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//////////////////////////////////////////////////////////////////////////// /////////////////////////wMAAAAAAA== ------=_NextPart_01C6420F.43233000 Content-Location: file:///C:/1C09C636/Environmental_influences_Pronczuk_2006_files/master06.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252"
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Second level
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‹date/ti= me›
‹#›
Environment = and reproductive health
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------=_NextPart_01C6420F.43233000 Content-Location: file:///C:/1C09C636/Environmental_influences_Pronczuk_2006_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C6420F.43233000 Content-Location: file:///C:/1C09C636/Environmental_influences_Pronczuk_2006_files/slide0020.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Environmental influences on reproductive health: from conception to birth…and beyond - Jenny Pronczuk
Training Course in Reproductive Healt= h / Sexual Health Research
 7 March 2006, WHO HQ=
Children's Health and the Environment <= /span>
WHO Training Package for the Health Sector =
World Health Organization
www.who.int/ceh
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Environment and reproductive health
WHAT IS THE ENVIRONMENT?
"Everything that is not me" A. Einstein
"Everything that surrounds anything" web.mala.bc.ca
All the physical, chemical, biological and social factors that may affect the origin, growth, development and survival of an organism in a given setting.
------=_NextPart_01C6420F.43233000 Content-Location: file:///C:/1C09C636/Environmental_influences_Pronczuk_2006_files/slide0046.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Environmental influences on reproductive health: from conception to birth…and beyond - Jenny Pronczuk
Environment and reproductive health
Causes and estimated number of deaths/ye= ar in children  0 to 4 y<= span style=3D'mso-hansi-font-family:Arial'>rs
Acute respiratory infections: 1 000 000
Diarrhoeal diseases: 1 600 000 
Malaria <= span style=3D'mso-hansi-font-family:Arial'>and other vector-borne: 1 000 000
Injuries (non-intentional) 300 000=
Poisonings     16 000
  =
www.who.int/evidenc= e 2002 data
 The environment and health for children= and their mothers, Fact sheet WHO/284, 2005
Diseases strongly linked to environmental threats are present in places where children grow, live, learn and... work
WHO ACTIVITIES ON CHILDREN'S HEALTH & THE ENVIRONMEN= T
------=_NextPart_01C6420F.43233000 Content-Location: file:///C:/1C09C636/Environmental_influences_Pronczuk_2006_files/slide0048.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Environmental influences on reproductive health: from conception to birth…and beyond - Jenny Pronczuk
Environment and reproductive health
<= span style=3D'font-size:39%;visibility:hidden'>v=
<= span style=3D'font-size:122%'>v  Poor hygiene and sanitation
<= span style=3D'font-size:122%;visibility:hidden'>v=
<= span style=3D'font-size:122%'>v  Air pollution – indoor and outdoor = ;
<= span style=3D'font-size:122%;visibility:hidden'>v
<= span style=3D'font-size:122%'>v  Household water insecurity
<= span style=3D'font-size:122%;visibility:hidden'>v
<= span style=3D'font-size:122%'>v  Disease vectors =
<= span style=3D'font-size:122%;visibility:hidden'>v
<= span style=3D'font-size:122%'>v  Chemical hazards
<= span style=3D'font-size:122%'>v  Injuries and accidents =
<= span style=3D'font-size:122%;visibility:hidden'>v
<= span style=3D'font-size:122%;color:#0000CC'>v…. EMERGING ISSUES!
Over 5 000 000 children under 14 yrs die every year from diseases that relate to environmental conditions, mainly in the developing <= span lang=3DEN-GB style=3D'font-size:111%;color:#0000CC'>world. www.who.int/world-health-day/2003=
MAIN GLOBAL ENVIRONMENTAL HEALTH RISKS
------=_NextPart_01C6420F.43233000 Content-Location: file:///C:/1C09C636/Environmental_influences_Pronczuk_2006_files/slide0039.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Environmental influences on reproductive health: from conception to birth…and beyond - Jenny Pronczuk
Environment and reproductive health
  RISKS
  Physical
  Chemical
  Biological
  Social
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Environment and reproductive health
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MEDIA
W= ater, Air, Food
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  Social
MEDIA
W= ater, Air, Food
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SETTINGS
Rural/urban
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Environment and reproductive health
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  Chemical
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  Social
MEDIA
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Environment and reproductive health
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  Physical
  Chemical
  Biological
  Social
MEDIA
W= ater, Air, Food
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SETTINGS
Rural/urban
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Field, Street,
Work
ACTIV= ITIES
Ea= ting, Drinking, Working,
Ho= bbies, Habits, ….
SU= SCEPTIBILITY
Cr= itical windows
Nu= trition
Po= verty
Et= hnic minorities
EF= FECTS ON
Or= gans, Systems
Fu= nctions: Reproduction&#= 13;
We= ll-being
De= velopment
Su= rvival
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Environment and reproductive health
=
  RISKS
  Physical
  Chemical
  Biological
  Social
MEDIA
W= ater, Air, Food
<= span style=3D'mso-spacerun:yes'> Soil, Objects
SETTINGS
Rural/urban
Home, Park,
Field, Street,
Work
ACTIV= ITIES
Ea= ting, Drinking, Working,
Ho= bbies, Habits, ….
SU= SCEPTIBILITY
Cr= itical windows
Nu= trition
Po= verty
Et= hnic minorities
EF= FECTS ON
Or= gans
Sy= stems
Fu= nctions
We= ll-being
De= velopment
Su= rvival
CO= MPLEX ENVIRONMENTS,
MU= LTIPLE PROBLEMS,
ST= RATEGIC APPROACHES <= /div>
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Environment and reproductive health
v= The biological process of reproduction involves:
v
§= Production of healthy germ cells
§= Conception
§= Viable conceptus (embryo)
§<= /span>Growth & development of fetus in favourable maternal environment
§= Successful delivery of baby
§Growth and development of baby = into healthy child and a healthy adult= … and parent!
§
v= Any environmental factor that aff= ects one or more of these key stages can result in reproductive failure<= /span>
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Environment and reproductive health
REPRODUCTIVE HEALTH
v
vFemales are born with all their ova =
vExposure to toxicants during the formation of fetal ovaries and ova will impact on fut= ure generations.
v
v
vMales produce sperm continuously <= /b>
§Past, rec= ent, or ongoing occupational/environmental exposures may alter spermatogenesis – with the = possibility of "recovery"= ;
§
v
vE.g.: Lead and some pesticides have been detected in follicular fluid and semen <= span style=3D'font-size:86%;color:#0000CC;mso-special-format:lastCR;display:non= e'>
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Environment and reproductive health
vEffects on the female<= /u> reproductive system:
v
§<= /span>Sexual behaviour
§<= /span>Onset of puberty and menstrual cycles
§<= /span>Fertility (decreased)
§<= /span>Gestation time
§<= /span>Lactation (decreased)
§<= /span>Menopause (cause premature menopause)
§<= b>
§Eg:  - = Lead exposure: menstrual disorders, infertility
§   - PCBs can bring irregularities in men= strual cycle.
v
REPRODUCTIVE TOXICANTS/FACTORS
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Environment and reproductive health
ENVIRONMENTAL THREATS TO FEMALE FERTILITY
vCauses of female infertility:
v
§Tu= bal factors 36%
§Ov= ulatory factors 33%
§En= dometriosis 6% <= /div>
§Un= known 40% ??
§
v
v
v= Eg. :
§Car exhaust fumes= linked to reduction in ovarian weight and n° of  follicles
§Coffee linked to = higher risk of not conceiving for 12 months
§Smoking and obesi= ty linked to ageing of genetic material
v
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Environment and reproductive health
REPRODUCTIVE HEALTH
vDES (diethystilbestrol)
v<= b>
vSynthetic hormone dev= eloped in 1930s to prevent mis= carriage
v<= b>
vMothers who took DES:=
v
v Daughters with vaginal adenocarcinoma&#= 13;
v Boys: reproductive organ abnormalitise&= #13;
v Higher rates of breast cancer <= /span>
v
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Environment and reproductive health
 
=
=
v=
v
v
v= Pre-conception PCBs and Pb maternal body burdens are linked to abortion, stillbirth and learning disabilities
v= Folate deficien= cy leads to neural tube defects
v=
v=
v=
v= In utero <= /span>Thalidomide phocomelia
v= DES        vaginal cancer
v= X-rays          leukaemia
v= Heat         neural tube defects
v= Alcohol FAS (fetal alcohol <= /b>syndrome)
v= Lead Neurodevelopmental effects= Methyl mercury
v= PCBs  <= /span>
MOTHERS AND THEIR OFFSPRING
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Environment and reproductive health
REPRODUCTIVE TOXICANTS/FACTORS
vIn the male reproductive system they can alte= r:
v
§= Sperm count and morphology
§= Sexual behaviour
§= Fertility (decreased)
§
§Eg:
§ - Exposure to phtalates, PCBs and organochlorine pesticides affect quality of sperm
§
§ - Lead reduces male fertility
§
§ - Carbon disulfide and some pesticides (chlordecone, ethylene dibromide and dibromochloropropane)
§ - = Scrotal hyperthermia
§
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Environment and reproductive health
Environmental factors that influe= nce fertility:
DBCP (dibromo-3-chloropropane)
Pesticide used in banana & pineapple plantations
•<= /span> Azoospermia and oligospermia in 64 to 9= 0% of men exposed for 3 ys
•<= /span> Failure of spermatogonial development  (rats)
•<= /span> DBCP-treated human sperm does not penet= rate the oocytes
 
