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PubMed1996

A screening method for occupational reproductive health risk.

Most currently recognized occupational exposure limits do not consider reproductive toxicological end points consistently when establishing recommended exposure limits. In many cases the information is not available, but perhaps as often, existing data is not employed. Further, many manufacturer's material safety data sheets omit reproductive hazard information. A method for identifying potential reproductive toxins and screening levels for associated health risks useful for hazard communication and exposure control is presented. To date, the Registry of Toxic Effects of Chemical Substances lists between 5000 and 6000 chemicals, drugs, and natural substances that show a positive outcome in at least 1 reproductive effects study. This reproductive health risk assessment began with these substances. Using elements of the Environmental Protection Agency's health risk assessment process, the list was reduced to 213 chemicals during the hazard identification step. Occupational reproductive guidelines (ORGs) were developed in the dose-response evaluation step. At the time of this writing, 85% of the chemicals identified in the hazard identification step have had a screening level dose-response assessment completed. Of these, 13% are greater than or equal to a threshold limit value (TLV). The remaining 87% do not have a TLV or ORGs below the TLV. The reproductive toxins list, along with the corresponding dose-response-derived ORGs that have been completed, appears at the end of the text.

Dose-Response Relationship, Drug↗
PubMedDate not supplied

Users of reproductive health clinic services in a school pregnancy prevention program.

Although the potential of school-based programs in the prevention of adolescent pregnancy is well recognized, few have been evaluated. This paper describes the use of a reproductive health care clinic associated with a school pregnancy prevention program which had demonstrated success. The program operated in one junior and one senior high school in a large city during the 3 school years from 1981 to 1984. Three facets of the 818 users of the program clinic are explored: who enrolled in the clinic, why they enrolled and what contraceptive methods they received, and their continuation with the clinic. Chi-square analysis and Student's t-tests were used to test for significant differences between the two school and sex groups. Life table and regression techniques were employed to examine clinic continuation. The main findings are teens of both sexes used the clinic, and junior high males used it in surprisingly large numbers; there were no major school or sex differences in the characteristics of those who enrolled; most students enrolled to obtain a contraceptive method; although many females served by the clinic had previously used another family planning clinic, the majority of them had unmet needs; the rate of clinic continuation was high; and certain factors contributed to clinic continuation. These findings suggest that a clinic in a school-linked setting can successfully attract students to use its services and it may offer certain advantages for reaching sexually active teens in search of contraceptive protection.

Adolescent↗
PubMed1993

Protecting reproductive health and the environment: toxics use reduction.

Toxics use reduction is a new chemical hazard management approach that has emerged in several state laws over the past years. While toxics use reduction has been promoted as a means of preventing environmental pollution, little thought has been given to its adoption as a means of managing reproductive hazards. This paper provides illustrations of use reduction approaches to conventionally recognized reproductive and developmental toxicants. These approaches will require the opening of a new dialogue between industrial designers and process managers and those most concerned about reproductive health. Several different strategies are proposed that might be adopted into state programs for promoting reduction in the use of reproductive and developmental toxicants.

Hazardous Substances↗
PubMed1996

Preserving the pot and water: a traditional concept of reproductive health in a Yoruba community, Nigeria.

Within the background of the outcome of the 1994 Cairo Conference, this paper describes a traditional conceptualization of prenatal care in a Nigerian community and draws their implication for effective delivery of reproductive health services in the area. The data used were from qualitative interviews during 2 field trips to the community in 1988-89 and 1991. The finding of the study highlights a local metaphor that likened the risks of pregnancy and child birth to a group of women that trekked to a local brook to fetch water with their earthen pots: some fell, broke their pots; some missed steps and spilt their water but kept their pots, and others returned without any mishap. The first group represented cases of maternal mortality; the second group were cases of miscarriage, still-births or infant deaths, and the third group represented successful outcomes for both pregnancy and the resultant baby. Various steps that were traditionally taken to ensure that the mother neither lost her pot nor spilled her water are described. The implications of these findings for policy and research are discussed in the paper.

