News | Science Selection Volume 122 | Issue 8 | August 2014
Environ Health Perspect; DOI:10.1289/ehp.122-A223
BPA and Reproductive Health: Reviewing the Current State of the Science
Julia R. Barrett, MS, ELS, a Madison, WI–based science writer and editor, has written for EHP since 1996. She is a member of the National Association of Science Writers and the Board of Editors in the Life Sciences.
Related EHP Article
In 2006 a panel of experts reviewed the literature to that point on potential health effects arising from exposure to bisphenol A (BPA), a high-production-volume chemical that is broadly detectable in the environment as well as in most people’s bodies in developed countries.1 A new review takes stock of the knowledge gained since then, focusing on potential reproductive health effects while also considering new and lingering questions.2
BPA is a component of polycarbonate plastics and epoxies, and is used in products ranging from food and beverage containers to thermal-paper receipts. It has been found to leach from these products to varying degrees, imparting chronic, low-level exposures via dermal, respiratory, and oral routes.1,3 Such exposures were thought to be within the current reference dose set by the U.S. Environmental Protection Agency, but investigations conducted since that limit was set have suggested adverse health effects may occur at much lower doses.1,3
© Burger/phanie/Phanie Sarl/Corbis
Furthermore, in contrast to early assumptions that BPA is an extremely weak estrogenic compound, recent investigations indicate that in some cases low-level BPA can stimulate cellular responses with a potency equal to estradiol (natural estrogen).4 In addition to genomic estrogen receptors, BPA binds to several other receptors that are involved in its various actions. Biomonitoring data indicate that most people are exposed to levels of BPA that are predicted to be biologically active.1,3
The current review draws on laboratory data and human studies published between 2007 and 2013.2 It takes a structured approach to assessing the wide-ranging body of intricate research. “I think the reason why the studies are so complicated is because BPA is very complex,” says coauthor Jodi Anne Flaws, a professor of comparative biosciences at the University of Illinois at Urbana–Champaign. “It probably has different mechanisms of action, in different tissues, in different species, at different doses, and at different developmental windows of exposure.”
The review encompasses both high- and low-dose studies involving pre-, neo-, and postnatal exposures and numerous end points. The consolidated data were deemed “strong” if multiple studies in multiple species indicated similar BPA-associated effects, “limited” if some but not most studies indicated a similar end point or if studies disagreed across species, or “inconclusive” if studies were limited in number or had only been done in one species or in vitro.
The authors concluded that strong evidence exists that BPA is an ovarian toxicant in both animals and humans and a uterine and prostate toxicant in animals. They concluded that evidence was limited for effects on the number of offspring, birth weight, and length of gestation; human studies were inconsistent, but animal studies were somewhat stronger. Evidence was also limited for BPA as a testicular toxicant and a factor in impaired embryo implantation in humans. Insufficient information is available to draw conclusions about BPA and effects on the oviduct, placenta, and pubertal development.
“The comparison of data from human studies with that of animal studies where possible is an important contribution and is a major strength of the manuscript,” says Beverly Rubin, an associate professor of integrative physiology and pathobiology at Tufts University. “The review provides an excellent resource for investigators in the field as well as those wanting to learn about BPA’s potential impacts on reproduction that—as illustrated here—are widespread, can occur at many different levels, and can be profoundly influenced by the window and the dose of exposure.” Rubin was not involved in the review.
The authors recommend that future studies emphasize critical periods during development and use continuous BPA exposure measures and doses that better reflect actual human exposure. Studies should also recognize potential interactions with coexisting factors, and differentiate between permanent and transient effects. Johanna Rochester, a research associate at the Endocrine Disruption Exchange who was not involved with the review, also suggests weighing how well studies are designed and executed, which she felt was a potential limitation in this otherwise strong work.
“One of the things that I think is really important with these systematic-type reviews is looking at study quality,” Rochester says. She would welcome further systematic reviews like the current one, saying, “If you can see in vivo, in vitro, and human results all presented together, showing the mechanisms, showing the relations between the doses, it’s much easier to get the bigger picture.”
1. vom Saal FS, et al. Chapel Hill bisphenol A expert panel consensus statement: integration of mechanisms, effects in animals and potential to impact human health at current levels of exposure. Reprod Toxicol 24(2):131–138 (2007); doi: 10.1016/j.reprotox.2007.07.005.
2. Peretz J, et al. Bisphenol A and reproductive health: update of experimental and human evidence, 2007–2013. Environ Health Perspect 122(8):775–786 (2014); doi: 10.1289/ehp.1307728.
3. Vandenberg LN, et al. Human exposures to bisphenol A: mismatches between data and assumptions. Rev Environ Health 28(1):37–58 (2013); doi: 10.1515/reveh-2012-0034.
4. Rubin BS. Bisphenol A: an endocrine disruptor with widespread exposure and multiple effects. J Steroid Biochem Mol Biol 127(1–2):27–34 (2011); doi: 10.1016/j.jsbmb.2011.05.002.
CEHN December 2014 Article of the Month
“The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Integration of Animal and Human Evidence for PFOA Effects on Fetal Growth” (Environ Health Perspect; DOI:10.1289/ehp.1307923) has been selected by the Children’s Environmental Health Network (CEHN) as its December 2014 Article of the Month. These CEHN summaries discuss the potential policy implications of current children’s environmental health research.
Introducing Children’s Health Collection 2014
EHP’s fifth annual Children’s Health Collection is now available. The collection comprises abstracts of all relevant articles published in EHP from October 2013 through September 2014: peer-reviewed research articles, news features, Science Selections, and editorials.
ISEE 2014 Abstracts Now Available
EHP is pleased to present the abstracts for the 26th annual conference of the International Society for Environmental Epidemiology (ISEE), From Local to Global: Advancing Science for Policy in Environmental Health, held 24–28 August 2014 in Seattle, Washington.
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Recent Advance Publications
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Attention Deficit/Hyperactivity Disorder and Childhood Autism in Association with Prenatal Exposure to Perfluoroalkyl Substances: A Nested Case–Control Study in the Danish National Birth Cohort
Autism Spectrum Disorder and Particulate Matter Air Pollution before, during, and after Pregnancy: A Nested Case–Control Analysis within the Nurses’ Health Study II Cohort
Comparative Effects of Di(n-Butyl) Phthalate Exposure on Fetal Germ Cell Development in the Rat and in Human Fetal Testis Xenografts
Interaction Effects of Temperature and Ozone on Lung Function and Markers of Systemic Inflammation, Coagulation, and Fibrinolysis: A Crossover Study of Healthy Young Volunteers