Trends in reproductive health in Israel: implications for environmental health policy

Israel Journal of Health Policy Research

Itamar Grotto²  Ronni Gamzu⁴  Hagai Levine³  Tamar Berman¹ 

[1] Public Health Services, Israel Ministry of Health, Jerusalem, Israel;Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;Braun School of Public Health and Community Medicine, Hebrew University – Hadassah, POB 12272, Jerusalem, 91120, Israel;Ministry of Health, Jerusalem, Israel

关键词: Exposure;    Surveillance;    Health policy;    Epidemiology;    Trends;    Fertility;    Reproduction;   

Others  :  810284
DOI  :  10.1186/2045-4015-1-34

 received in 2012-02-26, accepted in 2012-07-15,  发布年份 2012

【 摘 要 】

Nearly two decades ago, researchers first reported that endocrine disrupting chemicals in the environment were affecting reproductive health in the general population. The purpose of this article is to examine the evidence of adverse reproductive health trends in Israel and to explore implications for environmental health policy in Israel. We reviewed studies and data in Israel regarding trends in reproductive health indices, specifically: breast and testis cancer, hypospadias, sperm quality, male factor infertility, and age at menarche. The data provide some evidence of adverse reproductive trends in the Israeli population: an increase in testicular cancer from 1990 to 2007, a decrease in age at menarche from 1986 to 2000, an increase in the prevalence of male factor infertility, and some evidence of decreasing sperm counts. However, we note that much of the evidence is limited.

The policy implications of reported adverse reproductive health trends possibly related to environmental exposure have been radically different in Europe and the United States. In Europe, such reports led the Parliament of the European Community to adopt a resolution on endocrine disruptors, which emphasizes the application of the Precautionary Principle. U.S. Environmental Protection Agency policy is focused on screening chemicals for endocrine disrupting properties and does not specifically refer to the Precautionary Principle. To date, there has been no formal governmental policy or strategy in Israel regarding endocrine disrupting chemicals. Environmental health policy on endocrine disruptors requires integrating evidence on human reproductive health trends, evidence on adverse reproductive outcomes in wildlife and experimental systems, and data from biomonitoring studies. Despite gaps in evidence and current data, we support a precautionary approach to regulating potential endocrine disrupting chemicals and reducing public exposures, especially in sensitive groups such as children and pregnant women.