Given the persistent nature of DBCP contami= nation in areas of past use, efforts should be made to remediate th= ese areas and to follow exposed populations for development of cert= ain human cancers, including breast, ovarian, stomach, respira= tory, oral and nasal cancers, among others.
Clark & Snedeker - Critical evaluation of the cancer risk of bromochloropropane
En= viron Sci Health C Environ Carcinog Ecotoxicol Rev. 2005;23(2):215-60.
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Environment and reproductive health
ENVIRONMENTAL THREAT= S TO MALE FERTILITY
üSm= oking
üPe= sticides
üPO= Ps (PCBs, dioxins)
üSo= lvents
üAir pollution
üMo= nosodium glutamate (fla= vour enhancer in chips, packaged soups, meat seasonings) <= /span>
üOb= esity
üAn= aesthesia (enflurane)= 3;
üSo= ya products (affe= cts ability of sperm to enter the egg)
üCo= caine
üCh= lorine-based chemicals (suspected)
üHi= gh scrotal temperature (laptop users)
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Environment and reproductive health
=
=
v=
vPaternal exposure to:         = Hg, ethylene oxide, rubber chemicals,                                               =          solvents,
v= linked to spontaneous abortion
v=
vPaternal occupation: Painters – anencephaly
v= (Brender. Am J Epidemiol, 1990, 131(3):517)
v=
v= Mechanics,= welders – Wilms tumour
v= (Olshan. Cancer Res, 1990, 50(11):3212)
v=
v= Textiles <= /b>– stillbirth, pre-term delivery
v= (Savitz. Am J Epidemiol, 1989, 129(6):1201)
v=
v= Possible mechanism: impairment of a paternal gene required for the normal growth and development of the fetus = ;
v=
v=
v= “The special and unique vulnerability of children to environmental hazards” Bearer, Neurotoxicology, 2000, 21(6):925
FATHERS AND THEIR OFFSPRING
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Environment and reproductive health
REPRODUCTIVE TOXICANTS
v= Eg: POPs (Persistent Organic Pollutants)
v= Stockholm Convention
v
§CB-153 and DDE in semen of 149 Swedish fishermen fro= m the eastern Baltic coast had a high pro= portion of Y-chromosome bearing semen. Also high levels of the POPs in blood.
§= Higher prevalence of chryptorchidism in Lithuania =
§
§Environmental factors may be changing the ra= tio of <= i>sperm carrying the X or Y (sex determining) chromosomes and may be contribu= ting to male reproductive disorders
§
§ Human Reproduction – 28 Apr= il 2005
§ www.eshre.com <= /span>
v
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Environment and reproductive health
REPRODUCTIVE HEALTH
v= Adverse occupational and environmental exposure= s may result in adverse reproductive outcomes:
v
§= Reduced semen quality
§= Ovarian dysfunction
§= Infertility
§= Fetal loss
§= Growth retardation
§= Altered parturition
§= Still birth and birth defects
§
§ Timing of exposure is crucial!
v <= /div>
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Environment and reproductive health
FERTILIZATION
BIRTH
Placentation
Labor
Organ maturation
Implantation
Organ development
Environmental facto= rs influence:
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Environment and reproductive health
FERTILIZATION
BIRTH
Placentation
Labor
Organ maturation
Implantation
Organ development
Environmental facto= rs influence:
Reproductive system
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Environment and reproductive health
FERTILIZATION
BIRTH
Placentation
Labor
Organ maturation
Implantation
Organ development
Environmental facto= rs influence:
Reproductive system
CHILDHOOD
PERI-PUBERTY and PUBERTY
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Environment and reproductive health
CRITICAL WINDOWS OF EXPOSURE IN REPRODUCTIVE HEAL= TH
§ Pre-conceptional
§<= span style=3D'mso-spacerun:yes'> Pre-natal
§<= span style=3D'mso-spacerun:yes'> Gonadal differentiation
§ Urogenital system development
§ Breast developmen= t
§<= span style=3D'mso-spacerun:yes'> Early post-natal =
§<= span style=3D'mso-spacerun:yes'> Peripuberty and puberty
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Environment and reproductive health
CRITICAL WINDOWS OF EXPOSURE IN REPRODUCTIVE HEALTH
§<= span style=3D'mso-spacerun:yes'> Pre-conceptional =
§ Damage to spermatozoal DNA may result in embryo deat= h or fetal malformations
§ Numerical errors or structural changes = in sex chromosomes – ab= normal gonadal development and infertility (e.g. deletion in the Y chromosome) 
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Environment and reproductive health
Copyright ©2004 Society for the Study= of Reproduction
Fleming, T. P. et al. Biol Reprod = 2004;71:1046-1054 <= /span>
Biology of Reproduction
Schematic representing the potenti= al interactions between the environment of the embryo, <= span lang=3DEN-GB style=3D'font-size:89%'>in vitro/ in vivo, the embryo's sh= ort-term responses & long-term consequences...
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Environment and reproductive health
 Moore, El= sevier Inc, 1973
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Environment and reproductive health
CRITICAL WINDOWS OF EXPOSURE IN REPRODUCTIVE HEALTH
§P= re-natal
§<= span style=3D'mso-spacerun:yes'> Gonadal differentiation  <= /span>
- Migration and proliferation of germ cel= ls to form the gonad
- Proliferation to establish a pool of oo= gonia or spermatogonia
 
§ Urogenital system development
-Regulated = by hormonal systems
- POPs and hypospadias? Cryptorquidia? Testicular maldescent?
- DES – effects that appeared after puberty
- Progesterone and hypospadias
§ Breast developmen= t
§
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Environment and reproductive health
Environmental risk factors and pre-term delivery
§ Occupational exposures (solvents in W; pesticides in M)
§ Air pollutants
§ POPs
§ DDE (metabolite of DDT)
§ Ethane
§ PCBs – affects growth of female fetus&#= 13;
§ Metals: Pb, As
§ Water disinfection by-products
§ Video display terminals
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Environment and reproductive health
Environmental risk factors and pr= e-term delivery
Air pollutants
§ Maternal smoking: 2-fold increase in LB= W and IUGR
§ Second-hand tobacco smoke and LBW <= /span>
Tobacco smoke  causes chronic hypoxia: lowers maternal uterine blood flow, reduces supply of O= 2 from uterus to placenta, raises maternal and fetal COHb levels <= /span>
§ PM 10 or PM2.5 linked to LBW or IUGR= 3;
§ CO
§ SO2
§ Polycyclic aromatic hydrocarbons (PAH)<= /span>
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Environment and reproductive health
CRITICAL WINDOWS OF EXPOSURE IN REPRODUCTIVE HEALTH
§<= span style=3D'mso-spacerun:yes'> Early post-natal =
-=  First 6 months crucial for testis development
-<= /span> Exposure to PCB and anti-thyroid activity
 
