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Caporossi L, Viganò P, Paci E, Capanna S, Alteri A, Campo G, Pigini D, De Rosa M, Tranfo G, Papaleo B. Female Reproductive Health and Exposure to Phthalates and Bisphenol A: A Cross Sectional Study. TOXICS 2021; 9:toxics9110299. [PMID: 34822691 PMCID: PMC8622554 DOI: 10.3390/toxics9110299] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/26/2021] [Accepted: 11/04/2021] [Indexed: 11/16/2022]
Abstract
The xenoestrogenicity of some plasticisers (phthalates and bisphenol A) is documented in the literature and may pose a risk to female reproductive health. The aim of this study was to assess exposure to six phthalates. This was achieved by measuring their respective metabolites (mono-ethylphthalate (MEP); mono-n-butylphthalate (MnBP); mono-n-ottylphthalate (MnOP); and monobenzylphthalate (MBzP)), as well as the sum of two of the diethyl-hexyl phthalate metabolites-(∑DEHP) and bisphenol A (BPA) in a female population with infertility problems, and by conducting a correlation analysis between infertility factors, work activities, and lifestyle habits, in order to formulate a causal hypothesis. A cross-sectional epidemiological study was carried out and women under 43 years of age were recruited from an assisted reproduction technology (ART) center; the sample of 186 women was given a specific questionnaire and a spot urine sample was collected. Phthalate metabolites and urinary BPA were analyzed by HPLC/MS/MS. The results showed significantly higher mean values for MEP in women with recurrent pregnancy loss (RPL) (820.5 ± 1929.5 µg/g of creatinine) and idiopathic infertility (230.0 ± 794.2 µg/g of creatinine) than in women with other infertility factors (76.9 ± 171.8 µg/g of creatinine). Similarly, for MnOP levels, women with idiopathic infertility (2.95 ± 3.44 µg/g of creatinine) showed significantly higher values than women with the other infertility factors taken together (1.35 ± 2.05 µg/g of creatinine). Women with tubal factors of infertility, RPL, and endocrine dysfunctions show higher values of DEHP (p = 0.032). Considering occupations, women working in commerce showed more than twice as much urinary BPA levels (1.10 ± 0.48 µg/g of creatinine) compared to women working in other industries (0.45 ± 0.35 µg/g of creatinine). The presence of significantly higher values of certain phthalates, DEHP in particular, especially in women with RPL and idiopathic infertility, suggests a possible involvement of these compounds as competing factors in reproductive issues. The study of sources of exposure suggested that the working activity in trade, as a casher in particular, represents a major one for BPA (p = 0.015).
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Affiliation(s)
- Lidia Caporossi
- INAIL—National Institute for Insurance against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (E.P.); (S.C.); (D.P.); (M.D.R.); (G.T.); (B.P.)
- Correspondence:
| | - Paola Viganò
- Fondazione Scientific Institute for Research, Hospitalization and Healthcare Ca’ Granda Ospedale Maggiore Policlinico, Infertility Unit, Via M. Fanti, 20132 Milan, Italy;
| | - Enrico Paci
- INAIL—National Institute for Insurance against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (E.P.); (S.C.); (D.P.); (M.D.R.); (G.T.); (B.P.)
| | - Silvia Capanna
- INAIL—National Institute for Insurance against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (E.P.); (S.C.); (D.P.); (M.D.R.); (G.T.); (B.P.)
| | - Alessandra Alteri
- Scientific Institute for Research, Hospitalization and Healthcare San Raffaele Scientific Institute, Obstetrics and Gynecology Unit, Via Olgettina 60, 20132 Milan, Italy; (A.A.); (G.C.)
| | - Giovanni Campo
- Scientific Institute for Research, Hospitalization and Healthcare San Raffaele Scientific Institute, Obstetrics and Gynecology Unit, Via Olgettina 60, 20132 Milan, Italy; (A.A.); (G.C.)
| | - Daniela Pigini
- INAIL—National Institute for Insurance against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (E.P.); (S.C.); (D.P.); (M.D.R.); (G.T.); (B.P.)
| | - Mariangela De Rosa
- INAIL—National Institute for Insurance against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (E.P.); (S.C.); (D.P.); (M.D.R.); (G.T.); (B.P.)
| | - Giovanna Tranfo
- INAIL—National Institute for Insurance against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (E.P.); (S.C.); (D.P.); (M.D.R.); (G.T.); (B.P.)
| | - Bruno Papaleo
- INAIL—National Institute for Insurance against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (E.P.); (S.C.); (D.P.); (M.D.R.); (G.T.); (B.P.)
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