:Reproductive toxicity

Infertility is medically defined as a failure of a couple to conceive over the course of one year of unprotected intercourse.{{Cite book |title=Current Medical Diagnosis & Treatment |vauthors=Long J |publisher=McGraw Hill |year=2022}} Primary infertility indicates that a person has never been able to achieve pregnancy while secondary inferility is defined as a person having at least one pregnancy before.{{Cite web |title=Infertility |url=https://www.who.int/news-room/fact-sheets/detail/infertility |access-date=2024-04-11 |website=www.who.int |language=en}} As many as 20% of couples experience infertility. Infertility may be caused by an issue along any part of the process of fertilizing an egg through birth of the child. This can include: the release of the egg, the ability of the sperm to fertilize the egg, the implantation of the egg in the uterine wall, and the ability of the fetus to complete development without miscarriage.{{Cite web |date=2023-04-26 |title=Infertility {{!}} CDC |url=https://www.cdc.gov/reproductivehealth/infertility/index.htm |access-date=2024-04-11 |website=www.cdc.gov |language=en-us}} Among males oligospermia is defined as a paucity of viable spermatozoa in the semen, whereas azoospermia refers to the complete absence of viable spermatozoa in the semen. Males may also experience issues in sperm motility and morphology, which means the sperm are less likely to make it to the egg or to be able to fertilize the egg. Female infertility could be a result of an issue regarding their uterus, ovaries, or fallopian tubes and can be impacted by various diseases, endocrine/hormone disruption, or reproductive toxicant.

The Globally Harmonized System of Classification and Labelling of Chemicals (GHS) separates reproductive toxicity from germ cell mutagenicity and carcinogenicity, even though both these hazards may also affect fertility.{{Cite book |last=Nations |first=United |url=https://www.un-ilibrary.org/content/books/9789210573207 |title=Globally Harmonized System of Classification and Labelling of Chemicals (GHS): Sixth Revised Edition |date=2015-06-19 |publisher=United Nations |isbn=978-92-1-057320-7 |language=en |doi=10.18356/591dabf9-en}}

Many drugs can affect the human reproductive system. Their effects can be

• desired (hormonal contraception),
• a minor unwanted side effect (many antidepressants) or
• a major public health problem (thalidomide).

However, most studies of reproductive toxicity have focused on occupational or environmental exposure to chemicals and their effects on reproduction. Both consumption of alcohol and tobacco smoking are known to be "toxic for reproduction" in the sense used here.

One well-known group of substances which are toxic for reproduction are teratogens – substances which cause birth defects. (S)-thalidomide is possibly the most notorious of these.{{Cite web |author=International Programme on Chemical Safety|author-link=International Programme on Chemical Safety|year=2002|title=Global assessment of the state-of-the-science of endocrine disruptors|url=https://www.who.int/ipcs/publications/new_issues/endocrine_disruptors/en/|url-status=dead|location=Geneva|publisher=World Health Organization|id=WHO/PCS/EDC/02.2|archive-url=https://web.archive.org/web/20040709125636/http://www.who.int/ipcs/publications/new_issues/endocrine_disruptors/en/|archive-date=July 9, 2004}}

Another group of substances which have received much attention (and prompted some controversy) as possibly toxic for reproduction are the so-called endocrine disruptors. Endocrine disruptors change how hormones are produced and how they interact with their receptors.{{Cite web |title=Endocrine Disruptors |url=https://www.niehs.nih.gov/health/topics/agents/endocrine |access-date=2024-02-10 |website=National Institute of Environmental Health Sciences |language=en}} Endocrine disruptors are classified as estrogenic, anti-estrogenic, androgenic or anti-androgenic. Each category includes pharmaceutical compounds and environmental compounds. Estrogenic or androgenic compounds will cause the same hormonal responses as the sex steroids (estrogen and testosterone). However anti-estrogenic and anti-andogenic compounds bind to a receptor and block the hormones from binding to their receptors, thus preventing their function. A few examples of the many types of endocrine disruptors are trenbolone (androgenic), flutamide (anti-androgenic), diethylstilbestrol (estrogenic), bisphenol A (estrogenic) and tributyltin (anti-estrogenic).[http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2004:152:0001:0311:EN:PDF Commission Directive 2004/73/EC of 29 August 2004 adapting to technical progress for the 29th time Council Directive 67/548/EEC on the approximation of the laws, regulations and administrative provisions relating to the classification, packaging and labelling of dangerous substances.] OJEC L152, 30.04.2004, pp. 1–311 (index no. 082-001-00-6).[http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2008:353:0001:1355:EN:PDF Regulation (EC) No 1272/2008 of the European Parliament and of the Council of 16 December 2008 on classification, labelling and packaging of substances and mixtures, amending and repealing Directives 67/548/EEC and 1999/45/EC, and amending Regulation (EC) No 1907/2006.] OJEC L353, 31.12.2008, pp. 1–1355 at p. 444 (index no. 082-001-00-6).

