Women's Health
Residential Environmental Risks for
Reproductive-Age Women
Published in Journal of Midwifery Women's Health, 2005, 50(4)
309-314
From the time of implantation, through gestation, birth, and early
childhood, humans are exposed to chemicals and chemical combinations, which
place their health in jeopardy.[1] Numerous toxic agents have
been detected in umbilical cord blood samples, a finding potentially
significant because tissues, organs, and genetic material of the unborn and
young are particularly susceptible to biologic insult.[2,3] The
National Research Council reported in 1993 that children are uniquely
vulnerable to pollutant exposures because growing and developing organ
systems may suffer permanent impairment.[4]
A growing body of literature suggests there is an association between
maternal inhalation of common ambient air pollutants and adverse birth
outcomes, including an increased risk for preterm delivery, intrauterine
growth retardation (IUGR), low birth weight, small head circumference, and
increased rate of malformations.[5-14] Potentially more worrisome
are recent studies, which report a relationship between exposure to airborne
particulate matter and heritable mutations in laboratory animals.[15]
The contaminants noted in these studies are ubiquitous to many urban
environments.[16]
Outdoor air pollution is not the only potential source of
non-employment-related airborne contamination. The United States
Environmental Protection Agency (EPA) determined that people in developed
countries spend 90% of their time indoors, where the air pollutant
concentration is 3 to 5 times higher than outdoors.[17,18]
Although research examining the effect of indoor air pollutants on pregnancy
outcomes is sparse, data gleaned from environmental tobacco smoke studies
suggest reason for concern. Nonsmoking pregnant women exposed to
environmental tobacco smoke have an increased risk of delivering a low birth
weight infant.[19-21]
After birth, children continue to be vulnerable, particularly for
exposure to air pollutants. The EPA found that children under the age of 1
have inhalation rates 3.4 times higher per kilogram of body weight than
their adult counterparts; for children aged 3 to 5 years, the ratio is 2.8
times higher.[22] Children very likely internalize greater doses
of contamination from pollutants suspended in the air column as a function
of their inhalation rates and body weight, and endure greater risk of
excessive tissue damage because of their underdeveloped immune systems.[2]
Children suffer disproportionately from exposure to environmental hazards
in general and indoor air pollutants in particular. Globally, 40% of disease
burden attributable to environmental factors impacts children under the age
of 5, although this cohort accounts for only 10% of the world's population.[23] |