Environmental and occupational exposure to bisphenol A and endometriosis: urinary and peritoneal fluid concentration levels

ObjectivesThe study aimed to give a first data set of bisphenol A (BPA) levels in the peritoneal fluid of patients suffering from endometriosis and to investigate the relationship between BPA exposure and endometriosis.MethodsA questionnaire investigating the occupational context, life environment, and habits was administered to 68 patients suffering from endometriosis and 60 endometriosis-free subjects (control group). Urine and peritoneal fluids samples were collected and analysed by GC/MSMS for BPA dosage.ResultsSome of the investigated environmental/lifestyle risk factors (closeness to industries/activities at risk) were associated with an increase in endometriosis; smoking resulted as protective factor; others (use of food plastic boxes) did not seem to influence the onset of pathology. The association between the occupational exposure summarising all examined risk factors (working activity, personal protective equipment, seniority) and endometriosis was statistically significant (χ2 = 5.252, p = 0.02). Contrasting results were obtained when specific activities were examined. Detectable urinary BPA levels were found in all analysed samples (patients: 1.17–12.68 pg/µl; mean ± SD, 5.31 ± 3.36 pg/µl; control group: 1.28–2.35 pg/µl; mean ± SD, 1.64 ± 0.49 pg/µl; median; 1.46 pg/µl), with a statistically significant difference between patients and controls, showing an association between BPA exposure and endometriosis. Only a few subjects from the control group supplied peritoneal fluid; hence, no comparison test with patients (range 0.39–1.46 pg/µl; mean ± SD, 0.67 ± 0.30 pg/µl; median, 0.58 pg/µl) was carried out.ConclusionsResults highlight the potential association between BPA exposure and endometriosis, as well as the current lack of knowledge regarding occupational exposure to BPA and the need of epidemiological studies focused on single activities/occupations, such as housewives, cleaners, students.

[1]  W. L. Roux,et al.  Health risk implications from simultaneous exposure to multiple environmental contaminants. , 2013, Ecotoxicology and environmental safety.

[2]  K. Osteen,et al.  Immune interactions in endometriosis , 2011, Expert review of clinical immunology.

[3]  G. Ying,et al.  4-Nonylphenol, bisphenol-A and triclosan levels in human urine of children and students in China, and the effects of drinking these bottled materials on the levels. , 2013, Environment international.

[4]  Åke Bergman,et al.  State of the Science of Endocrine Disrupting Chemicals - 2012 , 2012 .

[5]  T. K. Jensen,et al.  Human urinary excretion of non-persistent environmental chemicals: an overview of Danish data collected between 2006 and 2012. , 2014, Reproduction.

[6]  M. Vrijheid,et al.  A job-exposure matrix for potential endocrine-disrupting chemicals developed for a study into the association between maternal occupational exposure and hypospadias. , 2002, The Annals of occupational hygiene.

[7]  M. Quinn,et al.  Occupational exposure to estrogenic chemicals and the occurrence of breast cancer: an exploratory analysis. , 1998, American journal of industrial medicine.

[8]  L. Cobellis,et al.  Measurement of bisphenol A and bisphenol B levels in human blood sera from healthy and endometriotic women. , 2009, Biomedical chromatography : BMC.

[9]  Cheryl S Watson,et al.  In vitro molecular mechanisms of bisphenol A action. , 2007, Reproductive toxicology.

[10]  A. Aris,et al.  Estimation of bisphenol A (BPA) concentrations in pregnant women, fetuses and nonpregnant women in Eastern Townships of Canada. , 2014, Reproductive toxicology.

[11]  Richard David Evans,et al.  State of the art assessment of endocrine disruptors: Final Report , 2011 .

[12]  C. Watson,et al.  Non-Genomic Effects of Xenoestrogen Mixtures , 2012, International journal of environmental research and public health.

[13]  P. Nazni Association of western diet & lifestyle with decreased fertility , 2014, The Indian journal of medical research.

[14]  L. Knudsen,et al.  Urinary excretion of phthalate metabolites, phenols and parabens in rural and urban Danish mother-child pairs. , 2013, International journal of hygiene and environmental health.

[15]  C. Richter,et al.  In vivo effects of bisphenol A in laboratory rodent studies. , 2007, Reproductive toxicology.

[16]  W. Ahrens,et al.  Occupational exposure to endocrine-disrupting chemicals and the risk of uveal melanoma. , 2012, Scandinavian journal of work, environment & health.

[17]  Masatoshi Morita,et al.  Bisphenol A levels in human urine. , 2002, Environmental health perspectives.

[18]  S. Andra,et al.  Influence of household cleaning practices on the magnitude and variability of urinary monochlorinated bisphenol A. , 2014, The Science of the total environment.

[19]  N. Le,et al.  Identification of occupational cancer risks in British Columbia. A population-based case-control study of 995 incident breast cancer cases by menopausal status, controlling for confounding factors. , 2000, Journal of occupational and environmental medicine.

[20]  Tadao Tanaka,et al.  Urinary bisphenol-A concentration in infertile Japanese women and its association with endometriosis: A cross-sectional study , 2007, Environmental health and preventive medicine.

[21]  Courtney C. Carignan,et al.  Predictors of tris(1,3-dichloro-2-propyl) phosphate metabolite in the urine of office workers. , 2013, Environment international.

[22]  M. Stanton,et al.  Anatomy and physiology of the peritoneum. , 2014, Seminars in pediatric surgery.

[23]  Laura N. Vandenberg,et al.  Human exposure to bisphenol A (BPA). , 2007, Reproductive toxicology.

[24]  B. Rubin,et al.  Bisphenol A: An endocrine disruptor with widespread exposure and multiple effects , 2011, The Journal of Steroid Biochemistry and Molecular Biology.

