A new report a professor in the School of Medicine and Health Sciences co-authored details how physicians can help patients avoid toxins that disrupt normal brain development and cause pregnancy complications.
Nathaniel DeNicola, an assistant professor of obstetrics and gynecology, co-authored a report outlining how physicians can help patients avoid chemicals, like lead and mercury, associated with brain development and pregnancy complications, according to a medical school release last week. Obstetrics experts said the guidelines will help health care providers teach their patients how to avoid toxic chemical exposures linked to pregnancy complications and neurodevelopmental disease.
“Discussions between patients and their physicians focused on preventing future exposures rather than past exposures and possible implications may be the most productive way to determine what is best,” DeNicola said in the release.
DeNicola did not return requests for comment.
The report includes a table of recommendations, like eating fish with lower levels of mercury and purchasing organic produce, for how to avoid toxins linked to neurodevelopmental disorders and reproductive health issues, like infertility and miscarriage.
The report recommends that obstetrician and gynecologist patients fill out questionnaires identifying potential incidents of toxic chemical exposure – like proximity to high-traffic areas and regular usage of plastic containers. If patients indicate they may be regularly exposed to toxic chemicals, health care providers should provide “targeted” advice to patients on how to limit their exposure, the report states.
“Reproductive care professionals do not need to be experts in environmental health science to provide useful information to patients and refer patients to appropriate specialists when a hazardous exposure is identified,” the report states.
The report states that the fetal period is one of the most important phases of human development, and toxic exposures during pregnancy can disrupt normal brain development. Previous studies have found that exposure to toxic chemicals like pesticides, certain flame retardants, lead and mercury in utero contribute to neurodevelopmental disorders, like autism and attention deficit hyperactivity disorder.
Obstetrics experts said health care providers must prioritize educating patients, especially pregnant patients, during medical appointments about avoiding exposure to environmental toxins.
Veena Singla, the associate director for the program of reproductive health and the environment at the University of California, San Francisco, said health care providers should give their patients brochures describing measures, like eating less plastic-packaged food, that reduce exposure to environmental toxins.
She added that providers can also document patients’ “environmental health history,” which lists potential chemical toxins patients are exposed to depending upon where they live and work, to identify potential sources of exposure.
Singla said documenting what toxins patients have encountered in the past can help physicians identify what environmental exposures patients must avoid in the future to reduce the risk that their children will develop neurodevelopmental disorders like autism and ADHD.
“Doctors and health care providers are in a very good position to help make people aware about some of these harmful exposures and provide resources and clinical counseling,” she said.
Singla added that some chemical exposures, like particulate air pollution, are nearly impossible to avoid. She said scientists must use their expertise to advocate for federal chemical policies that reduce air pollution to ensure the amount of air toxins decreases over time.
“There’s many environmental exposures that we as individuals have very little control over,” Singla said.
Liping Feng, an associate professor of obstetrics and gynecology at Duke University, said physicians must take steps to educate their patients about the effects of chemical exposures on fetal development. She said exposure to toxic chemicals can result in pregnancy loss and increase the likelihood that pregnant mothers will experience complications like pre-eclampsia – or severely high blood pressure – during pregnancy.
“Neural development is crucial for physical development during pregnancy, and if it’s affected by polluted compounds, it could cause pregnancy loss which is a disaster to the whole family or it could cause developmental delays,” Feng said.
Emily Barrett, an associate professor of epidemiology at Rutgers University, said “lax” U.S. chemical policy has increased the prevalence of “potentially hazardous” chemicals like pesticides and phthalates – a chemical found in plastic – in the environment.
Barrett said health care providers can encourage families to make “common sense” decisions, like purchasing fresh food instead of plastic-packaged food to lessen their exposure to harmful chemicals.
“Families may be able to lower their chemical burden by making safer choices with the products they buy and the foods they eat, but they can only do that if they have the right tools,” Barrett said in an email. “Navigating what’s safe and what isn’t is very difficult, and research shows that families trust health care providers to advise them on environmental health issues.”