Adolescent↗
PubMed1992

Sister chromatid exchange frequencies in a group of individuals with unfavorable reproductive health.

Sister chromatid exchange (SCE) frequencies and other cytogenetic parameters were investigated in peripheral blood lymphocytes from 92 subjects comprising 44 parents of malformed offspring or repeated fetal wastage (Group I) and 48 controls, age and sex matched, having normal reproductive health (Group II). The karyotypes were normal and the mean mitotic indices were comparable in both groups. The mean frequency of SCE per metaphase in Group I (8.67 +/- 0.32) was significantly higher than the mean for group II (6.65 +/- 0.16), and the cellular replicative index in Group I (1.78 +/- 0.04) was significantly different from that of Group II (1.66 +/- 0.03). The results are discussed in the light of the present understanding of the etiology and mechanism of production of sister chromatid exchanges.

Abortion, Habitual↗
PubMed2006

Herbal care for reproductive health: ethno medicobotany from Uttara Kannada district in Karnataka, India.

Traditional herbal medicine is predominantly practiced by the rural people of India, especially remote areas such as the Uttara Kannada District in Western Ghats of Karnataka. Local traditional healers play an important role in the management of reproductive health problems of the native population due to socio-economical and geographical factors. In the present study, 92 traditional medicine practitioners/healers from various regions of Uttara Kannada district were interviewed to collect information on the use of herbal treatments for a range of female and male reproductive disorders. Information was also collected on the method of preparation, dose and duration along with the botanical names, family and local names of the medicinal plants. The plants were then collected and identified. A total of 18 formulations from 25 plant species belonging to 17 families were identified, which are commonly used to treat 12 different reproductive ailments. This study identifies herbal remedies not previously documented, that are used by indigenous people in the treatment of reproductive disorders. Additionally, the paper highlights the need to retain and explore the rich biodiversity associated with Indian rain forests that may result in the discovery of new medical treatments. Finally, this paper notes the continuing reliance on herbal medicines and healing traditions by local people in remote areas. Understanding and working with local healers and tribes provides a unique opportunity to learn about the use of potentially new herbal and plant medications.

Ethnobotany↗
PubMed1995

The reproductive health of women with von Willebrand Disease unresponsive to DDAVP: results of an international survey. On behalf of the Subcommittee on von Willebrand Factor of the Scientific and Standardization Committee of the ISTH.

An international registry was established on the reproductive health of women with types of von Willebrand disease (vWd) unresponsive to DDAVP. Data was collected on 44 women from 16 treatment centers in nine countries. Severe menorrhagia requiring blood product therapy occurred at least once in 80% of the women for whom data was reported. Most of the reported episodes occurred prior to the diagnosis of vWd and/or the use of oral contraceptive (OC) therapy. OC therapy was clinically effective in the treatment of chronic menorrhagia in 22 of 25 (88%) women treated. Two of the women, however, were unable to tolerate chronic OC use and a third became refractory to treatment. Hysterectomy was performed in 10 of the 44 women (23%). The reported indication for six of the procedures was menorrhagia. Seventy percent were performed at two treatment centers, suggesting different thresholds for the performance of the procedure. There were 69 pregnancies reported in 31 of the 44 women. Fifteen of the pregnancies resulted in spontaneous abortions. The incidence of miscarriage was 22% and appeared clustered, with 10 of 15 of the miscarriages occurring in just four of the women.

Abortion, Spontaneous↗
PubMed2002

Reproductive health risk and protective factors among youth in Lusaka, Zambia.