However, many substances which are toxic for reproduction do not fall into any of these groups: lead compounds, for example, are considered to be toxic for reproduction given their adverse effects on the normal intellectual and psychomotor development of human babies and children.

{{for|list of drugs that may cause abnormalities of physiological development in organisms during their life|Teratology#Drugs}}

File:A piece of lead.jpg

Lead, a heavy metal that can exist in both organic and inorganic forms, and is associated with adverse effects on male libido, erectile disfunction, premature ejaculation and poor sperm quality.{{Cite book| vauthors = LaDou J |title=Current Diagnosis and Treatment: Occupational Mediccine|publisher=McGraw Hill Medical|year=2014|isbn=978-1-259-25145-0|location=United States|pages=455–459 |language=English}} Lead is also associated with negative effects on the female reproductive system particularly for pregnant people.{{Cite web |date=2023-05-01 |title=Lead & Other Heavy Metals - Reproductive Health {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/repro/heavymetals.html |access-date=2024-02-17 |website=www.cdc.gov |language=en-us}} Elevated blood lead levels can increase risk of preeclampsia and miscarriage and can lead to birth defects.{{Cite journal |last1=Zhong |first1=Zixing |last2=Yang |first2=Qingmei |last3=Li |first3=Chu |last4=Chen |first4=Xiaohong |last5=Zhou |first5=Feifei |date=2022-12-23 |title=A global perspective of correlation between maternal blood lead levels and risks of preeclampsia: An updated systematic review and meta-analysis |journal=Frontiers in Public Health |volume=10 |doi=10.3389/fpubh.2022.1072052 |doi-access=free |pmid=36620238 |pmc=9816335 |issn=2296-2565}}{{Cite journal |last1=Kaur |first1=Mandeep |last2=Sharma |first2=Priya |last3=Kaur |first3=Rajinder |last4=Khetarpal |first4=Preeti |date=2022-01-02 |title=Increased incidence of spontaneous abortions on exposure to cadmium and lead: a systematic review and meta-analysis |url=https://www.tandfonline.com/doi/full/10.1080/09513590.2021.1942450 |journal=Gynecological Endocrinology |language=en |volume=38 |issue=1 |pages=16–21 |doi=10.1080/09513590.2021.1942450 |pmid=34169802 |s2cid=235634230 |issn=0951-3590|url-access=subscription }} Lead is believed to predominantly affect male reproduction by the disruption of hormones, which reduces the quantity of sperm production in the seminiferous tubules. It has also been proposed that lead causes poor semen quality by promoting the generation of reactive oxygen species such as hydrogen peroxide due to lipid peroxidation, which can cause cellular damage.{{cite journal | vauthors = Vigeh M, Smith DR, Hsu PC | title = How does lead induce male infertility? | journal = Iranian Journal of Reproductive Medicine | volume = 9 | issue = 1 | pages = 1–8 | date = 2011 | pmid = 25356074 | pmc = 4212138 | doi = | url = }}{{cite journal | vauthors = Dorostghoal M, Seyyednejad SM, Jabari A | title = Protective effects of Fumaria parviflora L. on lead-induced testicular toxicity in male rats | journal = Andrologia | volume = 46 | issue = 4 | pages = 437–46 | date = May 2014 | pmid = 23611729 | doi = 10.1111/and.12100 | s2cid = 24028551 | doi-access = free }} Lead can be found in contaminated soil, water, as well as manufactured goods like jewelry, toys, and paint.{{Cite web |date=2023-05-25 |title=Lead (Pb) Toxicity: What Are Routes of Exposure to Lead? {{!}} Environmental Medicine {{!}} ATSDR |url=https://www.atsdr.cdc.gov/csem/leadtoxicity/exposure_routes.html |access-date=2024-02-17 |website=www.atsdr.cdc.gov |language=en-us}} Common routes of exposure are inhalation and digestion, though dermal exposure can occur albeit less frequently. Occupational exposures remain a high risk, particularly for industries such as battery/electronic recycling, construction, mining, smelting, and welders or any other industry which interacts with lead. Families and cohabitants of the above workers may be at risk of take-home exposure and may need to take precautions to avoid reproductive impacts.{{Cite web |date=2023-05-01 |title=Take-Home Exposures - Reproductive Health {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/repro/takehome.html |access-date=2024-02-17 |website=www.cdc.gov |language=en-us}}