§<= span style=3D'mso-spacerun:yes'> Peripuberty and puberty =
- Developing testes are more sensitive (phthalate= esters; DBCP; dinitrobenzene…)
- Ovarian toxicants poorly characterized – depletion of oocytes associated with early menopause, osteoporosis, …
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Environment and reproductive health
Environmental factors influence:
•=  Conception (and pre-conception)
•=  Pregnancy
•=  Embryo/fetus
•=  Child birth
•=  Newborn/infant/child/adolescent (and adults!)
•
With an effect on: HEALTH= DEVELOPMENT WELL BEING
= ;
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Environment and reproductive health
ADVICE ON HOW TO REDUCE EXPOSURE TO CHEMICA= LS
vEat fewer processed foods (which cont= ain additives)
vEat organic food (without pesticides = and preservatives)
vDon't microwave in plastic containers=
vUse a home filter for tap water. =
vEat less meat and high fat dairy products
vUse less cosmetics and personal care products
vAvoid artificial fragrances
vDon't use solvents and stain repellen= ts
<= span style=3D'font-size:71%'>vReduce number of household cleaners (= use soap and water!)
<= span style=3D'font-size:71%'>vDo not use gasoline-powdered yard too= ls (only manual or electric)
vAvoid breathing gasoline fumes when f= illing your car
vEat seafood low in PCB and mercury contamination  (salmon, canned tuna)
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Environment and reproductive health
IF PREGNANT ALSO
vTry t= o find someone else to use household cleaners and pump gas for you. <= /div>
v
vPaint= baby room long before you conceive
v
vDon't= use nail polish
v
vEat c= anned salmon instead of canned tuna.
v
vDon't= let people in your household smoke
v
vCalci= um supplements minimize mineral loss from bone during pregnancy, therefore minimizin= g lead release form the bones (associated to calcium)
v
v
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Environment and reproductive health
IF PREGNANT ALSO
v= Many pregnancy/birth problems could be avoided through:
v=
§Family planning,
§Balanced, organic diet
§Management of maternal health problems
§Avoiding maternal infection
§
vUsual advice:
v
vFolic acid in flou= r to prevent neural tube defects,
vIodine in salt pre= vents severe congenital hypothyroidism,
vVit B= 12 (methyl donor important for DNA and protein modification) around conception
vRubella vaccinatio= ns prevents congenital rubella syndrome.
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Environment and reproductive health
v=
vRecognize teratogens and learn about them.
v=
vAsk= for policies and procedures dealing with reproductive health to be established in your workplace
v=
vDo not rely only on material safety d= ata sheets and be careful of misleading risk research.
v=
vDet= ermine if potential teratogenic agents can be replaced with safer materials.
v
vBe cautious … but not overly cautious= .
v=
RECOMMENDATIONS TO WORKING PARENTS
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Environment and reproductive health
v  "Improving children and mothers' environmental health by addressing and tackling issues affecting their health, presents an essential contribution towards the achievement of the Millennium Development Goa= ls (MDGs)"
http:= //www.who.int/ceh/publications/factsheets/fs284/en/
WHO
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<<NOTE TO USER:  Please add details of the date, time, = place and sponsorship of the meeting for which you are using this presentation in the space indicated.>>
<<NOTE TO USER:  Both emb= ryonic and fetal environmental health will be considered in this presentat= ion. The end of the eighth week of gestation marks the end of the "embryonic period" and the beginning of the "fetal period">>
Ref:
www.ivf.net/content/index.php?page=3Dout&id=3D= 1504
www.chem-tox.vom/infertility/default.htm
<<READ SLIDE.= >>
Despite extraordinary advances in the= twentieth century:
2000: 10.9 = million deaths in children under 5 years
1990: 12.7 million  Black, Lancet, 2003, 361: 2226
= www.unicef.org/sowc02summary/table= 8.html
A number of public health accomplishment= s, such as improved sanitation, vaccinations, antibiotic= s, improved nutrition and medical surveil= lance programmes, have reduced morbidity and mortality among children, especially in the economi= cally developed countries.
In 2000 there were 10.9 million deaths <= /span>among children under the age of 5 years, whereas, in 1990, there were 12.7 mill= ion. Although this reduction is remarkable,= both the deaths and the proportional reduction in mor= tality rates are distributed unevenly: over 98% of these deaths occurred in developing countries. &= #13;
The five major childhood conditions whic= h are responsible for deaths in under-fives in low- and-middle income countries are: diarrhoea, acute respiratory infections, malaria, measles and perinatal conditions. Most of these are  the consequence of poverty and economic inequity, which have risen sharply in m= any of the least developed countries, reducing the reso= urces available for health care.
The "big killers" are diseases= that have a strong environmental c= omponent: indoor air pollution from biomass fuels (causes = acute respiratory infections (ARI)), unsa= fe water and food (cause diarrhoea) and the proliferation of vectors i= n the environment (cause various other diseases such as malaria).
<<NOTE TO USER: Insert regional figures.>>
Refs:
•World Health Report 2002 (www.who.int/whr/en/).
•www.who.int/evidence (2002 data, available in 2004).
•Black. Where and why are 10 million children dying every year? Lancet, 2003, 361:2226.
•UNICEF.<= i> The state of the world' s children 2002: leadership: the rate of progress (www.unicef.org/sow= c02summary/table8.html).
•WHO. = The environment and health for children and their mothers, Fact sheet WHO/284, 2005.
According to WHO, there are  six main GLOBAL environmental risk factors for children.&#= 13;
=
<<NOTE T= O USER: The six risk fac= tors will be described i= n more detail in the following slides.>>
=
•<= /span>Household water inse= curity. This is = one of the main causes = of diarrhoea. Safe drinking-water, as defined by the WHO Guidelines, does not represent any significant risk to health over a lifetime of consumption, including diffe= rent sensitivities that may occur at diffe= rent life stages. • Poor hygiene and san= itation. This leads to inadequate washing and cleaning practices, and therefore to disease= . • Air pollution, both indoor and outdoor. This triggers or aggravates respiratory diseases. • Disease vectors. These cause o= ne million deaths a year in children, due to malaria, dengue fever, leishmaniasis, Japanese encephalitis = and others.
• Chemical hazards.
•<= /span> Injuries and accidents. I= njuries including road accidents, drowning, burns and poisoning cause 400= 000 deaths per y= ear. •= EMERGING ISSUES! These include global change (climate and others), ozone depletion, electromagnetic radiation, contamination by persistent organic pollutants...
•
Refs: = 3;
•<= /span>Healthy <= span style=3D'mso-hansi-font-family:Arial'>environments for children and a healthier planet. Booklet. Geneva, WHO, 2002.&#= 13;•= WHO Guidelines for drinking-water quality,3rd ed. Geneva, World He= alth Organization, 2004 <= /i>(www.who.int/water_sanitation_health/dwq/gdwq3/en/).
The biological process of reproduction involves key stages:
Production of healthy germ cells
Conception
Viable conceptus
Growth and development of fetus in favourable maternal environment= 3;
Successful delivery of baby
Growth and development of baby into healthy child and healthy adult &= #13;
=
Any environmental (chemical, physical, biological, social<= span lang=3DEN-GB style=3D'mso-hansi-font-family:Arial;font-size:83%'>) factor = that affects one or more of these key stages can result in reproductive failure.
Ref:
Xu, Reproductive health and pesticide ex= posure. From "Silent invaders, Pesticides, liveliho= ods an women's health". Ed: Jacobs, Pesticide Acti= on Network, UK, 2003.
Reproductive disorders can be a result of exposures of their parents, and/or in utero, and/or childhood and adulthood.
Females are born with all their ova they will release during their reproductive life.
Exposure to toxic substances for a female carrying a female fetus can affect her grandchildren if toxic effects occur during the formation of fetal ovaries and ova.
Sperm (produced continuously during adult reproductive years) may be influenced by past, recent, or ongoing occupational/environmental exposures
Lead and pesticides have been detected in follicular fluid and semen =
Ref:
CPCHE, Child health and the environment: a primer, CPCHE, 2005.
Reasons for female infertility
Tubal factors 36%=
Ovulatory factors 33%
Endometriosis 6%
unknown cause 40%
Car exhaust linked to reduction in ovarian weight and in number of  ovarian follicles
Coffee linked to higher risk of not conceiving for 12 months
Smoking and obesity are linked to ageing genetic material =
Jobs:
Women working in rubber, plastics or synthetics industry: 50% increas= e in preterm delivery.
Hairdressers (intrauterine-growth retarded infants)
Ref:
www.ivf.net/content/index.php?page=3Dout= &id=3D1486
www.chem-tox.vom/infertility/default.htm=
Rylander, Reproductive outcomes among hairdressers, Scand J Work Environ Health (2005)= 31 (3): 212.
Exposure before concep= tion can result in chromosomal abnormalities or mutation in DNA of ov= a or sperm that will have developmental effects in offspring.
If alterations are permanent, result can have multigenerational effect
Example: DES (diethystilbestrol): synthetic hormone developed in 1930s to prevent miscarriage, among other indications. Off the market in the 1970s.
Mothers who took DES&#= 13;
Higher rates of breast cancer
Sons and daughters had higher rates of reproductive organ abnormalities, reduced fertility, adverse pregnancy outcomes, rare reproductive cancers (specially vaginal adenocarcinoma) and immune system disorders
Ref:
CPCHE, Child health an= d the environment: a primer, CPCHE, 2005.
Mother= s’ exposures both prior to conception and during pregnancy are = associated with a variety of outcomes including spontaneous abortion, stillbirth or neonatal death, poor intrauterine growth, major birth defects and functional deficits.
<<READ SLIDE.>>
<<NOTE TO USER:  you may want to stress exposures/o= ccupations that are regionally specific if there are data to support prenatal or preconception effects.>>
Ref:
CPCHE, Child health and the environment: a primer, CPCHE, 2005. <= /div>
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1: Int = J Occup Environ Health. 1999 Apr-Jun;5(2):116-22.= Related A= rticles, Links &#= 13;

Azoospermia and oligospermia among a large c= ohort of DBCP applicators in 12 countries.<= /span>

Slutsky M= , Levin JL<= /a>, Levy BS.

The University of Texas Health Center at Tyler,= 11937 U.S. Highway 271, P.O. Box 2003, Tyler, Texas 75708-3154, USA.

Azoospermia and oligospermia have been well demonstrated among workers exposed to 1,2-dibromo-3-chloropropane (DBCP) in manufactur= ing and formulation of this pesticide. After DBCP was banned in the United States in the late 1970s, two American companies continued to export it to many less developed countries. In t= he early to mid-1990s, attorneys assembled a cohort= of approximately 26,400 male plaintiffs who, as wor= kers on banana and pineapple plantations in 12 of the= se countries, had been exposed to DBCP, primarily during its application. These attorneys, for the purpose of a lawsuit ag= ainst the two American companies, developMedian exposu= re ed from interrogatories a database on these men that included information about stated periods of occupational DBCP exposure. Seminal fluid analys= is results were also entered into the database. Analyzing information in this database, the authors found that, after a median exposure to DBCP of three years, 64.3% of= these men overall, and 90.1% of men studied from the Philippines, had azoospermia or oligospermia. Th= e mean number of children reported by the men was 2.5 overall. The percentage of men with no children was 28.5% overall. = This report represents the largest cohort of DBCP-exposed wor= kers in which adverse reproductive health effects hav= e been described, and the first report of the adverse e= ffects on the reproductive health of workers exposed to= DBCP primarily through its application in a cohort of this size. This serious and extensive occurrence of adverse reproductive health effects due to the export of a hazardous pesticide bef= ore and after its ban in the United States illustrat= es a number of needs for monitoring, research, educat= ion, and policy development.
1: J O= ccup Environ Med. 1995 Nov;37(11):1287-92.Related A= rticles, Links &#= 13;

Dibromochloropropane (DBCP): a 17-year reassessment of testicular function and reproductive performance.

Potashnik= G, Porath A<= /a>.

Department of Obstetrics and Gynecology, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.