【 授权许可】

   
2012 Berman et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Colborn T, vom Saal FS, Soto AM: Developmental effects of endocrine-disrupting chemicals in wildlife and humans. Environ Health Perspect 1993, 101(5):378-384.
• [2]Diamanti-Kandarakis E, Bourguignon J-P, Giudice LC, Hauser R, Prins GS, Soto AM, Zoeller T, Gore AC: Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement. Endocr Rev 2009, 30(4):293-342.
• [3]de Mouzon J, Lancaster P, Nygren KG, Sullivan E, Zegers-Hochschild F, Mansour R, Ishihara O, Adamson D, International Committee for Monitoring Assisted Reproductive Technology: World Collaborative Report on Assisted Reproductive Technology, 2002. Hum Reprod 2009, 24:2310-2320.
• [4]Bar-Chana M: Israel National Cancer Registry, Cancer Incidence Tables. 2010. http://www.health.gov.il/download/sartan/trends/Testis.pdf webcite
• [5]Beri A, Matzkin H, Liphshitz I, Barchana M: Epidemiological characteristics and trends of testicular cancer in Israel 1992–2002. Harefuah 2007, 146(7):515-519. 575 [Hebrew]
• [6]Bar-Chana M: Israel National Cancer Registry, Cancer Incidence Tables. 2010. http://www.health.gov.il/download/sartan/trends/Breast.pdf webcite
• [7]International Clearinghouse for Birth Defects: Annual Report. 2010. http://www.icbdsr.org/filebank/documents/ar2005/Report2010.pdf webcite
• [8]Rubin L: Undescended Testes and Hypospadias in Israel 2000–2008. Presentation at Conference on Reproductive Health and Estrogenic and anti-androgenic Chemicals, Tel Aviv, Israel; 2009.
• [9]Dor J, Homburg R, Rabau E: An evaluation of etiologic factors and therapy in 665 infertile couples. Fertil Steril 1977, 28(7):718-722.
• [10]Farhi J, Ben-Haroush A: Distribution of causes of infertility in patients attending primary fertility clinics in Israel. Isr Med Assoc J 2011, 13(1):51-54.
• [11]Sella T, Chodick G, Lunenfeld E, Shalev V: Further evidence on the high prevalence of male factor infertility diagnosis in Israel. Isr Med Assoc J 2011, 13(6):386.
• [12]Almagor M, Ivnitzki I, Yaffe H, Baras M: Changes in semen quality in Jerusalem between 1990 and 2000: A cross-sectional and longitudinal study. Arch Andrology 2003, 49(2):139-144.
• [13]Benshushan A, Shoshani O, Paltiel O, Schenker J, Lewin A: Is there really a decrease in sperm parameters among health young men? A survey of sperm donation during 15 years. J Assist Reprod Genet 1997, 14(6):347-353.
• [14]Haimov-Kochman R, Har-Nir R, Ein-Mor E, Ben-Shoshan V, Greenfield C, Eldar I, Bdolah Y, Hurwitz A: Is The Quality of Donated Semen Deteriorating? Findings from a 15 Year Longitudinal Analysis of Weekly Sperm Samples. Isr Med Assoc J 2012, 14:372-377.
• [15]Chodick G, Huerta M, Balicer RD, Davidovitch N, Grotto I: Secular trends in age at menarche, smoking, and oral contraceptive use among Israeli girls. Prev Chronic Dis 2005, 2(2):A12.
• [16]Neumark YD, Grotto I, Kark JD: Twenty-year trends in illicit drug use among young Israelis completing military duty. Addiction 2004, 99(5):641-648.
• [17]Gross R, Brammli-Greenberg S, Rabinowitz J, Gordon B, Afek A: Disparities in obesity temporal trends of Israeli adolescents by ethnic origin. Int J Pediatr Obes 2011, 6(2–2):e154-e161.
• [18]Rosen B, Merkur S: Israel: Health system review. In Health Systems in Transition. Edited by Merker S. World Health Organization; 2009:1-226.
• [19]Berger-Achituv S, Shohat T, Romano-Zelekha O, Ophir E, Rachmani S, Malovizky D, Garty BZ: Widespread use of soy-based formula without clinical indications. J Pediatr Gastroenterol Nutr 2005, 41(5):660-666.
• [20]Fronczak CM, Kim ED, Barqawi AB: The Insults of Recreational Drug Abuse on Male Fertility. J Androl 2011. 0.2164/jandrol.110.011874 [Epub ahead of print]
• [21]Gaudineau A, Ehlinger V, Vayssiere C, Jouret B, Arnaud C, Godeau E: Factors associated with early menarche: results from the French Health Behaviour in School-aged Children (HBSC) study. BMC Publ Health 2010, 10:175. BioMed Central Full Text
• [22]Huyghe E, Matsuda T, Thonneau P: Increasing incidence of testicular cancer worldwide: a review. J Urol 2003, 170(1):5-11.
