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Vallée A, Ceccaldi PF, Carbonnel M, Feki A, Ayoubi JM. Pollution and endometriosis: A deep dive into the environmental impacts on women's health. BJOG 2024; 131:401-414. [PMID: 37814514 DOI: 10.1111/1471-0528.17687] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND The interaction between pollution and endometriosis is a pressing issue that demands immediate attention. The impact of pollution, particularly air and water pollution, or occupational hazards, on hormonal disruption and the initiation of endometriosis remains a major issue. OBJECTIVES This narrative review aims to delve into the intricate connection between pollution and endometriosis, shedding light on how environmental factors contribute to the onset and severity of this disease and, thus, the possible public health policy implications. DISCUSSION Endocrine-disrupting chemicals (EDCs) in pollutants dysregulate the hormonal balance, contributing to the progression of this major gynaecological disorder. Air pollution, specifically PM2.5 and PAHs, has been associated with an increased risk of endometriosis by enhancing chronic inflammation, oxidative stress, and hormonal imbalances. Chemical contaminants in water and work exposures, including heavy metals, dioxins, and PCBs, disrupt the hormonal regulation and potentially contribute to endometriosis. Mitigating the environmental impact of pollution is required to safeguard women's reproductive health. This requires a comprehensive approach involving stringent environmental regulations, sustainable practices, responsible waste management, research and innovation, public awareness, and collaboration among stakeholders. CONCLUSION Public health policies have a major role in addressing the interaction between pollution and endometriosis in a long-term commitment.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France
| | - Pierre-François Ceccaldi
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Foch Hospital, Suresnes, France
- Medical School, University of Versailles, Saint-Quentin-en-Yvelines (UVSQ), Versailles, France
| | - Marie Carbonnel
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Foch Hospital, Suresnes, France
- Medical School, University of Versailles, Saint-Quentin-en-Yvelines (UVSQ), Versailles, France
| | - Anis Feki
- Department of Gynaecology and Obstetrics, University Hospital of Fribourg, Fribourg, Switzerland
| | - Jean-Marc Ayoubi
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Foch Hospital, Suresnes, France
- Medical School, University of Versailles, Saint-Quentin-en-Yvelines (UVSQ), Versailles, France
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Kim JH, Hong SH, Moon NL, Kang DR. Effects of Exposure Duration and Exposure Levels of Ambient Air Pollutants on the Risk of Polycystic Ovarian Syndrome: A 2015-2019 Korean Population-Based Cohort Study. TOXICS 2022; 10:542. [PMID: 36136507 PMCID: PMC9501187 DOI: 10.3390/toxics10090542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/07/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
Exposure to ambient air pollution is associated with an increased risk of menstrual disorders and infertility. This study examined the relationships between the levels and duration of air pollution exposure and the risk of polycystic ovarian syndrome (PCOS) using Korean population-based cohort data (2015-2019). Real-time data on PM10, PM2.5, O3, CO, SO2, and NO2 were provided by the Korean Ministry of Environment. The average monthly air pollutant concentration from 1 January 2014 to 31 December 2018 was analyzed. To assess individual-level exposure to air pollutants, a spatial prediction model and an area-averaging approach were used. In total, 237,582 PCOS cases were analyzed. The annual age-adjusted PCOS incidence was 6.70, 8.28, 9.73, 11.58, and 11.97% from 2015-2019, respectively. The PCOS risk increased 1.29-1.32, 1.43-1.52, and 1.32-fold following exposure to the 2-year and 3-year average levels of PM2.5, O3, and NO2, respectively, compared to their 1-year average levels. The PCOS risk increased 1.75-fold (95% confidence interval: 1.66-1.85) in the fourth-quartile for the NO2 level. Increased SO2 and CO levels in the second- and third-quartiles were also associated with an increased PCOS risk. Exposure to air pollutants thus increased the risk for PCOS in the Korean population.
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Affiliation(s)
- Ju-Hee Kim
- Department of Nursing, College of Nursing Science, Kyung Hee University, Seoul 02447, Korea
| | - Se-Hwa Hong
- Department of Biostatistics, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea
| | - Na-Lae Moon
- Department of Nursing, College of Nursing Science, Kyung Hee University, Seoul 02447, Korea
| | - Dae-Ryong Kang
- Department of Precision Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea
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Marchandot B, Curtiaud A, Matsushita K, Trimaille A, Host A, Faller E, Garbin O, Akladios C, Jesel L, Morel O. Endometriosis and cardiovascular disease. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeac001. [PMID: 35919664 PMCID: PMC9242051 DOI: 10.1093/ehjopen/oeac001] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/13/2021] [Indexed: 11/21/2022]
Abstract
Endometriosis is a chronic gynaecological disease affecting 1 in 10 reproductive-age women. It is defined as the presence of endometrium-like tissue outside the uterus. Beyond this placid anatomical definition, endometriosis is a complex, hormonal, inflammatory, and systemic condition that poses significant familial, psychological, and economic burden. The interaction between the cardiovascular system and endometriosis has become a field of interest as the underlying mutual mechanisms become better understood. On the basis of accumulating fundamental and clinical evidence, it is likely that there exists a close relationship between endometriosis and the cardiovascular system. Therefore, investigating the endometriosis-cardiovascular interaction is highly clinically significant. In this review, we highlight our current understanding of the pathophysiology of endometriosis with systemic hormonal, pro-inflammatory, pro-angiogenic, immunologic, and genetic processes beyond the peritoneal microenvironment. Additionally, we provide current clinical evidence about how endometriosis interacts with cardiovascular risk factors and cardiovascular disease (CVD). To date, only small associations between endometriosis and CVD have been reported in observational studies, inherently limited by the potential influence of unmeasured confounding. Cardiovascular disease in women with endometriosis remains understudied, under-recognized, and underdiagnosed. More detailed study of the cardiovascular-endometriosis interaction is needed to fully understand its clinical relevance, underlying pathophysiology, possible means of early diagnosis and prevention.
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Affiliation(s)
- Benjamin Marchandot
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Anais Curtiaud
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Kensuke Matsushita
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Antonin Trimaille
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Aline Host
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Emilie Faller
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Olivier Garbin
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Chérif Akladios
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Laurence Jesel
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Olivier Morel
- Division of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, 1 place de l’Hôpital, 67000 Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
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Abstract
PURPOSE OF REVIEW Data science is an exploding trans-disciplinary field that aims to harness the power of data to gain information or insights on researcher-defined topics of interest. In this paper we review how data science can help advance environmental health research. RECENT FINDINGS We discuss the concepts computationally scalable handling of Big Data and the design of efficient research data platforms, and how data science can provide solutions for methodological challenges in environmental health research, such as high-dimensional outcomes and exposures, and prediction models. Finally, we discuss tools for reproducible research. SUMMARY In this paper we present opportunities to improve environmental research capabilities by embracing data science, and the pitfalls that environmental health researchers should avoid when employing data scientific approaches. Throughout the paper, we emphasize the need for environmental health researchers to collaborate more closely with biostatisticians and data scientists to ensure robust and interpretable results.
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Affiliation(s)
| | - Danielle Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA
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