The current study summarizes a 17-year reevalua= tion of testicular function and reproductive performa= nce of 15 production workers with dibromochloropropane (DBCP)-induced testicular dysfunction. Sperm cou= nt recovery was evident within 36 to 45 months in t= hree of the nine azoospermic and in three of the six = oligozoospermic men with no improvement thereafter. A significant increase in plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and a nonsignificant decrease in testosterone level were detected in the severely affected individuals. There was no increase in the rate of spontaneous= abortions and congenital malformations among pregnancies conceived during or after exposure. A low prevalence of male = infants conceived during paternal exposure was found as compared with the preexposure period (16.6% versus 52.9%; P<.025). Restoration of fertility was followed by a gradua= l increase of this value to 41.4%.
= 3;
These factors= have a more negative impact if men already have a higher level of damaged sperm.
Ref:
www.chem-tox.vom/infertility/default.htm= 3;
Tiido, Exposure to persistent organochlorine pollutants associates with human sperm X:Y ratio, Human Reproduction (2005) 20 (7): 1903
www.ivf.net/content/index.php?page=3Dout&id=3D= 1507
Sheynkin, Increase in scrotal temperature in laptop com= puter users, Human reproduction (2005) 20 (2): 452.= 3;
pMen exposed to high dioxin levels (more likely to have daughters than sons (Seveso, Italy, 1976) =
http://www.ourstolenfuture.org/NewScience/reproduction/sexratio/sexra= tio.htm
Preconception paternal exposures are now increasingly recognized as important to the health = and development of the fetus.
Such exposures may increase the chance of certain diseases or adverse pregnancy outcomes as seen in the offspring. This is supported by research in animals and may well have a genetic or epigenetic mechanism.
<<READ SLIDE.>>
<<NOTE TO USER: =  = you may want to stress exposures/occupations that are regionally specific if there are data to support prenatal or preconception effects.>>
Refs:
•<= /span>Bearer. The special and unique vulnerability= of children to environmental hazards. Neurotoxicology, 2000, 21:925.
•<= /span>Brender. Paternal occupation and anencephaly<= /span>. Am J Epidemiol, 1990, 131:517.
•= Olshan. Wilms' tumor and paternal occupation= . Cancer Res, 1990, 50:3212.
A case–control study was conducted to exa= mine the relationship between Wilms' tumour and paternal occupational exposures. The case group consisted of 200 <= /span>children diagnosed as having Wilms= ' tumour who were registered at selected National Wilms' Tumour Study institutions during the per= iod 1 June, 1984, to 31 May, 1986. Disease-free controls were matched to each case using a random dig= it dialling procedur= e. The parents of cases and controls completed a self-administered questionnaire. There was no consis= tent pattern of increased risk for paternal occupational exposure to hydrocarbons or lead f= ound in this study. However, certain paternal occupations were found to have an elevated odds ratio (OR= ) of Wilms' tumour, in= cluding vehicle mechanics, auto body repairmen, and welders. Offspring of fathers who were auto mechanics ha= d a 4- to 7-fold increased risk of Wilms' tumour for all three time periods. The largest increas= ed odds ratio for auto mechanics was in the preconception period [OR =3D 7.58; 95% confiden= ce interval (CI) =3D 0.90–63.9]. Welders had a 4- to 8-fold increased odds = ratio, with the strongest association during pregnancy (OR =3D 8.22; CI =3D 0.95<= span lang=3DEN-GB style=3D'font-size:83%'>–71.3). Although chance cannot be excluded as a = possible explanation, association = of Wilms' tumour with these occupations has been reported in previous studies. Further study is = needed to provide data on the specific occupational exposures involved.
•Savitz. Effect of parents' occupational expo= sures on risk of stillbirth, preterm delivery, and small-for-gestational-age infants. Am J Epidemiol, 1989,<= span lang=3DEN-GB style=3D'font-size:83%'> 129:1201.
Ref:
Human Reprod= uction – 28 April 2005
www.eshre.co= m
Ref:
Xu, Reproductive health and pesticide exposure. From "Silent invaders, Pesticides, livelihoods an women's health". Ed: Jacobs, Pesticide Acti= on Network, UK, 2003.
Health-damaging exposure to environmental risks can begin before birth. Lead in air, mercury in food and other chemicals can result in long-term, often irreversible effects, such as infertility, miscarriage, and birth defects. Women's exposure to pesticides, solvents and persistent organic pollutants may potentially affect the health of the fetus. Additionally, while the overal= l benefits of breastfeed= ing are recognized, the health of the newborn may be affected by high <= span style=3D'mso-hansi-font-family:Arial;font-size:83%'>levels of contaminants= in breast milk. Small children, whose bodies are rapidly developing, are particularly susceptib= le - and in some instances the health impacts may only emerge later in <= span style=3D'mso-hansi-font-family:Arial;font-size:83%'>life. Furthermore, children = as young as five years old sometimes work in hazardous settings. Pregnant women living = and working in hazardous environments and poor mothers and their children are at a high= er risk, as they are exposed to the most degraded environments, are often unaware of the h= ealth implications, and lack access to information on potential solutions. <= /span>
http://www.= who.int/ceh/publications/factsheets/fs284/en/
Health-damaging exposure to environmental risks can begin before birth. Lead in air, mercury in food and other chemicals can result in long-term, often irreversible effects, such as infertility, miscarriage, and birth defects. Women's exposure to pesticides, solvents and persistent organic pollutants may potentially affect the health of the fetus. Additionally, while the overal= l benefits of breastfeed= ing are recognized, the health of the newborn may be affected by high <= span style=3D'mso-hansi-font-family:Arial;font-size:83%'>levels of contaminants= in breast milk. Small children, whose bodies are rapidly developing, are particularly susceptib= le - and in some instances the health impacts may only emerge later in <= span style=3D'mso-hansi-font-family:Arial;font-size:83%'>life. Furthermore, children = as young as five years old sometimes work in hazardous settings. Pregnant women living = and working in hazardous environments and poor mothers and their children are at a high= er risk, as they are exposed to the most degraded environments, are often unaware of the h= ealth implications, and lack access to information on potential solutions. <= /span>
http://www.= who.int/ceh/publications/factsheets/fs284/en/
Health-damaging exposure to environmental risks can begin before birth. Lead in air, mercury in food and other chemicals can result in long-term, often irreversible effects, such as infertility, miscarriage, and birth defects. Women's exposure to pesticides, solvents and persistent organic pollutants may potentially affect the health of the fetus. Additionally, while the overal= l benefits of breastfeed= ing are recognized, the health of the newborn may be affected by high <= span style=3D'mso-hansi-font-family:Arial;font-size:83%'>levels of contaminants= in breast milk. Small children, whose bodies are rapidly developing, are particularly susceptib= le - and in some instances the health impacts may only emerge later in <= span style=3D'mso-hansi-font-family:Arial;font-size:83%'>life. Furthermore, children = as young as five years old sometimes work in hazardous settings. Pregnant women living = and working in hazardous environments and poor mothers and their children are at a high= er risk, as they are exposed to the most degraded environments, are often unaware of the h= ealth implications, and lack access to information on potential solutions. <= /span>
http://www.= who.int/ceh/publications/factsheets/fs284/en/
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1: Int = J Occup Environ Health. 1999 Apr-Jun;5(2):116-22.= Related A= rticles, Links &#= 13;

Azoospermia and oligospermia among a large c= ohort of DBCP applicators in 12 countries.<= /span>

Slutsky M= , Levin JL<= /a>, Levy BS.

The University of Texas Health Center at Tyler,= 11937 U.S. Highway 271, P.O. Box 2003, Tyler, Texas 75708-3154, USA.

Azoospermia and oligospermia have been well demonstrated among workers exposed to 1,2-dibromo-3-chloropropane (DBCP) in manufactur= ing and formulation of this pesticide. After DBCP was banned in the United States in the late 1970s, two American companies continued to export it to many less developed countries. In t= he early to mid-1990s, attorneys assembled a cohort= of approximately 26,400 male plaintiffs who, as wor= kers on banana and pineapple plantations in 12 of the= se countries, had been exposed to DBCP, primarily during its application. These attorneys, for the purpose of a lawsuit ag= ainst the two American companies, developMedian exposu= re ed from interrogatories a database on these men that included information about stated periods of occupational DBCP exposure. Seminal fluid analys= is results were also entered into the database. Analyzing information in this database, the authors found that, after a median exposure to DBCP of three years, 64.3% of= these men overall, and 90.1% of men studied from the Philippines, had azoospermia or oligospermia. Th= e mean number of children reported by the men was 2.5 overall. The percentage of men with no children was 28.5% overall. = This report represents the largest cohort of DBCP-exposed wor= kers in which adverse reproductive health effects hav= e been described, and the first report of the adverse e= ffects on the reproductive health of workers exposed to= DBCP primarily through its application in a cohort of this size. This serious and extensive occurrence of adverse reproductive health effects due to the export of a hazardous pesticide bef= ore and after its ban in the United States illustrat= es a number of needs for monitoring, research, educat= ion, and policy development.
1: J O= ccup Environ Med. 1995 Nov;37(11):1287-92.Related A= rticles, Links &#= 13;

Dibromochloropropane (DBCP): a 17-year reassessment of testicular function and reproductive performance.

Potashnik= G, Porath A<= /a>.

Department of Obstetrics and Gynecology, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.

The current study summarizes a 17-year reevalua= tion of testicular function and reproductive performa= nce of 15 production workers with dibromochloropropane (DBCP)-induced testicular dysfunction. Sperm cou= nt recovery was evident within 36 to 45 months in t= hree of the nine azoospermic and in three of the six = oligozoospermic men with no improvement thereafter. A significant increase in plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and a nonsignificant decrease in testosterone level were detected in the severely affected individuals. There was no increase in the rate of spontaneous= abortions and congenital malformations among pregnancies conceived during or after exposure. A low prevalence of male = infants conceived during paternal exposure was found as compared with the preexposure period (16.6% versus 52.9%; P<.025). Restoration of fertility was followed by a gradua= l increase of this value to 41.4%.
= 3;
 Display   Show          
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1: Int = J Occup Environ Health. 1999 Apr-Jun;5(2):116-22.= Related A= rticles, Links &#= 13;

Azoospermia and oligospermia among a large c= ohort of DBCP applicators in 12 countries.<= /span>

Slutsky M= , Levin JL<= /a>, Levy BS.

The University of Texas Health Center at Tyler,= 11937 U.S. Highway 271, P.O. Box 2003, Tyler, Texas 75708-3154, USA.

Azoospermia and oligospermia have been well demonstrated among workers exposed to 1,2-dibromo-3-chloropropane (DBCP) in manufactur= ing and formulation of this pesticide. After DBCP was banned in the United States in the late 1970s, two American companies continued to export it to many less developed countries. In t= he early to mid-1990s, attorneys assembled a cohort= of approximately 26,400 male plaintiffs who, as wor= kers on banana and pineapple plantations in 12 of the= se countries, had been exposed to DBCP, primarily during its application. These attorneys, for the purpose of a lawsuit ag= ainst the two American companies, developMedian exposu= re ed from interrogatories a database on these men that included information about stated periods of occupational DBCP exposure. Seminal fluid analys= is results were also entered into the database. Analyzing information in this database, the authors found that, after a median exposure to DBCP of three years, 64.3% of= these men overall, and 90.1% of men studied from the Philippines, had azoospermia or oligospermia. Th= e mean number of children reported by the men was 2.5 overall. The percentage of men with no children was 28.5% overall. = This report represents the largest cohort of DBCP-exposed wor= kers in which adverse reproductive health effects hav= e been described, and the first report of the adverse e= ffects on the reproductive health of workers exposed to= DBCP primarily through its application in a cohort of this size. This serious and extensive occurrence of adverse reproductive health effects due to the export of a hazardous pesticide bef= ore and after its ban in the United States illustrat= es a number of needs for monitoring, research, educat= ion, and policy development.
1: J O= ccup Environ Med. 1995 Nov;37(11):1287-92.Related A= rticles, Links &#= 13;

Dibromochloropropane (DBCP): a 17-year reassessment of testicular function and reproductive performance.

