Impact of air pollution on reproductive health.

Airpollution may have an impact on adverse reproductive outcomes in bothfemales and males. It has long been known that air pollution can affect human health. Dockery et al. (1) and Schwartz (2) reported that increasing concentrations of pollutants are responsible for the significant increase of daily mortality. Respirable particulate matter is considered to be responsible for this increase. This association has been repeatedly observed in the United States (1,2), Europe (3), Brazil (4), and China (5). The results sparked discussions on new standards for levels of particulate matter < 10 Pm (PM O), as well as proposals to measure, separately, respirable particles < 2.5 pm (PM2.5) Similar data were observed on the effect of air pollution on neonatal and postneonatal mortality (6,7). These data raise questions about whether pollution influences birth weight or other pregnancy outcomes. The list of end points in reproductive toxicology has expanded in recent years to include many functional birth defects. In 1987, Generoso et al. (8) postulated that the mutagen ethylene oxide increased the incidence of developmental abnormalities and death of mouse fetuses when early zygotic stages were exposed to the mutagen. Later, Rutledge (9) was able to induce fetal abnormalities by other mutagens. These results contradict the perception of experimental tera-tology that most induced embryonic damage resulting in adverse developmental consequences originates from treatment during organogenesis and that earlier exposure of the conceptus produces death rather than persistent developmental consequences. If the hypothesis is correct that air pollutants can similarly affect fetal development in humans, inducing not only infant mortality and birth defects but also developmental abnormalities such as functional defects, an appropriate test area would be a highly polluted environment such as the Black Triangle, which includes the Czech Republic, the former East Germany, and Poland. This region is one of the largest sources of pollution in Europe, resulting from the combustion of brown coal in power plants and heavy industrialization. There have only been a few reports on the potential association of pregnancy outcome with air pollution. Bobak and Leon (6) reported an association of total suspended particulate (TSP) and SO2 with neonatal and postneonatal mortality in the Czech Republic. Woodruff et al. (7) found that early postneonatal mortality was associated with the PMIO level for selected causes of death in the United States. Wang et al. (10) reported an increasing exposure-response relationship between SO2 and TSP levels and low birth weight …