Exposure to toxic environmental chemicals occurs every day, to everyone, everywhere across America. Due to deficiencies in the current regulatory regime, toxic chemicals are in the food we eat, the water we drink, the air we breathe, and the products in our homes. As obstetricians, we know that preconception and prenatal exposure to toxic chemicals is antithetical to healthy pregnancies, healthy children and healthy future generations.
Now, as the U.S. House and Senate take up needed reforms to the Toxic Substances Control Act, which governs the use of toxic chemicals in commerce, we urge lawmakers to consider evidence of the negative health impacts of toxic substances on the public, and produce a strong law that will effectively protect pregnant women, children and other vulnerable populations from these harms.
Studies have documented that dozens of toxic chemicals are found in virtually every pregnant woman in the United States. Robust scientific evidence demonstrates that preconception and prenatal exposure to toxic chemicals can have a profound and lasting impact on health across a patient’s life, including increased risk of cancer in childhood and impairment of reproductive health development in adulthood, such as infertility. We still lack adequate safety data for most of the chemicals currently in commerce. Quite simply, we don’t know what we don’t know about all of the environmental chemicals that are in the bodies of pregnant women and children.
The Toxic Substances Control Act, unchanged since its passage in 1976, could do much more to protect the public — especially pregnant women and children– from unsafe chemical exposures. U.S. and global chemical production has risen steadily, with a more-than-15-fold increase between 1947 and 2007. A reformed Toxic Substances Control Act can give us a greater understanding of the risks posed by toxic chemicals in our environment, and better equip us to inform and care for our patients.
Right now, unlike pharmaceuticals, most chemicals on the marketplace lack detailed data on whether they pose health threats to pregnant women and children. We don’t know where most harmful chemicals are used, how we are exposed to them, or what the health risks from exposure might be.
The potential impact of exposure to toxic chemicals in our daily lives concerns us all, and is especially alarming for pregnant women and children. Harmful chemicals can cross the placenta, and some – such as methyl mercury – can accumulate in the fetus, resulting in higher fetal than maternal exposure. This means that the fetus could be even more intensely exposed, and harmed, by the chemical exposure. No parent wants this for their child.
One of the most important changes that Congress can make is to shift the burden of proof about a chemical’s safety or toxicity to the manufacturers before a chemical can be released into the environment. This is the same burden shouldered by America’s pharmaceutical companies.
The bill must also specifically protect vulnerable and underserved populations, including pregnant women, infants, and children, from aggregate exposure to harmful chemicals, and it must adopt a safety standard based on health considerations only. Reform will be meaningless without firm deadlines and timetables to ensure implementation.
Since the mid-1970s, dozens of major U.S. environmental policies have advanced the ways in which we control, manage, and mitigate the threat of chemicals in our air, our water, and our land. Many of these policies have had dramatic, positive impacts on our environment and, consequently, on our health.
Reform of the Toxic Substances Chemicals Act is 38 years overdue. We are encouraged that discussions are being held, and urge members of Congress to ensure enactment of a bill that will protect the women and children in their lives – both in their own families and their constituents’ – and to remember the harm that exposure to toxic chemicals can wreak on American generations to come.
By Jeanne A. Conry, MD, PhD, president of the American Congress of Obstetricians, and Linda C. Giudice, MD, PhD, past president of the American Society for Reproductive Medicine.