[25]  M. Lamberti,et al.  Solid-phase microextraction-gas chromatography-mass spectrometry method validation for the determination of endogenous substances: urinary hexanal and heptanal as lung tumor biomarkers. , 2011, Analytica chimica acta.

[26]  G. Prins,et al.  A review of the carcinogenic potential of bisphenol A. , 2016, Reproductive toxicology.

[27]  A. Baldi,et al.  New evidence in endometriosis. , 2015, The international journal of biochemistry & cell biology.

[28]  J. Angerer,et al.  Human biomonitoring: state of the art. , 2007, International journal of hygiene and environmental health.

[29]  N. Pandis,et al.  Occupational hazards in orthodontics: a review of risks and associated pathology. , 2007, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[30]  A. Templeton,et al.  Peritoneal environment, cytokines and angiogenesis in the pathophysiology of endometriosis. , 2002, Reproduction.

[31]  Wolfgang Völkel,et al.  Metabolism and kinetics of bisphenol a in humans at low doses following oral administration. , 2002, Chemical research in toxicology.

[32]  L. Giudice,et al.  Bisphenol A and phthalates and endometriosis: the Endometriosis: Natural History, Diagnosis and Outcomes Study. , 2013, Fertility and sterility.

[33]  H. Koch,et al.  A population-based case-control study of urinary bisphenol A concentrations and risk of endometriosis. , 2014, Human reproduction.

[34]  V. Holt,et al.  Lifetime occupational history and risk of endometriosis. , 2009, Scandinavian journal of work, environment & health.

[35]  Antonia M. Calafat,et al.  Exposure of the U.S. Population to Bisphenol A and 4-tertiary-Octylphenol: 2003–2004 , 2007, Environmental health perspectives.

[36]  C. Kyama,et al.  Potential involvement of the immune system in the development of endometriosis , 2003, Reproductive biology and endocrinology : RB&E.

[37]  C. Selwitz Epoxy resins in stone conservation , 1992 .

[38]  F. Ciardo,et al.  Correlation of Endocrine Disrupting Chemicals Serum Levels and White Blood Cells Gene Expression of Nuclear Receptors in a Population of Infertile Women , 2013, International journal of endocrinology.

[39]  D. Montano Chemical and biological work-related risks across occupations in Europe: a review , 2014, Journal of Occupational Medicine and Toxicology.

[40]  N. Roeleveld,et al.  Occupational exposure to potential endocrine disruptors: further development of a job exposure matrix , 2009, Occupational and Environmental Medicine.

[41]  K. Kannan,et al.  A Survey of Alkylphenols, Bisphenols, and Triclosan in Personal Care Products from China and the United States , 2014, Archives of Environmental Contamination and Toxicology.

[42]  N. Tempest,et al.  Theories on the Pathogenesis of Endometriosis , 2014, International journal of reproductive medicine.

[43]  T. Eliades,et al.  Assessment of bisphenol-A release from orthodontic adhesives. , 2007, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[44]  Robin E. Dodson,et al.  Endocrine Disruptors and Asthma-Associated Chemicals in Consumer Products , 2012, Environmental health perspectives.

[45]  A. Mantovani,et al.  Bisphenol a and the female reproductive tract: an overview of recent laboratory evidence and epidemiological studies , 2014, Reproductive Biology and Endocrinology.

[46]  Yankai Xia,et al.  High urinary bisphenol A concentrations in workers and possible laboratory abnormalities , 2012, Occupational and Environmental Medicine.

[47]  Andrew Watterson,et al.  Breast cancer risk in relation to occupations with exposure to carcinogens and endocrine disruptors: a Canadian case–control study , 2012, Environmental Health.

[48]  Wolfgang Ahrens,et al.  Development and evaluation of a tool for retrospective exposure assessment of selected endocrine disrupting chemicals and EMF in the car manufacturing industry. , 2011, The Annals of occupational hygiene.

[49]  Matthias Beck,et al.  Chemical Exposures of Women Workers in the Plastics Industry with Particular Reference to Breast Cancer and Reproductive Hazards , 2013, New solutions : a journal of environmental and occupational health policy : NS.

[50]  A. Calafat,et al.  Pilot Study of Urinary Biomarkers of Phytoestrogens, Phthalates, and Phenols in Girls , 2006, Environmental health perspectives.

[51]  Samuel P. Caudill,et al.  Urinary Concentrations of Bisphenol A and 4-Nonylphenol in a Human Reference Population , 2004, Environmental health perspectives.

[52]  Alfonso Baldi,et al.  Endometriosis: pathogenesis, diagnosis, therapy and association with cancer (review). , 2008, Oncology reports.

[53]  Kurunthachalam Kannan,et al.  Occurrence of Bisphenol A in Indoor Dust from Two Locations in the Eastern United States and Implications for Human Exposures , 2011, Archives of environmental contamination and toxicology.

[54]  O. Tsutsumi Assessment of human contamination of estrogenic endocrine-disrupting chemicals and their risk for human reproduction , 2005, The Journal of Steroid Biochemistry and Molecular Biology.

[55]  F. Benetti,et al.  Cytotoxicity and antibacterial activity of a new generation of nanoparticle-based consolidants for restoration and contribution to the safe-by-design implementation. , 2015, Toxicology in vitro : an international journal published in association with BIBRA.

[56]  V. Kailasam,et al.  Bisphenol A release from orthodontic adhesives and its correlation with the degree of conversion. , 2015, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[57]  Philippe Lecomte,et al.  A review of dietary and non-dietary exposure to bisphenol-A. , 2012, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[58]  J. Sampson,et al.  Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity , 1927 .