To conduct a literature review of racial/ethnic disparities in environmental chemicals and the effects on women’s health outcomes in the U.S., we searched all English articles in PubMed and EMBASE from the inception of all databases to Jan 15, 2016. We pre-specified four major EDCs (phthalates, BPA, parabens and PBDEs) and specific women’s reproductive health outcomes (i.e. puberty, fibroids, pregnancy, and pregnancy complications). In article searching for chemical exposures from Pubmed, we combined the Medical Subject Headings (MeSH) terms and key words as follows: “phthalic acids,” “bisphenol A-glycidyl methacrylate,” “parabens,” or “halogenated diphenyl ethers,” as MeSH terms, and phthalic acid, phthalate, bisphenol A, methylparaben, butylparaben, propylparaben, polybrominated diphenyl ether, and organobromine compound as specific key words in texts.
For women’s health outcomes, the MeSH terms included “puberty,” “puberty, delayed,” “puberty, precocious,” “pregnancy,” “infertility, female,” “ovarian reserve,” “ovarian follicle,” “pregnancy complications,” “premature birth,” and “leiomyoma,” key words included menarche, thelarche, breast development, antral follicle count, preeclampsia, gestational diabetes and preterm.
Similarly, in our EMBASE search for chemical exposure, we combined Emtree terms and key words as follows: “phthalic acid derivative,” “phthalate,” “4,4 isopropylidenediphenol,” “4 hydroxybenzoic acid ester,” “propyl paraben,” “methyl paraben,” “ethyl paraben,” “butyl paraben,” “benzyl paraben,” and “polybrominated diphenyl ether” searched as Emtree terms; phthalate, BPA, paraben, polybrominated diphenyl ethers, and PBDE as key words in text.
For women’s health outcomes, we used all the Emtree terms including “puberty,” “delayed puberty,” “precocious puberty,” “adrenarche,” “breast development,” “pregnancy diabetes mellitus,” “preeclampsia,” “premature labor,” “pregnancy complication,” “pregnancy rate,” “uterus myoma,” and “leiomyoma. After excluding in vitro studies, animal studies, studies conducted outside of the U.S., as well as studies that did not assess the outcomes of interests, the searching strategies yielded a total of 612 articles in Pubmed and EMBASE.
We reviewed these articles and identified 46 discrete studies examining the association between environmental EDCs and women’s reproductive health outcomes among women living in the U.S. We also documented whether race-specific measures of association were reported in the main findings.
James-Todd T.M., Chiu Y.H, & Zota A.R. (2016). Racial/ethnic disparities in environmental endocrine disrupting chemicals and women’s reproductive health outcomes: epidemiological examples across the life course. Current epidemiology reports, 3(2), 161-180.