Potashnik= G, Porath A<= /a>.

Department of Obstetrics and Gynecology, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.

The current study summarizes a 17-year reevalua= tion of testicular function and reproductive performa= nce of 15 production workers with dibromochloropropane (DBCP)-induced testicular dysfunction. Sperm cou= nt recovery was evident within 36 to 45 months in t= hree of the nine azoospermic and in three of the six = oligozoospermic men with no improvement thereafter. A significant increase in plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and a nonsignificant decrease in testosterone level were detected in the severely affected individuals. There was no increase in the rate of spontaneous= abortions and congenital malformations among pregnancies conceived during or after exposure. A low prevalence of male = infants conceived during paternal exposure was found as compared with the preexposure period (16.6% versus 52.9%; P<.025). Restoration of fertility was followed by a gradua= l increase of this value to 41.4%.
= 3;
Schematic representing the poten= tial interactions between the environment of the embryo, either in vitro or in vivo, the embryo's short-term responses, and their long-term consequences. Different stages and lineages of embryo development are shown in different colors representing undifferentiated cells (pink), trophectoderm (yellow),= ICM (pale blue), and primitive endoderm (deep blue).
Ref: Fleming, The emb= ryo and its future, Biology of Reproduction (2004) 71: 1046. www.biolre= prod.org/cgi/content/full/71/4/1046
Picture: Copyright pending.
Physiological differences manifest in more ways than immature metabolic pathways. Becaus= e important systems are still differentiating and gr= owing, the fetus and then the child, has unique susceptibilities compared to adults — and critical time windows in those susceptibilities.&= #13;
•<= /span>Preconception
•<= /span>Gestation
– thalidomide, DES
– ionizing radiation
– methylmercury, Pb
– second-hand tobacco smoke
– lead.
There has been an explosion of knowledge about development in past decade or so,= and it is hard to remember that it was on= ly about 50 years ago that the discovery was made that the fetus is vulnerable to exposures. The phocomelia epidemic resulting from use of thalidomide in pregnancy was an early and dramatic example of the ability of chemica= ls to cross the placenta and damage the fetus.  Additionally, thalidomide administered during a small, 4-day window between gestational days 20 and 24, may increase the risk of autism (Stromland, 1994).  More than one system can be susceptible and different pathology may occur depending upon the dose and timing of exposure.
Now we know that other exposures during gestation can harm systems, and some a= re listed here. We also know that preconception exposure of both parents can cause harm to children, = as well as postnatal exposures.
<<NOTES TO USER:  It is important to point= out the different responses to insults shown on the bottom bar of the figure.  Significant insult during the embryonic phase will result in pregnancy loss (first 2 weeks) or major organ malformation. During the fetal stage, damage is more subtle and related to system dysfunction.>> <= /div>
Ref:
•<= /span>Stromland, Autism in thalidomide embryopathy: a population study, Developmental Medic= ine & Child Neurology (1994) 36(4):351.
Of a population of 100 Swedish thalidomide embryopathy cases, at least four met full criteria for DSM-III-R autistic disorder and ICD-10 childhood autism. Thalidomide embryopathy of the kind encountered in these cases affects fetal development early in pregnancy, probably on days 20 to 24 after conception. It is argued that the possible association of thalidomide embryopathy with autism may sh= ed some light on the issue of which neural circuitries may be involved in autism pathogenesis.
Figure: Reprinted from The developing human, Moore, Elsevier Inc., 1973. Used with copyright permission (2004) fr= om Elsevier.
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1: Int = J Occup Environ Health. 1999 Apr-Jun;5(2):116-22.= Related A= rticles, Links &#= 13;

Azoospermia and oligospermia among a large c= ohort of DBCP applicators in 12 countries.<= /span>

Slutsky M= , Levin JL<= /a>, Levy BS.

The University of Texas Health Center at Tyler,= 11937 U.S. Highway 271, P.O. Box 2003, Tyler, Texas 75708-3154, USA.

Azoospermia and oligospermia have been well demonstrated among workers exposed to 1,2-dibromo-3-chloropropane (DBCP) in manufactur= ing and formulation of this pesticide. After DBCP was banned in the United States in the late 1970s, two American companies continued to export it to many less developed countries. In t= he early to mid-1990s, attorneys assembled a cohort= of approximately 26,400 male plaintiffs who, as wor= kers on banana and pineapple plantations in 12 of the= se countries, had been exposed to DBCP, primarily during its application. These attorneys, for the purpose of a lawsuit ag= ainst the two American companies, developMedian exposu= re ed from interrogatories a database on these men that included information about stated periods of occupational DBCP exposure. Seminal fluid analys= is results were also entered into the database. Analyzing information in this database, the authors found that, after a median exposure to DBCP of three years, 64.3% of= these men overall, and 90.1% of men studied from the Philippines, had azoospermia or oligospermia. Th= e mean number of children reported by the men was 2.5 overall. The percentage of men with no children was 28.5% overall. = This report represents the largest cohort of DBCP-exposed wor= kers in which adverse reproductive health effects hav= e been described, and the first report of the adverse e= ffects on the reproductive health of workers exposed to= DBCP primarily through its application in a cohort of this size. This serious and extensive occurrence of adverse reproductive health effects due to the export of a hazardous pesticide bef= ore and after its ban in the United States illustrat= es a number of needs for monitoring, research, educat= ion, and policy development.
1: J O= ccup Environ Med. 1995 Nov;37(11):1287-92.Related A= rticles, Links &#= 13;

Dibromochloropropane (DBCP): a 17-year reassessment of testicular function and reproductive performance.

Potashnik= G, Porath A<= /a>.

Department of Obstetrics and Gynecology, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.

The current study summarizes a 17-year reevalua= tion of testicular function and reproductive performa= nce of 15 production workers with dibromochloropropane (DBCP)-induced testicular dysfunction. Sperm cou= nt recovery was evident within 36 to 45 months in t= hree of the nine azoospermic and in three of the six = oligozoospermic men with no improvement thereafter. A significant increase in plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and a nonsignificant decrease in testosterone level were detected in the severely affected individuals. There was no increase in the rate of spontaneous= abortions and congenital malformations among pregnancies conceived during or after exposure. A low prevalence of male = infants conceived during paternal exposure was found as compared with the preexposure period (16.6% versus 52.9%; P<.025). Restoration of fertility was followed by a gradua= l increase of this value to 41.4%.
= 3;
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1: Int = J Occup Environ Health. 1999 Apr-Jun;5(2):116-22.= Related A= rticles, Links &#= 13;

Azoospermia and oligospermia among a large c= ohort of DBCP applicators in 12 countries.<= /span>

Slutsky M= , Levin JL<= /a>, Levy BS.

The University of Texas Health Center at Tyler,= 11937 U.S. Highway 271, P.O. Box 2003, Tyler, Texas 75708-3154, USA.

Azoospermia and oligospermia have been well demonstrated among workers exposed to 1,2-dibromo-3-chloropropane (DBCP) in manufactur= ing and formulation of this pesticide. After DBCP was banned in the United States in the late 1970s, two American companies continued to export it to many less developed countries. In t= he early to mid-1990s, attorneys assembled a cohort= of approximately 26,400 male plaintiffs who, as wor= kers on banana and pineapple plantations in 12 of the= se countries, had been exposed to DBCP, primarily during its application. These attorneys, for the purpose of a lawsuit ag= ainst the two American companies, developMedian exposu= re ed from interrogatories a database on these men that included information about stated periods of occupational DBCP exposure. Seminal fluid analys= is results were also entered into the database. Analyzing information in this database, the authors found that, after a median exposure to DBCP of three years, 64.3% of= these men overall, and 90.1% of men studied from the Philippines, had azoospermia or oligospermia. Th= e mean number of children reported by the men was 2.5 overall. The percentage of men with no children was 28.5% overall. = This report represents the largest cohort of DBCP-exposed wor= kers in which adverse reproductive health effects hav= e been described, and the first report of the adverse e= ffects on the reproductive health of workers exposed to= DBCP primarily through its application in a cohort of this size. This serious and extensive occurrence of adverse reproductive health effects due to the export of a hazardous pesticide bef= ore and after its ban in the United States illustrat= es a number of needs for monitoring, research, educat= ion, and policy development.
1: J O= ccup Environ Med. 1995 Nov;37(11):1287-92.Related A= rticles, Links &#= 13;

Dibromochloropropane (DBCP): a 17-year reassessment of testicular function and reproductive performance.

Potashnik= G, Porath A<= /a>.

Department of Obstetrics and Gynecology, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.

The current study summarizes a 17-year reevalua= tion of testicular function and reproductive performa= nce of 15 production workers with dibromochloropropane (DBCP)-induced testicular dysfunction. Sperm cou= nt recovery was evident within 36 to 45 months in t= hree of the nine azoospermic and in three of the six = oligozoospermic men with no improvement thereafter. A significant increase in plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and a nonsignificant decrease in testosterone level were detected in the severely affected individuals. There was no increase in the rate of spontaneous= abortions and congenital malformations among pregnancies conceived during or after exposure. A low prevalence of male = infants conceived during paternal exposure was found as compared with the preexposure period (16.6% versus 52.9%; P<.025). Restoration of fertility was followed by a gradua= l increase of this value to 41.4%.
= 3;
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1: Int = J Occup Environ Health. 1999 Apr-Jun;5(2):116-22.= Related A= rticles, Links &#= 13;

Azoospermia and oligospermia among a large c= ohort of DBCP applicators in 12 countries.<= /span>

Slutsky M= , Levin JL<= /a>, Levy BS.