File:Cadmium-crystal bar.jpg

Cadmium is a heavy metal used in jewelry making, electronics, welding and galvanizing steel.{{cite journal | vauthors = Bernhoft RA | title = Cadmium toxicity and treatment | journal = TheScientificWorldJournal | volume = 2013 | pages = 394652 | date = 2013 | pmid = 23844395 | pmc = 3686085 | doi = 10.1155/2013/394652 | doi-access = free }} The human route of exposure is primarily inhalational or oral; environmental exposure among the non-occupationally exposed can occur due to exposure to cigarette smoking. The oral route of exposure can occur due to ingesting plants and shellfish that have taken up cadmium from water and soil. Exposure to cadmium results in adverse male fertility in terms of decreased spermatogenesis, semen quality, sperm motility and impaired hormonal synthesis.{{cite journal | vauthors = Kumar S, Sharma A | title = Cadmium toxicity: effects on human reproduction and fertility | journal = Reviews on Environmental Health | volume = 34 | issue = 4 | pages = 327–338 | date = December 2019 | pmid = 31129655 | doi = 10.1515/reveh-2019-0016 | s2cid = 167205593 }} Likewise, exposure to cadmium impairs female fertility in terms of menstrual cycle regularity and reproductive hormonal balance. Cadmium exposure can negatively impact fetal development throughout the gestation as well as ovulation and implantation.{{Cite journal |last1=Thompson |first1=J |last2=Bannigan |first2=J |date=April 2008 |title=Cadmium: Toxic effects on the reproductive system and the embryo |url=https://linkinghub.elsevier.com/retrieve/pii/S0890623808000166 |journal=Reproductive Toxicology |language=en |volume=25 |issue=3 |pages=304–315 |doi=10.1016/j.reprotox.2008.02.001|pmid=18367374 |url-access=subscription }}

Hexavalent chromium ( Cr VI) is used in the electronics industry and for metal plating.{{cite journal | vauthors = Pereira SC, Oliveira PF, Oliveira SR, Pereira ML, Alves MG | title = Impact of Environmental and Lifestyle Use of Chromium on Male Fertility: Focus on Antioxidant Activity and Oxidative Stress | journal = Antioxidants | volume = 10 | issue = 9 | pages = 1365 | date = August 2021 | pmid = 34572997 | pmc = 8468676 | doi = 10.3390/antiox10091365 | doi-access = free }} Chromium exposure is primarily inhalation or through ingestion.{{cite journal | vauthors = Costa M, Klein CB | title = Toxicity and carcinogenicity of chromium compounds in humans | journal = Critical Reviews in Toxicology | volume = 36 | issue = 2 | pages = 155–163 | date = February 2006 | pmid = 16736941 | doi = 10.1080/10408440500534032 | s2cid = 85928480 }} Human and animal studies show that exposure to hexavalent chromium decreases semen quality and sperm counts.{{cite journal | vauthors = Li H, Chen Q, Li S, Yao W, Li L, Shi X, Wang L, Castranova V, Vallyathan V, Ernst E, Chen C | title = Effect of Cr(VI) exposure on sperm quality: human and animal studies | journal = The Annals of Occupational Hygiene | volume = 45 | issue = 7 | pages = 505–511 | date = October 2001 | doi = 10.1016/S0003-4878(01)00004-7 | pmid = 11583652 | url = https://pubmed.ncbi.nlm.nih.gov/11583652/ }}

