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ENVIRONMENTAL PCB AND PESTICIDE EXPOSURE AND RISK OF ENDOMETRIOSIS
Citation:
Buck, G. M., J. M. Weiner, H. Greizerstein, E. R. Whitcomb, E. F. Schisterman, P. Kostyniak, J. M. Sperrazza, AND D. T. LOBDELL. ENVIRONMENTAL PCB AND PESTICIDE EXPOSURE AND RISK OF ENDOMETRIOSIS. Presented at Intl. Congress of Environmental Influences on Reproduction and Development, Chieti, Italy, October 11-12, 2002.
Description:
Environmental PCB and Pesticide Exposure and Risk of Endometriosis
Germaine M. Buck1, John M. Weiner2, Hebe Greizerstein3, Brian Whitcomb1, Enrique Schisterman1, Paul Kostyniak3, Danelle Lobdell4, Kent Crickard5, and Ralph Sperrazza5
1Epidemiology Branch, Division of Epidemiology, Statistics & Prevention Research, National Institute of Child Health & Human Development;
2Departments of Social & Preventive Medicine, 3Pharmacology & Toxicology and 5Gynecology & Obstetrics, University at Buffalo; 4Office of Research and Development, National Health and Environmental Effects Research Laboratory, United States Environmental Protection Agency
Endometriosis remains a clinical enigma with an elusive etiology and implications for human reproduction. Of late, there is considerable speculation that environmental agents may disrupt or mimic the action of hormones leading to disturbances in reproduction and development. We undertook a study to assess the relation between risk of endometriosis, an estrogen dependent gynecologic disease, and 64 individual polychlorinated biphenyl (PCBs) congeners and 7 pesticides (i.e., mirex, hexachlorobenzene (HCB), b-BHC, Oxychlordane, trans-nonachlor (t-Nonachlor), Aldrin, and 1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene (p,p-DDE)). After obtaining Institutional Review Board approval for the conduct of the study, a case control design was utilized among women undergoing laparoscopy for diagnostic or sterilization purposes between 1998-1999. We contacted 100 eligible women aged 18-40 years of which 84 (84%) agreed to be interviewed and to provide blood specimens (n=80; 95% of interviewed). Surgeons completed a short standardized instrument about operative findings including the diagnosis and staging of endometriosis. Thirty-two women had visually confirmed endometriosis at laparoscopy while 52 did not. Quantification of PCB congeners and pesticides were performed by the Toxicology Research Center at University of Buffalo. Specimens were run in batches of 14 including four quality control samples (i.e., reagent control, serum control, control with 15 calibration standards at known values, and a duplicate participant sample). Congeners were calculated from standard curves for the 15 calibration standards, and the remaining congeners from response factors that were laboratory generated. Each congener and pesticide was adjusted for percent recovery and lipids; batch specific reagent blanks were subtracted as well. All PCB concentrations were expressed as ng/g serum and summed into a total PCB score. DDE was the predominant measurable pesticide. Using unconditional logistic regression analysis, an elevated risk of endometriosis was observed for log of lipid adjusted total PCBs (OR=1.98; 95% CI =0.84,4.65) but not for DDE (OR=0.93; 95% CI=0.50,1.77) after controlling for household income, current cigarette smoking and parity. Risk of endometriosis remained for total PCBs after adjusting for DDE (OR=2.13; 95% CI=0.88,5.17). The limited size of this study coupled with wide confidence intervals inclusive of one for total PCBs and DDE precludes a more complete interpretation of the findings, but warrants further research into underlying mechanisms. This is an abstract of a proposed presentation and does not necessarily reflect EPA policy.
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