A recent survey of 2,600 U.S. obstetricians and gynecologists found that most do not warn their pregnant patients to avoid toxic chemicals in food and household products that might harm their fetuses, according to an article published earlier this week by the nonprofit news organization EnvironmentHealthNews.org.
Many of the doctors fail to discuss even well established environmental dangers with expectant mothers. For example, only about 40 percent of the doctors surveyed said they warn pregnant women about eating mercury-contaminated fish. Research has shown that mercury exposure in the womb can harm the developing brain and nervous system. Such exposure has been associated with lower IQs and cognitive problems in children.
About 8 percent of babies born in Minnesota, Wisconsin and Michigan have levels of methylmercury (a form of mercury found in certain fish) above the safe dose level set by the Environmental Protection Agency, according to a Minnesota Department of Health study released earlier this year.
Not a priority
Why are so many ob-gyns failing to warn their patients of environmental health hazards?
“Many doctors say their priority is to protect pregnant women from more immediate dangers, and that warning them about environmental risks may create undue anxiety,” writes EHN reporter Jane Kay. “Some say they don’t feel confident in their ability to discuss the topics.”
In addition, she notes, the average U.S. medical student receives fewer than six hours of environmental health training.
As Kay points out, virtually every pregnant woman in the U.S. has chemicals in her body that present some risk to her fetus — including lead, perchlorate, bisphenol A, flame retardants, organochlorine pesticides and phthalates. That potential harm includes, in addition to disrupting the development of the brain, an increased risk that the child will have asthma, immune system disorders, cancer and fertility problems later in life.
“Yet,” writes Kay, “that information is not reaching most women who are pregnant or may become pregnant.”
Almost all of the doctors in the new, nationwide survey, conducted by University of California, San Francisco researchers, said they routinely discussed smoking, alcohol, diet and weight gain. Eighty-six percent also said they discuss workplace hazards, and 68 percent warn about second-hand smoke.
But only 19 percent said they talk to their pregnant patients about pesticides and only 12 percent discuss air pollution. Forty-four percent said they routinely discussed mercury with pregnant women. Eleven percent said they mention volatile organic compounds, which are fumes emitted by gasoline, paints and solvents.
Even fewer physicians warned their patients about two chemicals in consumer products that are often in the news: bisphenol A (BPA) at 8 percent and phthalates at 5 percent. Nine percent of the doctors told their patients about polychlorinated biphenyls (PCBs), industrial compounds often found in fish.
The results show a disconnect between environmental health research and what the physicians do — and do not — tell their patients, said Patrice Sutton, a research scientist at University of California, San Francisco’s Program on Reproductive Health and the Environment who helped design the survey.
A class issue
Kay also reports that middle-to-upper-income women are more likely to ask their doctors about — and thus learn about — environmental hazards than low-income women.
“Most of my patients don’t ask me about environmental exposures,” a doctor who works with low-income women on California’s Medicaid program told Kay. “They don’t ask about cosmetic products, bisphenol A or organic foods. Most don’t have high-speed Internet access, and don’t read articles and get alerts.”
“The [Medicaid patients’] social circumstances are so burdensome,” the doctor added. “Some colleagues think the patients are already worried about paying rent, getting deported or their partner being incarcerated.”
You can read Kay’s article on EHN’s website.