Elemental mercury( Hg⁰) is a metal that exists as liquid form at room temperature and is commonly found in thermometers, blood pressure cuffs and dental amalgams. In terms of exposure, the route of absorption is primarily via inhalation through mercury vapor, which can in turn lead to mercury poisoning.{{cite journal |vauthors=Davis BJ, Price HC, O'Connor RW, Fernando R, Rowland AS, Morgan DL |date=February 2001 |title=Mercury vapor and female reproductive toxicity |journal=Toxicological Sciences |volume=59 |issue=2 |pages=291–296 |doi=10.1093/toxsci/59.2.291 |pmid=11158722}} Occupational exposure to inorganic mercury can occur in industries such as dentistry, fluorescent lamp production, and Chloralkali workers.{{Cite journal |last1=Bjørklund |first1=Geir |last2=Chirumbolo |first2=Salvatore |last3=Dadar |first3=Maryam |last4=Pivina |first4=Lyudmila |last5=Lindh |first5=Ulf |last6=Butnariu |first6=Monica |last7=Aaseth |first7=Jan |date=October 2019 |title=Mercury exposure and its effects on fertility and pregnancy outcome |url=https://onlinelibrary.wiley.com/doi/10.1111/bcpt.13264 |journal=Basic & Clinical Pharmacology & Toxicology |language=en |volume=125 |issue=4 |pages=317–327 |doi=10.1111/bcpt.13264 |pmid=31136080 |issn=1742-7835|hdl=11250/2648768 |hdl-access=free }} Data among female dental technicians exposed to mercury vapors have demonstrated decreased fertility among those who were exposed and practiced poor industrial hygiene while handling dental amalgams.{{cite journal | vauthors = Schuurs AH | title = Reproductive toxicity of occupational mercury. A review of the literature | journal = Journal of Dentistry | volume = 27 | issue = 4 | pages = 249–256 | date = May 1999 | pmid = 10193101 | doi = 10.1016/S0300-5712(97)00039-0 }} Elemental and organic mercury can cross the blood brain barrier, like many other heavy metals, making it particularly significant for pregnant people as it can impact fetal development and birth outcomes. Among female workers in mercury smelting plants an increase in spontaneous abortions has been reported.

File:Chromium(Cr).JPG

Dibromochloropropane (DBCP) is used as a pesticide against nematodes in the agricultural industry.{{cite journal | vauthors = Babich H, Davis DL, Stotzky G | title = Dibromochloropropane (DBCP): a review | journal = The Science of the Total Environment | volume = 17 | issue = 3 | pages = 207–221 | date = March 1981 | pmid = 7015501 | doi = 10.1016/0048-9697(81)90062-0 | bibcode = 1981ScTEn..17..207B }} DBCP is one of the most well-known reproductive toxicants known to cause testicular toxicity. Workers in chemical factories exposed to dibromochloropropane have been shown to develop dose-dependent oligospermia and azoospermia. Additional studies also demonstrated that DBCP-exposed workers in banana and pineapple plantations in central America and other countries also developed oligospermia and azoospermia.{{Cite journal | vauthors = Marinaro J |title=Environmental Toxins and Men's Health: Dibromochloropropane |journal=Effects of Lifestyle on Men's Health |via=Science Direct}} In 1977, the United States Environmental Protection Agency banned the use of DBCP in agriculture due to its effect on male fertility.{{Cite book | vauthors = Naistat DM |title=Encyclopedia of Toxicology |publisher=Science Direct |year=2014|edition=Third }} Despite being banned from use in agriculture, DBCP is still used as an intermediate in chemical manufacturing as well as a reagent in research.