• [23]Huyghe E, Plante P, Thonneau PF: Testicular cancer variations in time and space in Europe. Eur Urol 2007, 51(3):621-628.
• [24]Euling SY, Herman-Giddens ME, Lee PA, Selevan SG, Juul A, Sørensen TI, Dunkel L, Himes JH, Teilmann G, Swan SH: Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings. Pediatrics 2008, 121(S3):S172-S191.
• [25]Aksglaede L, Sørensen K, Petersen JH, Skakkebaek NE, Juul A: Recent decline in age at breast development: the Copenhagen Puberty Study. Pediatrics 2009, 123(5):e932-e939.
• [26]Carlsen E, Giwercman A, Keiding N, Skakkebaek NE: Evidence for deacreasing quality of semen during past 50 years. BMJ 1992, 305(6854):609-613.
• [27]Swan S, Elkin E, Fenster L: The Question of Declining Sperm Density Revisited: An Analysis of 101 Studies Published 1934–1996. Environ Health Perspect 2000, 108(10):961-966.
• [28]Merzenich H, Zeeb H, Blettner M: Decreasing sperm quality: a global problem? BMC Publ Health 2010, 10:24. BioMed Central Full Text
• [29]Andersson AM, Jørgensen N, Main KM, Toppari J, Rajpert De-Meyts E, Leffers H, Juul A, Jensen TK, Skakkebæk NE: Adverse trends in male reproductive health: we may have reached a crucial ‘tipping point’. Int J Androl 2008, 31:74-80.
• [30]European Workshop on the impact of endocrine disruptors on human health and wildlifehttp://ec.europa.eu/environment/endocrine/documents/reports_conclusions_en.htm webcite
• [31]Community Strategy for Endocrine Disruptorshttp://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=COM:1999:0706:FIN:EN:PDF webcite
• [32]4th Report on the implementation of the "Community Strategy for Endocrine Disrupters" a range of substances suspected of interfering with the hormone systems of humans and wildlife. http://ec.europa.eu/environment/endocrine/documents/sec_2011_1001_en.pdf webcite
• [33]Endocrine Disruptor Screening Program: Statement of Policy. http://www.epa.gov/endo/pubs/122898frnotice.pdf webcite
• [34]Vogel J: Perils of paradigm: Complexity, policy design, and the Endocrine Disruptor Screening Program. Environmental Health: A Global Access Science Source 2005, 4:2.
• [35]Consumer Product Safety Improvement Act of 2008. http://www.cpsc.gov/cpsia.pdf webcite
• [36]Bisphenol A, BPA: Use in Food Contact Application. http://www.fda.gov/newsevents/publichealthfocus/ucm064437.htm webcite
• [37]Centers for Disease Control: National Report on Human Exposure to Environmental Chemicals. National Report on Human Exposure to Environmental Chemicals; http://www.cdc.gov/exposurereport/ webcite
• [38]Berman T, Amitai Y, Almog S, Richter ED: Human biomonitoring in Israel: Past, present, future. Int J Hyg Environ Health 2012, 215(2):138-141.
• [39]Food and Drug Administration: Draft Assessment of Bisphenol A for Use in Food Contact Applications. 2008. http://www.fda.gov/ohrms/dockets/ac/08/briefing/2008-0038b1_01_02_FDA%20BPA%20Draft%20Assessment.pdf webcite
• [40]European Commission Health and Consumer Protection Directorate General: Opinion of the Scientific Committee on Food on Bisphenol A. 2002. http://ec.europa.eu/food/fs/sc/scf/out128_en.pdf webcite
• [41]Vom Saal FS, Akingbemi BT, Belcher SM, Birnbaum LS, Crain DA, Eriksen M, Farabollini F, Guillette LJ, Hauser R, Heindel JJ, Ho SM, Hunt PA, Iguchi T, Jobling S, Kanno J, Keri RA, Knudsen KE, Laufer H, LeBlanc GA, Marcus M, McLachian JA, Myers JP, Nadal A, Newbold RR, Olea N, Prins GS, Richter C, Rubin BS, Sonnenschein C, Soto AM, et al.: Chapel Hill Bisphenol A Expert Panel Consensus Statement: Integrations of mechanism, effects in animals and potential to impact human health at current levels of exposure. Reprod Toxicol 2007, 24(2):131-138.
• [42]Communication from the commission on the precautionary principlehttp://eurlex.europa.eu/smartapi/cgi/sga_doc?smartapi!celexplus!prod!CELEXnumdoc&numdoc=52000DC0001&lg=en webcite
• [43]Wier E, Schabas R, Wilson K, Mackie C: A Canadian Framework for Applying the Precautionary Principle to Public Health Issues. Can J Public Health 2010, 101(5):396-398.
• [44]Agreement on the application of sanitary and phytosanitary measures. http://www.wto.org/english/docs_e/legal_e/15-sps.pdf webcite