Reproductive Effects of Pesticide, PCB and Mercury Exposure in Laotian Immigrants
Condition: Amenorrhea; Dysmenorrhea; Oligomenorrhea; Anovulation; Infertility
MeSH terms: Infertility; Anovulation; Dysmenorrhea; Amenorrhea; Oligomenorrhea
Study type: Observational

Summary: 
      This project is examining the reproductive effects of exposure to certain compounds that are
      suspected to act on the endocrine system, e.g. they may act like or interfere with hormones
      such as estrogen. The study is being conducted among Laotian women, as it is suspected that
      they may have higher exposures to the compounds of interest (pesticides and PCBs) from their
      homeland and from consumption of fish caught in the San Francisco Bay. Fifty Laotian
      immigrants were recruited by community workers to collect urine daily during 3 menstrual
      cycles for measurement of steroid hormones (estrogen and progesterone). Additionally, they
      provided a blood sample to measure exposure levels, and completed 2 interviews in their
      native language. These measured levels, as well as the self-reported data on a number of
      factors including fish consumption, will be examined for possible effects on hormone levels
      and menstrual function.
    

Detailed description: 
      We are conducting a study to examine whether women who have been exposed to chlorinated
      pesticides or PCBs have alterations in their ovarian function as measured by the frequency of
      menstrual cycle disturbances. Such disturbances may impact the frequency of infertility and
      sub-fertility, as well as that of other hormone-dependent illnesses such as breast cancer and
      osteoporosis. The target population is a group of Laotian immigrants who are frequent
      consumers of fish caught locally in the San Francisco Bay. Contaminant levels above health
      protective advisories have been documented in Bay fish and shellfish for a number of these
      substances. Immigration from Asia, as well as consumption of contaminated fish, have been
      shown to be associated with higher organochlorine pesticide body burdens. Exposure is
      determined by measuring serum levels of a panel of pesticide metabolites, including those of
      DDT, chlordane, hepatochlor and others, as well as PCB congeners. In addition, mercury levels
      are measured in the blood. Menstrual function is assessed by measuring urinary metabolites of
      steroid hormones daily during three menstrual cycles of 50 Laotian women of reproductive age.
      The participants were also asked to complete two detailed in-person interviews about various
      factors, including fish consumption.

      We previously conducted a study of menstrual function in a group of 400 women during which we
      developed algorithms to determine ovulatory status, day of ovulation and menstrual cycle
      disturbances such as short luteal phase that can also be applied to the new sample. This
      previously collected sample (or the Asians therein) will serve as a baseline comparison group
      for the current sample. In addition, it will provide a source of data on the effects of
      lifestyle (such as smoking and alcohol consumption) and demographic (such as age and
      ethnicity) factors on menstrual function, allowing for more efficient examination of a small
      group of exposed women in the current study. In addition to serum organochlorine levels,
      questionnaire measures of exposure (e.g. species-specific fish consumption, occupational
      exposure and previous residence) will be examined in relation to ovarian function defined as
      continuous measures (e.g. cycle length, steroid conjugate levels) and dichotomous
      abnormalities (e.g. short luteal phase or anovulation). At this time all data collection is
      complete, hormones measured and analyses begun.

      In working with this refugee, lower socioeconomic status community we adopted a model of
      participatory research. Steps were taken to develop partnerships with various community
      organizations. Staff who spoke one of the three prominent dialects (Mien, Lao, or Khmu ) were
      hired from the local community and provided with training to present information about
      reproductive and environmental health to the community. Participants were compensated for
      their time, as well as being provided with educational materials about reproductive health,
      safe consumption of seafood and their own results.
    

Observational model: Defined Population
Time perspective: Prospective
Keywords: Organochlorine compounds; Endocrine disruptors; Sex Hormones; Reproductive function; Menstrual Disturbances