PURPOSE: To: (a) identify risk and protective factors for behaviors that expose Zambian youth to risk of HIV infection and, (b) assess whether research findings from the United States concerning protective factors in "high-risk" environments might apply to other settings. METHODS: A community-based sample of 2328 youth ages 10-24 years residing in Lusaka, Zambia was interviewed. Multivariate statistical methods were used to isolate risk and protective factors for selected sexual and contraceptive behaviors. Seven categories of factors were considered: sociodemographic factors, sexual-reproductive health knowledge and perceptions, nonsexual risk behaviors, peer influence, connections with parents and social institutions, and communication with sexual partners. RESULTS: A sizeable number of factors were associated with each outcome. Only two factors, school attendance and knowledge of AIDS, were associated with both lower levels of sexual activity and consistent use of condoms, and only engaging in higher-risk social activities with close friends was a risk factor for both. The effects of the other factors considered varied by outcome and gender. As in prior research, strong influences of peers were observed, but connections with parents and social institutions unexpectedly did not emerge as protective. CONCLUSION: Because of the number and diverse nature of factors influencing adolescent behaviors, it is unlikely that a single intervention will be found to immediately change sexual risk-taking behaviors in Zambia.

Adolescent↗
PubMed2005

Pregnancy intentions among Salvadoran fathers: results from the 2003 National Male Reproductive Health Survey.

CONTEXT: In El Salvador, fathers less commonly say that pregnancies are unintended than mothers do. However, men's pregnancy intentions are not understood as well as women's. METHODS: Data from 425 fathers participating in the 2003 National Male Reproductive Health Survey of El Salvador were analyzed to examine their intentions in regard to partners' pregnancies that had ended in a live birth in the last five years. They were asked whether they had been trying to avoid pregnancy at the time of conception, whether they had been trying to get their partner pregnant, how they had felt about the pregnancy and what they thought their partner's pregnancy intentions had been. Descriptive analyses were based on the most recent pregnancy reported by each man. RESULTS: A quarter of the pregnancies had been unintended from the men's perspective--13% had been mistimed and 11% had been unwanted. Almost half (46%) of unintended pregnancies had been conceived when the father was trying to avoid pregnancy. However, 36% of men reporting an unintended pregnancy said they had been happy when they found out about it. For 20% of all pregnancies, men perceived that their partner's pregnancy intentions differed from their own. CONCLUSIONS: Family planning services in El Salvador need improvement, and services and outreach should target men. Men's experiences with unintended pregnancies--in particular, contraceptive failure and discordance within couples about pregnancy intention--are complex and merit further investigation.

Adolescent↗
PubMed2001

Oestrogenic and antiandrogenic chemicals in the environment: effects on male reproductive health.

Exposures of human populations to pesticides and industrial pollutants, and to synthetic chemicals present in foods, beverages, and plastics, have raised concern that these substances can interfere with endogenous sex hormone function. Interference with sex hormone action can, in turn, result in a variety of developmental and reproductive anomalies. Compounds in this class are thus referred to as endocrine disruptors (EDs). EDs that affect reproductive processes in vertebrates act primarily by altering oestrogenic and antiandrogenic activities. The recent cloning of a second oestrogen receptor (ER) subtype (ERbeta) and its widespread tissue distribution pattern indicates that the first ER to be cloned, ERalpha, may not be the only, or even the primary, mediator of oestrogen action. It is anticipated that this discovery will lead to development of antagonist compounds specific to either ER subtype, and help to determine the function of each receptor subtype in reproductive and other tissues. Growing evidence suggests that EDs interfere with reproductive function at low exposure levels and cause distinct effects at different concentrations within the same organ. Developing organisms have increased susceptibility to the actions of EDs because differentiating tissues are more vulnerable to changes in hormonal milieu. Thus, children are at greater risk of toxicant-related illnesses than adults. However, most data are collected from laboratory studies, and it remains to be determined that the levels of chemicals in the environment can impair human reproductive health. There is also significant genetic variability between human and animal species in their reactions to chemicals. The effects of low-dose, chronic, and multiple chemical exposures warrant further investigation in order to characterize the risk of environmental agents to humans. The aims of this review, which will focus on male reproduction, are to: 1) identify synthetic chemicals in the environment that fall into the ED class; 2) describe their mechanisms of toxicity in reproductive tissues; and, 3) outline the direction of future research efforts with respect to EDs.