Ethylene dibromide

Ethylene dibromide (EDB) is a fumigant that was originally used to protect citrus fruits, grains and vegetables from insects.{{Cite web |title=Ethylene Dibromide (Dibromoethane) Hazard Summary |url=https://www.epa.gov/sites/default/files/2016-09/documents/ethylene-dibromide.pdf |access-date=March 31, 2022 |website=EPA.gov}} Use of EDB in the United States was banned by the United States Environmental Protection Agency in 1984, however EDB is still used in the United States as fumigant to treat timber logs for beetles and termites. Likewise, it is still used as an intermediate in chemical manufacturing. Exposure to EDB has been shown to adversely affect male fertility by leading to a decreased sperm counts, decreased numbers of viable sperm and increased abnormal sperm morphology.{{Cite journal |last=Schrader |first=Steven M. |title=Man and the workplace |journal=Chemical Health & Safety |year=2003 |volume=10 |issue=5 |pages=11–16 |doi=10.1016/s1074-9098(03)00089-3 }}{{cite journal |last1=Ratcliffe |first1=J. M. |last2=Schrader |first2=S. M. |last3=Steenland |first3=K. |last4=Clapp |first4=D. E. |last5=Turner |first5=T. |last6=Hornung |first6=R. W. |title=Semen quality in papaya workers with long term exposure to ethylene dibromide |journal=Occupational and Environmental Medicine |date=1 May 1987 |volume=44 |issue=5 |pages=317–326 |id={{ProQuest|1771266376}} |doi=10.1136/oem.44.5.317 |pmid=3297130 |pmc=1007829 }} The primary route of exposure is through inhalation.

Solvent exposure is common among men and women working in industrial settings. Specific solvents including xylene, perchloroethylene, toluene and methylene chloride have been shown to be associated with a concurrent elevation in risk for spontaneous abortion {{Cite book | vauthors = Janssen S |title=CURRENT Diagnosis & Treatment: Occupational & Environmental Medicine | edition = 6th |publisher=McGraw Hill |year=2021}}

Ionizing radiation in the form alpha, beta and gamma emissions are well known to adversely affect male and female fertility, as well as fetal development.{{Cite web |date=2023-05-01 |title=Radiation - Ionizing - Reproductive Health {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/repro/ionizingradiation.html |access-date=2024-04-11 |website=www.cdc.gov |language=en-us}}{{cite journal |vauthors=Kesari KK, Agarwal A, Henkel R |date=December 2018 |title=Radiations and male fertility |journal=Reproductive Biology and Endocrinology |volume=16 |issue=1 |pages=118 |doi=10.1186/s12958-018-0431-1 |pmc=6240172 |pmid=30445985 |doi-access=free}} Exposure to low doses of ionizing radiation can occur naturally in the environment or due to medical treatment or diagnosis, however, higher exposures may be associated with occupation. Occupations with documented risk include: healthcare workers who interact with radioactive material, certain manufacturing processes, and airline personnel. Exposure in the range of 0.1 to1.2 Gy is associated with spermatogonial injury; whereas between 4-6 Gy reductions of sperm counts have been reported. Ionizing radiation is considered a hazard particularly in pregnancy, due to its potential impact of gestational development. More specifically, ionizing radiation is associated with an increased risk of miscarriage and stillbirth.{{Cite journal |last1=Frangione |first1=Brianna |last2=Hinton |first2=Patrick |last3=Villeneuve |first3=Paul J. |date=January 2023 |title=Low-dose ionizing radiation and adverse birth outcomes: a systematic review and meta-analysis |journal=International Archives of Occupational and Environmental Health |language=en |volume=96 |issue=1 |pages=77–92 |doi=10.1007/s00420-022-01911-2 |issn=0340-0131 |pmc=9823032 |pmid=35913560|bibcode=2023IAOEH..96...77F }} Recent studies suggest that routine medical examinations that expose a pregnant person to ionizing radiation are not associated with an increase of risk of miscarriage or stillbirth.{{Cite journal |last=Lowe |first=Sandra A. |date=August 2020 |title=Ionizing radiation for maternal medical indications |url=https://pubmed.ncbi.nlm.nih.gov/31697844/ |journal=Prenatal Diagnosis |volume=40 |issue=9 |pages=1150–1155 |doi=10.1002/pd.5592 |issn=1097-0223 |pmid=31697844}}

