 1002–1007. https://doi.org/10.1038/ejcn.2017.83

• Bernier, M. R., & Vandenberg, L. N. (2017). Handling of thermal paper: Implications for dermal exposure to bisphenol A and its alternatives. PloS One, 12(6), e0178449. https://doi.org/10.1371/journal.pone.0178449

• Brook, R. D., Xu, X., Bard, R. L., Dvonch, J. T., Morishita, M., Kaciroti, N., … Rajagopalan, S. (2013). Reduced metabolic insulin sensitivity following sub-acute exposures to low levels of ambient fine particulate matter air pollution. The Science of the Total Environment, 448, 66–71. https://doi.org/10.1016/j.scitotenv.2012.07.034

• Chen, C.-Y., Chou, Y.-Y., Lin, S.-J., & Lee, C.-C. (2015). Developing an intervention strategy to reduce phthalate exposure in Taiwanese girls. The Science of the Total Environment, 517, 125–131. https://doi.org/10.1016/j.scitotenv.2015.02.021

• Esteves, S. C., & Bento, F. C. (2016). Air quality control in the ART laboratory is a major determinant of IVF success. Asian Journal of Andrology, 18(4), 596–599. https://doi.org/10.4103/1008-682X.166433

• Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., … Zoeller, R. T. (2015). EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocrine Reviews, 36(6), E1–E150. https://doi.org/10.1210/er.2015-1010

• Ha, S., Yeung, E., Bell, E., Insaf, T., Ghassabian, A., Bell, G., … Mendola, P. (2019). Prenatal and early life exposures to ambient air pollution and development. Environmental Research, 174, 170–175. https://doi.org/10.1016/j.envres.2019.03.064

• Heid, M. (2018). You Asked: Can Indoor Plants Really Purify the Air? Retrieved July 27, 2019, from Time website: https://time.com/5105027/indoor-plants-air-quality/

• Hertz-Picciotto, I., Sass, J. B., Engel, S., Bennett, D. H., Bradman, A., Eskenazi, B., … Whyatt, R. (2018). Organophosphate exposures during pregnancy and child neurodevelopment: Recommendations for essential policy reforms. PLoS Medicine, 15(10). https://doi.org/10.1371/journal.pmed.1002671

• Hwang, S., Lim, J.-E., Choi, Y., & Jee, S. H. (2018). Bisphenol A exposure and type 2 diabetes mellitus risk: A meta-analysis. BMC Endocrine Disorders, 18(1), 81. https://doi.org/10.1186/s12902-018-0310-y

• Liu, S., Hammond, S. K., & Rojas-Cheatham, A. (2013). Concentrations and Potential Health Risks of Metals in Lip Products. Environmental Health Perspectives, 121(6), 705–710. https://doi.org/10.1289/ehp.1205518

• Marraudino, M., Bonaldo, B., Farinetti, A., Panzica, G., Ponti, G., & Gotti, S. (2018). Metabolism Disrupting Chemicals and Alteration of Neuroendocrine Circuits Controlling Food Intake and Energy Metabolism. Frontiers in Endocrinology, 9, 766. https://doi.org/10.3389/fendo.2018.00766

• Park, C. J., Barakat, R., Ulanov, A., Li, Z., Lin, P.-C., Chiu, K., … Ko, C. J. (2019). Sanitary pads and diapers contain higher phthalate contents than those in common commercial plastic products. Reproductive Toxicology (Elmsford, N.Y.), 84, 114–121. https://doi.org/10.1016/j.reprotox.2019.01.005

• Peña-Rosas, J. P., De-Regil, L. M., Dowswell, T., & Viteri, F. E. (2012). Daily oral iron supplementation during pregnancy. The Cochrane Database of Systematic Reviews, 12, CD004736. https://doi.org/10.1002/14651858.CD004736.pub4

• Ruiz, D., Becerra, M., Jagai, J. S., Ard, K., & Sargis, R. M. (2018). Disparities in Environmental Exposures to Endocrine-Disrupting Chemicals and Diabetes Risk in Vulnerable Populations. Diabetes Care, 41(1), 193–205. https://doi.org/10.2337/dc16-2765

• Sargis, R. M., Heindel, J. J., & Padmanabhan, V. (2019). Interventions to Address Environmental Metabolism-Disrupting Chemicals: Changing the Narrative to Empower Action to Restore Metabolic Health. Frontiers in Endocrinology, 10. https://doi.org/10.3389/fendo.2019.00033

• Shelly, C., Grandjean, P., Oulhote, Y., Plomgaard, P., Frikke-Schmidt, R., Nielsen, F., … Valvi, D. (2019). Early life exposures to perfluoroalkyl substances in relation to adipokine hormone levels at birth and during childhood. The Journal of Clinical Endocrinology and Metabolism. https://doi.org/10.1210/jc.2019-00385

• Starling, A. P., Adgate, J. L., Hamman, R. F., Kechris, K., Calafat, A. M., & Dabelea, D. (2019). Prenatal exposure to per- and polyfluoroalkyl substances and infant growth and adiposity: The Healthy Start Study. Environment International, 131, 104983.

• Stel, J., & Legler, J. (2015). The Role of Epigenetics in the Latent Effects of Early Life Exposure to Obesogenic Endocrine Disrupting Chemicals. Endocrinology, 156(10), 3466–3472. https://doi.org/10.1210/en.2015-1434

• Street, M. E., Angelini, S., Bernasconi, S., Burgio, E., Cassio, A., Catellani, C., … Amarri, S. (2018). Current Knowledge on Endocrine Disrupting Chemicals (EDCs) from Animal Biology to Humans, from Pregnancy to Adulthood: Highlights from a National Italian Meeting. International Journal of Molecular Sciences, 19(6). https://doi.org/10.3390/ijms19061647

• Thongkorn, S., Kanlayaprasit, S., Jindatip, D., Tencomnao, T., Hu, V. W., & Sarachana, T. (2019). Sex Differences in the Effects of Prenatal Bisphenol AExposure on Genes Associated with Autism Spectrum Disorder in the Hippocampus. Scientific Reports, 9(1), 3038. https://doi.org/10.1038/s41598-019-39386-w

• Watkins, D. J., Eliot, M., Sathyanarayana, S., Calafat, A. M., Yolton, K., Lanphear, B. P., & Braun, J. M. (2014). Variability and predictors of urinary concentrations of phthalate metabolites during early childhood. Environmental Science & Technology, 48(15), 8881–8890. https://doi.org/10.1021/es501744v

• Zhang, W., Xia, W., Liu, W., Li, X., Hu, J., Zhang, B., … Li, Y. (2019). Exposure to Bisphenol a Substitutes and Gestational Diabetes Mellitus: A Prospective Cohort Study in China. Frontiers in Endocrinology, 10, 262. https://doi.org/10.3389/fendo.2019.00262

• Zota, A. R., Phillips, C. A., & Mitro, S. D. (2016). Recent Fast Food Consumption and Bisphenol A and Phthalates Exposures among the U.S. Population in NHANES, 2003-2010. Environmental Health Perspectives, 124(10), 1521–1528. https://doi.org/10.1289/ehp.1510803