Androgens↗
PubMed2004

[Sexuality, reproductive health and violence against the African Brazilian women: aspects of interest for nursing care].

Based on the referential of the critical racial theory, a review of the literature was made with the objective of searching for information that leads to an affirmative professional action against racism and sexism, based on scientific evidences and culturally competent. It was evidenced that the sexuality, reproductive health and violence against African Brazilian women are themes with scarce literature, suggesting that racism and sexism occur by the omission and negligence of State to weigh on African Brazilian women's mobilization. The study concluded that institutional discrimination in health needs to be neutralized by affirmative actions regarding to African Brazilian women that must be implemented or strengthen to promote equity in health.

Battered Women↗
PubMed2001

Effect of a phytoestrogen food supplement on reproductive health in normal males.

Animal studies and human intervention trials have demonstrated the cancer chemopreventive properties of plant phytoestrogens, and phytoestrogen supplements are now widely available 'over-the-counter'. However, consumption of phytoestrogen-rich diets can cause impaired fertility and reproductive tract disorders in some animals and the apparent decline in human sperm quality over recent decades may be related to increased exposure to environmental endocrine disruptors. The present study determines the effects of a short-term phytoestrogen supplement on semen quality and serum sex steroid and gonadotrophin levels in human males. Healthy volunteers took a supplement containing 40 mg of isoflavones daily for 2 months and donated blood and semen samples monthly for 2 months before and 4 months after supplementation. Semen samples were analysed for ejaculate volume, sperm concentration, total sperm count, motility and morphology. Blood samples were analysed for sex hormone and gonadotrophin levels and phytoestrogen concentrations, and testicular volume was measured using an orchidometer. The phytoestrogen supplement increased plasma genistein and daidzein concentrations to approx. 1 microM and 0.5 microM respectively; yet, there was no observable effect on endocrine measurements, testicular volume or semen parameters over the study period. This is the first study to examine the effects of a phytoestrogen supplement on reproductive health in males. We conclude that the phytoestrogen dose consumed had no effect on semen quality.

Adult↗
PubMed1999

Priorities in reproductive health in eastern Europe.

In this article, Dr. Brandrup-Lukanow identifies a number of women's health issues that stand in need of attention from practitioners and policy makers responsible for providing health care services to women, especially in the countries of Central and Eastern Europe and in the Newly Independent States of the former Soviet Union. Focusing especially on issues of reproductive health, Dr. Brandrup-Lukanow examines why the incidence of maternal and infant mortality and morbidity are so much higher in these countries than they are in Western Europe. The article concludes with some specific and integrated recommendations for improvement.

Europe, Eastern↗
PubMed2004

Reproductive health effects and teratogenicity of antiepileptic drugs.

Women with epilepsy are less likely to bear children than women in the general population, and although this reduced fertility can be attributed in part to effects of the disease itself, the effects of antiepileptic drugs (AEDs), including changes in reproductive endocrine function, are also a factor. Conversely, some AEDs interact with oral contraceptives and can increase the risk for contraceptive failure and unplanned pregnancy. Women with epilepsy also have elevated rates of congenital anomalies and major malformations in their offspring, for which exposure of the developing fetus to AEDs taken by the mother appears to be responsible. In utero exposure to some AEDs may also be associated with increased risk for impaired cognitive function in the growing child. Clearly, possible long-term effects on reproductive health and pregnancy outcomes require careful attention when AED therapy is being considered for a patient with childbearing potential. Moreover, because AEDs are increasingly being used in therapy for other conditions such as migraine, bipolar disorder, and pain, it is not only the treatment of women with epilepsy that will be affected by these concerns.

Abnormalities, Drug-Induced↗