Radio frequency electromagnetic fields, such as those generated from mobile phone devices, have been shown to decrease semen quality production in experimental animal models; however human data is still equivocal at best.{{cite journal | vauthors = Kesari KK, Kumar S, Nirala J, Siddiqui MH, Behari J | title = Biophysical evaluation of radiofrequency electromagnetic field effects on male reproductive pattern | journal = Cell Biochemistry and Biophysics | volume = 65 | issue = 2 | pages = 85–96 | date = March 2013 | pmid = 22926544 | doi = 10.1007/s12013-012-9414-6 | s2cid = 1710686 }}{{cite journal | vauthors = Liu K, Li Y, Zhang G, Liu J, Cao J, Ao L, Zhang S | title = Association between mobile phone use and semen quality: a systemic review and meta-analysis | journal = Andrology | volume = 2 | issue = 4 | pages = 491–501 | date = July 2014 | pmid = 24700791 | doi = 10.1111/j.2047-2927.2014.00205.x | s2cid = 8711367 | doi-access = free }} The International Association for the Research of Cancer(IARC) classifies radio frequency electromagnetic fields as a group 2B or possibly carcinogenic.{{Cite web | title = Iarc Classifies Radiofrequency Electromagnetic Fields as Possibly Carcinogenic to Humans |date=31 May 2011 | work = International Agency for the Research in Cancer, World Health Organization |url=https://www.iarc.who.int/wp-content/uploads/2018/07/pr208_E.pdf }}

Lipid soluble compounds that can cross the cell lipid bilayer and bind cytoplasmic steroid hormone receptors can translocate to the nucleus and act as estrogen agonists.{{cite journal | vauthors = Sharara FI, Seifer DB, Flaws JA | title = Environmental toxicants and female reproduction | journal = Fertility and Sterility | volume = 70 | issue = 4 | pages = 613–22 | date = October 1998 | pmid = 9797086 | doi = 10.1016/s0015-0282(98)00253-2 | doi-access = free }} Diethylstilbestrol (DES), a synthetic estrogen, is one such endocrine disruptor and acts as an estrogen agonist. Diethylstilbestrol was used from 1938 to 1971 to prevent spontaneous abortions. Diethylstilbestrol causes cancer and mutations by producing highly reactive metabolites, also causing DNA adducts to form. Exposure to diethylstilbestrol in the womb can cause atypical reproductive tract formation. Specifically, females exposed to diethylstilbestrol in utero during the first trimester have are more likely to develop clear cell vaginal carcinoma, and males have an increased risk of hypospadias.{{cite journal | vauthors = Klip H, Verloop J, van Gool JD, Koster ME, Burger CW, van Leeuwen FE | title = Hypospadias in sons of women exposed to diethylstilbestrol in utero: a cohort study | journal = Lancet | location = London, England | volume = 359 | issue = 9312 | pages = 1102–7 | date = March 2002 | pmid = 11943257 | doi = 10.1016/S0140-6736(02)08152-7 | s2cid = 45769124 }}