The University of Texas Health Center at Tyler,= 11937 U.S. Highway 271, P.O. Box 2003, Tyler, Texas 75708-3154, USA.

Azoospermia and oligospermia have been well demonstrated among workers exposed to 1,2-dibromo-3-chloropropane (DBCP) in manufactur= ing and formulation of this pesticide. After DBCP was banned in the United States in the late 1970s, two American companies continued to export it to many less developed countries. In t= he early to mid-1990s, attorneys assembled a cohort= of approximately 26,400 male plaintiffs who, as wor= kers on banana and pineapple plantations in 12 of the= se countries, had been exposed to DBCP, primarily during its application. These attorneys, for the purpose of a lawsuit ag= ainst the two American companies, developMedian exposu= re ed from interrogatories a database on these men that included information about stated periods of occupational DBCP exposure. Seminal fluid analys= is results were also entered into the database. Analyzing information in this database, the authors found that, after a median exposure to DBCP of three years, 64.3% of= these men overall, and 90.1% of men studied from the Philippines, had azoospermia or oligospermia. Th= e mean number of children reported by the men was 2.5 overall. The percentage of men with no children was 28.5% overall. = This report represents the largest cohort of DBCP-exposed wor= kers in which adverse reproductive health effects hav= e been described, and the first report of the adverse e= ffects on the reproductive health of workers exposed to= DBCP primarily through its application in a cohort of this size. This serious and extensive occurrence of adverse reproductive health effects due to the export of a hazardous pesticide bef= ore and after its ban in the United States illustrat= es a number of needs for monitoring, research, educat= ion, and policy development.
1: J O= ccup Environ Med. 1995 Nov;37(11):1287-92.Related A= rticles, Links &#= 13;

Dibromochloropropane (DBCP): a 17-year reassessment of testicular function and reproductive performance.

Potashnik= G, Porath A<= /a>.

Department of Obstetrics and Gynecology, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.

The current study summarizes a 17-year reevalua= tion of testicular function and reproductive performa= nce of 15 production workers with dibromochloropropane (DBCP)-induced testicular dysfunction. Sperm cou= nt recovery was evident within 36 to 45 months in t= hree of the nine azoospermic and in three of the six = oligozoospermic men with no improvement thereafter. A significant increase in plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and a nonsignificant decrease in testosterone level were detected in the severely affected individuals. There was no increase in the rate of spontaneous= abortions and congenital malformations among pregnancies conceived during or after exposure. A low prevalence of male = infants conceived during paternal exposure was found as compared with the preexposure period (16.6% versus 52.9%; P<.025). Restoration of fertility was followed by a gradua= l increase of this value to 41.4%.
= 3;
 Display   Show          
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1: Int = J Occup Environ Health. 1999 Apr-Jun;5(2):116-22.= Related A= rticles, Links &#= 13;

Azoospermia and oligospermia among a large c= ohort of DBCP applicators in 12 countries.<= /span>

Slutsky M= , Levin JL<= /a>, Levy BS.

The University of Texas Health Center at Tyler,= 11937 U.S. Highway 271, P.O. Box 2003, Tyler, Texas 75708-3154, USA.

Azoospermia and oligospermia have been well demonstrated among workers exposed to 1,2-dibromo-3-chloropropane (DBCP) in manufactur= ing and formulation of this pesticide. After DBCP was banned in the United States in the late 1970s, two American companies continued to export it to many less developed countries. In t= he early to mid-1990s, attorneys assembled a cohort= of approximately 26,400 male plaintiffs who, as wor= kers on banana and pineapple plantations in 12 of the= se countries, had been exposed to DBCP, primarily during its application. These attorneys, for the purpose of a lawsuit ag= ainst the two American companies, developMedian exposu= re ed from interrogatories a database on these men that included information about stated periods of occupational DBCP exposure. Seminal fluid analys= is results were also entered into the database. Analyzing information in this database, the authors found that, after a median exposure to DBCP of three years, 64.3% of= these men overall, and 90.1% of men studied from the Philippines, had azoospermia or oligospermia. Th= e mean number of children reported by the men was 2.5 overall. The percentage of men with no children was 28.5% overall. = This report represents the largest cohort of DBCP-exposed wor= kers in which adverse reproductive health effects hav= e been described, and the first report of the adverse e= ffects on the reproductive health of workers exposed to= DBCP primarily through its application in a cohort of this size. This serious and extensive occurrence of adverse reproductive health effects due to the export of a hazardous pesticide bef= ore and after its ban in the United States illustrat= es a number of needs for monitoring, research, educat= ion, and policy development.
1: J O= ccup Environ Med. 1995 Nov;37(11):1287-92.Related A= rticles, Links &#= 13;

Dibromochloropropane (DBCP): a 17-year reassessment of testicular function and reproductive performance.

Potashnik= G, Porath A<= /a>.

Department of Obstetrics and Gynecology, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.