File:Bisphenol A.svg

Bisphenol A (BPA) is used in polycarbonate plastic consumer goods and aluminum can liners.{{cite journal | vauthors = Peretz J, Vrooman L, Ricke WA, Hunt PA, Ehrlich S, Hauser R, Padmanabhan V, Taylor HS, Swan SH, VandeVoort CA, Flaws JA | title = Bisphenol a and reproductive health: update of experimental and human evidence, 2007-2013 | journal = Environmental Health Perspectives | volume = 122 | issue = 8 | pages = 775–786 | date = August 2014 | pmid = 24896072 | pmc = 4123031 | doi = 10.1289/ehp.1307728 }} BPA is an example of an endocrine disruptor which negatively affects reproductive development by acting as an estrogen mimicker (xenoestrogen) and a likely androgen mimicker.{{cite journal | vauthors = Richter CA, Birnbaum LS, Farabollini F, Newbold RR, Rubin BS, Talsness CE, Vandenbergh JG, Walser-Kuntz DR, vom Saal FS | title = In vivo effects of bisphenol A in laboratory rodent studies | journal = Reproductive Toxicology | year = 2007 | volume = 24 | issue = 2 | pages = 199–224 | pmid = 17683900 | doi = 10.1016/j.reprotox.2007.06.004 | pmc = 2151845 }} Bisphenol A exposure in fetal female rats leads to mammary gland morphogenesis, increased formation of ovarian tumors, and increased risk of developing mammary gland neoplasia in adult life. In lab animal models, BPA is considered to be both an ovarian and uterine toxicant as it impairs endometrial proliferation, decreases uterine receptivity and decreases the chances for successful implantation of the embryo {{cite journal | vauthors = Rochester JR | title = Bisphenol A and human health: a review of the literature | journal = Reproductive Toxicology | volume = 42 | issue = | pages = 132–155 | date = December 2013 | pmid = 23994667 | doi = 10.1016/j.reprotox.2013.08.008 }} The adverse reproductive toxicological impacts of bisphenol A have been better studied in females than in males.{{cite journal | vauthors = Jones BA, Wagner LS, Watson NV | title = The Effects of Bisphenol A Exposure at Different Developmental Time Points in an Androgen-Sensitive Neuromuscular System in Male Rats | journal = Endocrinology | volume = 157 | issue = 8 | pages = 2972–2977 | date = August 2016 | pmid = 27022676 | doi = 10.1210/en.2015-1574 | doi-access = free }}{{cite journal | vauthors = Soto AM, Sonnenschein C | title = Environmental causes of cancer: endocrine disruptors as carcinogens | journal = Nature Reviews. Endocrinology | volume = 6 | issue = 7 | pages = 363–370 | date = July 2010 | pmid = 20498677 | pmc = 3933258 | doi = 10.1038/nrendo.2010.87 }}

Antineoplastic drugs, commonly known as chemotherapy drugs, are considered hazardous drugs by the CDC, including hazardous to reproductive health.{{Cite report |url=https://www.cdc.gov/niosh/docs/2016-161/ |title=NIOSH list of antineoplastic and other hazardous drugs in healthcare settings, 2016. (Supersedes 2014-138). |date=2016-09-01 |publisher=U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health |doi=10.26616/nioshpub2016161 |language=en|url-access=subscription }} Exposure to chemotherapy drugs most often occurs through treatment for cancer, however, unintentional occupational exposure may occur in for workers involved in pharmaceutical production, pharmacists or technicians preparing the drugs, and nurses or other healthcare professionals who are administering medication to patients.{{Cite web |date=2020-02-20 |title=Antineoplastic Agents: Hazardous Drug Exposures in Healthcare {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/hazdrug/antineoplastic.html |access-date=2024-03-07 |website=www.cdc.gov |language=en-us}} Other hospital staff, particularly custodial workers, who interact or handle antineoplastic drugs in any capacity may also be at risk of exposure. Exposure can occur through inhalation, skin contact, ingestion, or injection.

Work schedule can become a reproductive toxicant when working hours are during the employee's typical sleeping hours (night shift), when a worker has an irregular work schedule (shift work) or long working hours.{{Cite web |date=2023-05-01 |title=Work Schedule - Reproductive Health {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/repro/workschedule.html |access-date=2024-03-28 |website=www.cdc.gov |language=en-us}} Work schedule's reproductive toxicity is primarily a result of impact on regularity, quality, and rhythm of sleep. Shift work is associated with menstrual disorders, which can in turn impact fertility.{{Cite journal |last1=Hu |first1=Fengying |last2=Wu |first2=Cuiyun |last3=Jia |first3=Yunfei |last4=Zhen |first4=Hualong |last5=Cheng |first5=Hengshun |last6=Zhang |first6=Fan |last7=Wang |first7=Liuqing |last8=Jiang |first8=Minmin |date=December 2023 |title=Shift work and menstruation: A meta-analysis study |journal=SSM - Population Health |language=en |volume=24 |pages=101542 |doi=10.1016/j.ssmph.2023.101542 |pmc=10632107 |pmid=37954014}} Irregular work schedule, working long hours, and working the night shift is associated with an increased risk of miscarriage and pre-term birth. Many occupations engage in shift work, including requiring rotating work schedules, long hours, or night shift work. Some occupations that frequently engage in shift work include first responders, airline personnel, healthcare workers, and service workers. The CDC estimates that fifteen-million Americans engage in shift work and 30% get less than six-hours of sleep.

Physical demands can include bending, lifting, and standing. Physical demands are considered a reproductive toxicant as they can increase the risk of adverse outcomes during pregnancy.{{Cite web |date=2023-05-01 |title=Physical Demands (lifting, standing, bending) - Reproductive Health {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/repro/physicaldemands.html |access-date=2024-04-11 |website=www.cdc.gov |language=en-us}} Bending, lifting, and standing are often associated with occupational responsibilities as the risk is minimal unless physical activity is prolonged. Standing and walking for more than three hours a day is associated with an increased risk of pre-term birth, while standing for six to eight hours a day is associated with an increased risk of miscarriage.{{Cite journal |last1=van Beukering |first1=M. D. M. |last2=van Melick |first2=M. J. G. J. |last3=Mol |first3=B. W. |last4=Frings-Dresen |first4=M. H. W. |last5=Hulshof |first5=C. T. J. |date=November 2014 |title=Physically demanding work and preterm delivery: a systematic review and meta-analysis |url=http://link.springer.com/10.1007/s00420-013-0924-3 |journal=International Archives of Occupational and Environmental Health |language=en |volume=87 |issue=8 |pages=809–834 |doi=10.1007/s00420-013-0924-3 |pmid=24390632 |bibcode=2014IAOEH..87..809V |issn=0340-0131|url-access=subscription }}{{Cite journal |last1=Bonde |first1=Jens Peter |last2=Jørgensen |first2=Kristian Tore |last3=Bonzini |first3=Matteo |last4=Palmer |first4=Keith T |date=July 2013 |title=Miscarriage and occupational activity: a systematic review and meta-analysis regarding shift work, working hours, lifting, standing, and physical workload |url=http://www.sjweh.fi/show_abstract.php?abstract_id=3337 |journal=Scandinavian Journal of Work, Environment & Health |language=en |volume=39 |issue=4 |pages=325–334 |doi=10.5271/sjweh.3337 |issn=0355-3140 |pmc=3699369 |pmid=23235838}} The weight and frequency of lifting is also associated with increased risk of miscarriage and preterm birth, with estimates of loads over 10 kg, or frequency a cumulative 100 kg/day.{{Cite journal |last=Croteau |first=Agathe |date=July 2020 |title=Occupational lifting and adverse pregnancy outcome: a systematic review and meta-analysis |url=https://oem.bmj.com/lookup/doi/10.1136/oemed-2019-106334 |journal=Occupational and Environmental Medicine |language=en |volume=77 |issue=7 |pages=496–505 |doi=10.1136/oemed-2019-106334 |pmid=32184210 |issn=1351-0711|url-access=subscription }}

Noise is considered a reproductive toxicant due to its potential impact on fetal development during pregnancy. While pregnant people may be able to use proper hearing protection to conserve their own hearing, after the 20th week of development babies' ears are susceptible to hearing loss.{{Cite web |date=2023-05-01 |title=Noise - Reproductive Health {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/repro/noise.html |access-date=2024-04-11 |website=www.cdc.gov |language=en-us}} Pregnant people who are past 20 weeks of development should consider avoiding noises above 85 decibels, including at work and recreational activities.

• Developmental toxicity
• CLP regulation
• Lead toxicity
• Mercury poisoning

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• {{cite book | vauthors = Scott AJ, LaDou J |chapter=Biological Rhythms, Shiftwork, and Occupational Health|date=2001-04-16 | title = Patty's Toxicology|place=Hoboken, NJ, USA |publisher=John Wiley & Sons, Inc. |doi=10.1002/0471435139.tox107 |isbn=978-0-471-12547-1 }}

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Category:Chemical safety

Category:Developmental biology

Category:Occupational safety and health