The current study summarizes a 17-year reevalua= tion of testicular function and reproductive performa= nce of 15 production workers with dibromochloropropane (DBCP)-induced testicular dysfunction. Sperm cou= nt recovery was evident within 36 to 45 months in t= hree of the nine azoospermic and in three of the six = oligozoospermic men with no improvement thereafter. A significant increase in plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and a nonsignificant decrease in testosterone level were detected in the severely affected individuals. There was no increase in the rate of spontaneous= abortions and congenital malformations among pregnancies conceived during or after exposure. A low prevalence of male = infants conceived during paternal exposure was found as compared with the preexposure period (16.6% versus 52.9%; P<.025). Restoration of fertility was followed by a gradua= l increase of this value to 41.4%.
= 3;
Health-damaging exposure to environmental risks can begin before birth. Lead in air, mercury in food and other chemicals can result in long-term, often irreversible effects, such as infertility, miscarriage, and birth defects. Women's exposure to pesticides, solvents and persistent organic pollutants may potentially affect the health of the fetus. Additionally, while the overal= l benefits of breastfeed= ing are recognized, the health of the newborn may be affected by high <= span style=3D'mso-hansi-font-family:Arial;font-size:83%'>levels of contaminants= in breast milk. Small children, whose bodies are rapidly developing, are particularly susceptib= le - and in some instances the health impacts may only emerge later in <= span style=3D'mso-hansi-font-family:Arial;font-size:83%'>life. Furthermore, children = as young as five years old sometimes work in hazardous settings. Pregnant women living = and working in hazardous environments and poor mothers and their children are at a high= er risk, as they are exposed to the most degraded environments, are often unaware of the h= ealth implications, and lack access to information on potential solutions. <= /span>
http://www.= who.int/ceh/publications/factsheets/fs284/en/
Ref:
Houlihan,  Body Burden, The pollution in newborns, EWG, 2005
Ref:
Houlihan,  Body Burden, The pollution in newborns, EWG, 2005
ehp.niehs.nih.gov/docs/2001/109-5/ss.html <= /i>
Ref:
The March of Dimes Global Report on Birth Defects, The Hidden Toll of <= /i>Dying and Disabled Children.
http://www.marchofdimes.com/professionals/871_18587.asp Fleming, The embryo and its future, Biology of Reproduction (2004) 71: 1046.
1) Recognize teratogens an= d learn about them. <= /div> Ask for policies and procedures= dealing with reproductive health to be established in your workplace
Do not rely only on material sa= fety data sheets and be careful of misleading risk research.
Determine if potential ter= atogenic agents can be replaced with safer materials.
Be cautious … but not over= ly cautious.
It is impossible to face "no exposure". This = is not an acceptable recommendation. Otherwise the whole world would be off-limits to pregnant patients.&= #13;
www.is
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{ return IsWin("PPTNts") } function IsSldOrNts() { return( IsWin("PPTSld")||IsWin("PPTNts") ) } function SupportsPPTAnimation() { return( navigator.platform =3D=3D "Win32"= && navigator.appVersion.indexOf("Windows")>0 ) } function SupportsPPTHTML() { var appVer=3Dnavigator.appVersion, msie=3DappVer.indexOf("MSIE "), ver=3D0 if( msie >=3D 0 ) ver=3DparseFloat( appVer.substring( msie+5, appVer.indexOf(";",msie) ) ) else ver=3DparseInt(appVer) return( ver >=3D 4 && msie >=3D 0 ) } function _RSW() { if( !g_supportsPPTHTML || IsNts() || ( !g_scaleInFrame && (!IsWin("PPTSld") || !parent.IsFullScrMode()) ) ) return var padding=3D0; if( IsWin("PPTSld") && parent.IsFramesMode() ) padding=3D6 cltWidth=3Ddocument.body.clientWidth-padding cltHeight=3Ddocument.body.clientHeight-padding factor=3D(1.0*cltWidth)/g_origW if( cltHeight < g_origH*factor ) factor=3D(1.0*cltHeight)/g_origH newSize =3D g_origSz * factor if( newSize < 1 ) newSize=3D1 s=3DSlideObj.style s.fontSize=3DnewSize+"px" 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return; if( ( g_allowAdvOnClick && !parent.IsFramesMode() ) || (event && (event.keyCode=3D=3D32) ) ) parent.GoToNextSld(); } var g_supportsPPTHTML =3D SupportsPPTHTML(), g_scaleInFrame =3D 1, gId=3D""= , g_bgSound=3D"", g_scaleHyperlinks =3D false, g_allowAdvOnClick =3D 1, g_showInBrowser = =3D 0, gLoopCont =3D 0, gUseSldTimings =3D 1; var g_showAnimation =3D g_supportsPPTHTML && SupportsPPTAnimation() && ( (w= indow.name=3D=3D"PPTSld" && !parent.IsFramesMode()) || g_showInBrowser );va= r g_animManager =3D null; var g_animUseRuntime =3D false; var g_animItemsToHide, g_animInteractiveItems, g_animSlideTime; var g_animMainSequence =3D null; var ENDSHOW_MESG=3D"End of slide show, click to exit.", SCREEN_MODE=3D"Fram= es", gIsEndShow=3D0, NUM_VIS_SLDS=3D40, SCRIPT_HREF=3D"script.js", FULLSCR_= HREF=3D"fullscreen.htm"; var gCurSld =3D gPrevSld =3D 1, g_offset =3D 0, gNtsOpen =3D gHasNts =3D gO= tlTxtExp =3D 0, gHasNarration =3D 0, gOtlOpen =3D true window.gPPTHTML=3DSupportsPPTHTML() var gMainDoc=3Dnew Array(new hrefList("slide0020.htm",1,-1,1),new hrefList(= "slide0003.htm",1,-1,1),new hrefList("slide0046.htm",1,-1,1),new hrefList("= slide0048.htm",1,-1,1),new hrefList("slide0039.htm",1,-1,1),new hrefList("s= lide0040.htm",1,-1,1),new hrefList("slide0041.htm",1,-1,1),new hrefList("sl= ide0042.htm",1,-1,1),new hrefList("slide0043.htm",1,-1,1),new hrefList("sli= de0044.htm",1,-1,1),new hrefList("slide0045.htm",1,-1,1),new hrefList("slid= e0069.htm",1,-1,1),new hrefList("slide0070.htm",1,-1,1),new hrefList("slide= 0073.htm",1,-1,1),new hrefList("slide0079.htm",1,-1,1),new hrefList("slide0= 080.htm",1,-1,1),new hrefList("slide0082.htm",1,-1,1),new hrefList("slide00= 74.htm",1,-1,1),new hrefList("slide0083.htm",1,-1,1),new hrefList("slide008= 1.htm",1,-1,1),new hrefList("slide0076.htm",1,-1,1),new hrefList("slide0093= .htm",1,-1,1),new hrefList("slide0088.htm",1,-1,1),new hrefList("slide0049.= htm",1,-1,1),new hrefList("slide0050.htm",1,-1,1),new hrefList("slide0051.h= 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function UpdOtlPane(){ if(gOtlLoaded) PPTOtl.UpdOtl() } function SetHasNts( fVal ) { if( gHasNts !=3D fVal ) { gHasNts=3DfVal UpdNavPane() } } function ToggleOtlText() { gOtlTxtExp=3D!gOtlTxtExp UpdOtlPane() } function ClearMedia() { // Clear any sounds playing before launching another browser window. Other= wise, // in fullscreen mode, you'll continue to hear the sound in the frames mod= e. if (PPTSld.pptSound) PPTSld.pptSound.loop =3D 0; } function FullScreen() {=20 if ( PPTSld.g_animUseRuntime ) PPTSld.document.body.pause(); ClearMedia(); var href =3D ( document.location.protocol =3D=3D 'mhtml:') ? FULLSCR_HREF = : FULLSCR_HREF+"#"+GetHrefObj(gCurSld).mSldHref; if(PPTNav.event.ctrlKey) { var w =3D (window.screen.availWidth * 1.0) / 2.0 var h =3D w * (PPTSld.g_origH * 1.0) / PPTSld.g_origW win =3D window.open( MHTMLPrefix+href,null,"toolbar=3D0,resizable=3D1,top= =3D0,left=3D0," + "width=3D"+ w + ",height=3D" + h ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } else { win =3D window.open( MHTMLPrefix+href,null,"fullscreen=3Dyes" ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } } function ToggleVNarration() { rObj=3DPPTSld.document.all("NSPlay") if( rObj && !PPTSld.g_animUseRuntime ) { if( (rObj.playState =3D=3D 1)||(rObj.playState =3D=3D 0) ) rObj.Play() else if( rObj.playState =3D=3D 2 ) rObj.Pause() else return; } else if( PPTSld.g_animUseRuntime ) { narObj =3D PPTSld.document.all("narrationID") if( narObj ) narObj.togglePause() } } function GetCurSldNum() { =20 obj=3DGetHrefObj(gCurSld) if( obj.mOrigVis =3D=3D 1 ) return obj.mSldIdx else =20 return gCurSld } function GetNumSlds() { =20 if( GetHrefObj(gCurSld).mOrigVis =3D=3D 1 ) return GetSldList().mNumVisSlds; else return GetSldList().mList.length } function GetSldNum( href ) { for(ii=3D0; ii 1 ) PopSldList(); else if( !IsFramesMode() ) { if( gLoopCont ) GoToFirst() else EndShow() } } function GoToPrevSld() { ii=3DgCurSld-1 if( ii > 0 ) { obj=3DGetHrefObj(ii) while ( obj && ( obj.mVis =3D=3D 0 ) && ( ii>0 ) ) obj=3DGetHrefObj(--ii) if( ii =3D=3D 0 ) ii=3D1 GoToSldNum(ii) } } function GoToFirst(){ GoToSld( GetHrefObj(1).mSldHref ) } function GoToLast() { ii=3DGetSldList().mList.length if( ii !=3D gCurSld ) GoToSld( GetHrefObj(ii).mSldHref ) } function GoToSldNum( num ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue obj =3D GetHrefObj( num ) obj.mVis=3D1 gPrevSld=3DgCurSld gCurSld =3D num; PPTSld.location.replace(MHTMLPrefix+obj.mSldHref) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function GoToSld( href ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue GetHrefObj( GetSldNum(href) ).mVis=3D1 PPTSld.location.replace(MHTMLPrefix+href) } function SldUpdated( id ) { if( id =3D=3D GetHrefObj(gCurSld).mSldHref ) return gPrevSld=3DgCurSld gCurSld=3DGetSldNum(id) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function PrevSldViewed(){ GoToSld( GetHrefObj(gPrevSld).mSldHref ) } function HasPrevSld() { return ( gIsEndShow || ( gCurSld !=3D 1 && GetHrefO= bj( gCurSld-1 ).mVis =3D=3D 1 )||( GetCurSldNum() > 1 ) ) } function HasNextSld() { return (GetCurSldNum() !=3D GetNumSlds()) } function CloseWindow() { if( HideMenu() ) return; =09 var event =3D PPTSld.event; if( !IsFramesMode() && event && (event.keyCode=3D=3D27 || event.keyCode=3D= =3D32 || event.type=3D=3D"click" ) ) window.close( self ); CatchNumKeys( self, event ); } function Unload() { gIsEndShow=3D0; } function SetupEndShow() { gIsEndShow=3D1; PPTSld.document.body.scroll=3D"no"; PPTSld.document.onkeypress=3DCloseWindow; PPTSld.document.onclick=3DCloseWindow; PPTSld.document.oncontextmenu=3D_CM; } function EndShow() { if( IsFramesMode() ) return if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue doc=3DPPTSld.document var dir =3D doc.body.dir if( dir !=3D "rtl" ) dir =3D "ltr"; doc.open() doc.writeln('


' + ENDSHOW_MESG + '

') doc.close() } function SetSldVisited(){ GetSldList().mList[gCurSld-1].mVisited=3Dtrue } function IsSldVisited(){ return GetSldList().mList[gCurSld-1].mVisited } function hrefList( sldHref, visible, advDelay, advClk ) { this.mSldHref=3D this.mNtsHref =3D sldHref this.mOrigVis=3D this.mVis =3D visible this.mVisited=3D false this.mAdvDelay=3D advDelay this.mAdvOnClk=3D advClk } function SldList(arr,curSld,fEnd) { this.mCurSld =3D curSld; this.mList =3D new Array(); var idx =3D 1; for(ii=3D0;ii 0) { PushSldList(sldList,fEnd); gCurSld =3D 1; } else if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue } function PushSldList(arr,fEnd) { var ii =3D gSldStack.length; gSldStack[ii] =3D new SldList(arr,gCurSld,fEnd); GoToSld( gSldStack[ii].mList[0].mSldHref ); } function PopSldList() { if (gSldStack[gSldStack.length-1].fEndShow) EndShow() else { gCurSld =3D gSldStack[gSldStack.length-1].mCurSld; gSldStack[gSldStack.length-1] =3D null; gSldStack.length--; var sldList =3D gSldStack[gSldStack.length-1]; GoToSld( sldList.mList[gCurSld - 1].mSldHref ); } } var custShowList=3Dnew Array(); /********************************************* Navigation button implementation There are 2 types of buttons: ImgBtn, TxtBtn implemented as function objects. They share a similiar interface so the event handlers can call SetActive, for example, on a button=20 object without needing to know exactly=20 what type of button it is. **********************************************/ //---------------------------------- function ImgBtn( oId,bId,w,action ) //---------------------------------- { var t=3Dthis t.Perform =3D _IBP t.SetActive =3D _IBSetA t.SetInactive=3D _IBSetI t.SetPressed =3D _IBSetP t.SetDisabled=3D _IBSetD t.Enabled =3D _IBSetE t.ChangeIcon =3D null t.UserAction =3D action t.ChgState =3D _IBUI t.mObjId =3D oId t.mBorderId=3D bId t.mWidth =3D w t.mIsOn =3D t.mCurState =3D 0 } function _IBSetA() { if( this.mIsOn ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _IBSetI() { if( this.mIsOn ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0=20 } } function _IBSetP() { if( this.mIsOn ) { obj=3Dthis.ChgState( gShadowClr,gHiliteClr,2 ) obj.style.posLeft+=3D1; obj.style.posTop+=3D1 } } function _IBSetD() { =20 obj=3Dthis.ChgState( gFaceClr,gFaceClr,0 ) obj.style.posTop=3D0=20 } function _IBSetE( state ) { var t=3Dthis GetObj( t.mBorderId ).style.visibility=3D"visible" if( state !=3D t.mIsOn ) { t.mIsOn=3Dstate if( state ) t.SetInactive() else t.SetDisabled() } } function _IBP() { var t=3Dthis if( t.mIsOn ) { if( t.UserAction !=3D null ) t.UserAction() if( t.ChangeIcon ) { obj=3DGetObj(t.mObjId) if( t.ChangeIcon() ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-4)*t.mWidth else obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-0)*t.mWidth } t.SetActive() } =20 } function _IBUI( clr1,clr2,nextState ) { var t=3Dthis SetBorder( GetObj( t.mBorderId ),clr1,clr2 ) obj=3DGetObj( t.mObjId ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-nextState)*t.mWidth-obj= .style.posTop t.mCurState=3DnextState return obj } //----------------------------------------- function TxtBtn( oId,oeId,action,chkState ) //----------------------------------------- { var t=3Dthis t.Perform =3D _TBP t.SetActive =3D _TBSetA t.SetInactive=3D _TBSetI t.SetPressed =3D _TBSetP t.SetDisabled=3D _TBSetD t.SetEnabled =3D _TBSetE t.GetState =3D chkState t.UserAction =3D action t.ChgState =3D _TBUI t.mObjId =3D oId t.m_elementsId=3D oeId t.mIsOn =3D 1 } function _TBSetA() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gHiliteClr,gShadowClr,0,0 ) } function _TBSetI() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) } function _TBSetP() { if( this.mIsOn ) this.ChgState( gShadowClr,gHiliteClr,1,1 ) } function _TBSetD() { =20 this.ChgState( gFaceClr,gFaceClr,0,0 ) this.mIsOn =3D 0 } function _TBSetE() { var t=3Dthis if( !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) else t.ChgState( gShadowClr,gHiliteClr,1,1 ) t.mIsOn =3D 1 } function _TBP() { var t=3Dthis if( t.mIsOn ) {=20 if( t.UserAction !=3D null ) t.UserAction() if( !t.GetState ) return if( t.GetState() ) t.SetPressed() else t.SetActive() } =20 } function _TBUI( clr1,clr2,lOffset,tOffset ) { SetBorder( GetObj( this.mObjId ),clr1,clr2 ) Offset( GetObj( this.m_elementsId ),lOffset,tOffset ) } function Offset( obj, top, left ){ obj.style.top=3Dtop; obj.style.left=3Dle= ft } function SetBorder( obj, upperLeft, lowerRight ) { s=3Dobj.style; s.borderStyle =3D "solid" s.borderWidth =3D 1=20 s.borderLeftColor =3D s.borderTopColor =3D upperLeft s.borderBottomColor=3D s.borderRightColor =3D lowerRight } function GetBtnObj(){ return gBtnArr[window.event.srcElement.id] } function BtnOnOver(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetActive() } function BtnOnDown(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetPressed() } function BtnOnOut(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetInactive() } function BtnOnUp() { b=3DGetBtnObj() if( b !=3D null ) b.Perform() else Upd() } function GetNtsState(){ return parent.gNtsOpen } function GetOtlState(){ return parent.gOtlOpen } function GetOtlTxtState(){ return parent.gOtlTxtExp } function NtsBtnSetFlag( fVal ) { s=3Ddocument.all.item( this.m_flagId ).style s.display=3D"none" if( fVal ) s.display=3D"" else s.display=3D"none" } function _BSetA_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etActive() } function _BSetI_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etInactive() } function _BSetP_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etPressed() } function _BSetA_BorderImg() {=20 b =3D gBtnArr[this.mBorderId]=20 if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _BSetI_BorderImg() {=20 b =3D gBtnArr[this.mBorderId] if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0 } } var gHiliteClr=3D"THREEDHIGHLIGHT",gShadowClr=3D"THREEDSHADOW",gFaceClr=3D"= THREEDFACE" var gBtnArr =3D new Array() gBtnArr["nb_otl"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOtlPan= e,GetOtlState ) gBtnArr["nb_otlElem"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOt= lPane,GetOtlState ) gBtnArr["nb_nts"] =3D new ImgBtn( "nb_nts","nb_ntsBorder",10,parent.ToggleN= tsPane ) gBtnArr["nb_nts"].SetActive =3D _BSetA_BorderImg; gBtnArr["nb_nts"].SetInactive =3D _BSetI_BorderImg; gBtnArr["nb_ntsBorder"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.= ToggleNtsPane,GetNtsState ) gBtnArr["nb_ntsElem"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.To= ggleNtsPane,GetNtsState ) gBtnArr["nb_prevBorder"] =3D gBtnArr["nb_prev"]=3D new ImgBtn( "nb_prev","n= b_prevBorder",30,parent.GoToPrevSld ) gBtnArr["nb_nextBorder"] =3D gBtnArr["nb_next"]=3D new ImgBtn( "nb_next","n= b_nextBorder",30,parent.GoToNextSld ) gBtnArr["nb_sldshw"]=3D new ImgBtn( "nb_sldshw","nb_sldshwBorder",18,parent= .FullScreen ) gBtnArr["nb_sldshwBorder"] =3D new TxtBtn( "nb_sldshw","nb_sldshwBorder",pa= rent.FullScreen,null ) gBtnArr["nb_sldshwBorder"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwBorder"].SetInactive =3D _BSetI_Border; gBtnArr["nb_sldshwText"] =3D new TxtBtn( "nb_sldshw","nb_sldshwText",parent= .FullScreen,null ) gBtnArr["nb_sldshwText"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwText"].SetInactive =3D _BSetI_Border; gBtnArr["nb_voice"] =3D gBtnArr["nb_voiceBorder"] =3D new ImgBtn( "nb_voice= ","nb_voiceBorder",18,parent.ToggleVNarration ) gBtnArr["nb_otlTxtBorder"] =3D gBtnArr["nb_otlTxt"]=3D new ImgBtn( "nb_otlT= xt","nb_otlTxtBorder",23,parent.ToggleOtlText ) gBtnArr["nb_ntsBorder"].m_flagId=3D "nb_nts" gBtnArr["nb_ntsBorder"].SetFlag =3D NtsBtnSetFlag gBtnArr["nb_otlTxt"].ChangeIcon=3D GetOtlTxtState /********************************************* Context menu implementation _CM() is the function that's hooked up to the oncontextmenu event. Once we're asked to show the menu, we first build it by creating DIVs on-the-fly. Then we position it=20 within the screen area so it doesn't get clipped. Creating the DIVs using createElement() means we don't have to write out any extra HTML into the slide HTML files. **********************************************/ var sNext=3D"Next",sPrev=3D"Previous",sEnd=3D"End Show",sFont=3D"Arial",sAr= row=3D"Arrow",sFreeform=3D"Freeform",sRect=3D"Rectangle",sOval=3D"Oval" function ShowMenu() { BuildMenu(); var doc=3DPPTSld.document.body,x=3DPPTSld.event.clientX+doc.scrollLeft,y= =3DPPTSld.event.clientY+doc.scrollTop m =3D PPTSld.document.all.item("ctxtmenu") m.style.pixelLeft=3Dx if( (x+m.scrollWidth > doc.clientWidth)&&(x-m.scrollWidth > 0) ) m.style.pixelLeft=3Dx-m.scrollWidth m.style.pixelTop=3Dy if( (y+m.scrollHeight > doc.clientHeight)&&(y-m.scrollHeight > 0) ) m.style.pixelTop=3Dy-m.scrollHeight m.style.display=3D"" } function _CM() { if( !parent.IsFullScrMode() ) return; if(!PPTSld.event.ctrlKey) { ShowMenu() return false } else HideMenu() } function BuildMenu() { if( PPTSld.document.all.item("ctxtmenu") ) return var mObj=3DCreateItem( PPTSld.document.body ) mObj.id=3D"ctxtmenu" mObj.style.visibility=3D"hidden" var s=3DmObj.style s.position=3D"absolute" s.cursor=3D"default" s.width=3D"120px" SetCMBorder(mObj,"menu","black") var iObj=3DCreateItem( mObj ) SetCMBorder( iObj, "threedhighlight","threedshadow" ) iObj.style.padding=3D2 CreateMenuItem( iObj,sNext,M_GoNextSld,M_True ) CreateMenuItem( iObj,sPrev,M_GoPrevSld,M_HasPrevSld ) =09 CreateSeparator( iObj ) CreateMenuItem( iObj,sEnd,M_End,M_True ) mObj.style.visibility=3D"visible" } function Cancel() { window.event.cancelBubble=3Dtrue; window.event.returnVa= lue=3Dfalse } function Highlight() { ChangeClr("activecaption","threedhighlight") } function Deselect() { ChangeClr("threedface","menutext") } function Perform() { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) e.Action() else PPTSld.event.cancelBubble=3Dtrue } function ChangeClr( bg,clr ) { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) { e.style.backgroundColor=3Dbg e.style.color=3Dclr } } function M_HasPrevSld() { return( parent.HasPrevSld() ) } function M_GoNextSld() { if( gIsEndShow ) M_End(); else GoToNextSld() } function M_GoPrevSld() { if( gIsEndShow ) { gIsEndShow=3D0; history.back();= PPTSld.event.cancelBubble=3Dtrue; } else GoToPrevSld() } function M_True() { return true } function M_End() { window.close( self ) } function CreateMenuItem( node,text,action,eval ) { var e=3DCreateItem( node ) e.type=3D"menuitem" e.Action=3Daction e.IsActive=3Deval e.innerHTML=3Dtext if( !e.IsActive() ) e.style.color=3D"threedshadow" e.onclick=3DPerform e.onmouseover=3DHighlight e.onmouseout=3DDeselect s=3De.style; 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charset="windows-1252" Environmental influences on reproductive health: from conception to birth…and beyond - Jenny Pronczuk ------=_NextPart_01C6420F.43233000 Content-Location: file:///C:/1C09C636/Environmental_influences_Pronczuk_2006_files/outline.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252"
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Outline
------=_NextPart_01C6420F.43233000 Content-Location: file:///C:/1C09C636/Environmental_influences_Pronczuk_2006_files/filelist.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C6420F.43233000--